Ear Infections: Symptoms and Treatment for Adults and Children

Ear infections are one of the most common reasons people of all ages see a GP. They can cause ear pain, a blocked or full feeling, reduced hearing and sometimes fever. Most ear infections settle within a few days, and many do not need antibiotics. Others need prompt treatment, particularly in young children or when symptoms are severe. This guide explains the different types of ear infection, how to recognise the symptoms in adults and children, what usually causes them, and when it is time to see your GP.

See a doctor urgently or call Healthline on 0800 611 116 if there is: severe or rapidly worsening ear pain, swelling or redness behind the ear, a very high fever, a stiff neck, drowsiness or confusion, sudden hearing loss, or weakness of the face. These can point to a more serious infection that needs same day assessment. In an emergency, call 111.

What is an ear infection?

The ear has three parts, and an infection can affect any of them. Knowing which part is involved helps explain the symptoms and the treatment.

• Outer ear infection (otitis externa). An infection of the ear canal, the tube between the outer ear and the eardrum. It is often called swimmer's ear because trapped water is a common trigger. The ear canal feels sore, itchy or swollen, and the outer ear can be tender to touch.
• Middle ear infection (otitis media). An infection behind the eardrum, usually following a cold or other upper respiratory infection. This is the type most common in young children. It causes ear pain, a blocked feeling and reduced hearing, and sometimes fever.
• Inner ear problems. Less common. These can affect balance and hearing and usually need medical assessment to identify the cause.

Ear infection symptoms in adults

In adults, the symptoms are usually easy to describe and may include:

• ear pain, which can be sharp, dull or throbbing
• a feeling of fullness or pressure in the ear
• reduced or muffled hearing on the affected side
• fluid or discharge draining from the ear
• itching or tenderness in the ear canal, more typical of outer ear infection
• a mild fever or feeling generally unwell

Ear infection symptoms in children

Young children often cannot say that their ear hurts, so parents usually notice changes in behaviour rather than a clear complaint. Watch for:

• tugging, pulling or rubbing at one ear
• unsettled behaviour, crying more than usual or trouble sleeping
• fever, reduced appetite or feeding difficulty in babies
• not responding to quiet sounds or turning up the volume
• fluid draining from the ear, which can bring sudden relief from pain
• balance problems or clumsiness in older children

What causes ear infections?

Middle ear infections often begin after a cold, flu or other viral illness. Swelling and mucus block the eustachian tube, the narrow passage that drains the middle ear, so fluid builds up behind the eardrum and can become infected. Children get more middle ear infections than adults because their eustachian tubes are shorter and more horizontal.

Outer ear infections are more often linked to moisture in the ear canal from swimming, showering or humid weather, or to damage from cotton buds. Common risk factors across both types include recent colds, exposure to cigarette smoke, allergies and, for swimmer's ear, frequent water contact.

How a GP diagnoses an ear infection

Your GP will ask about your symptoms and look inside the ear with an otoscope, a small lighted instrument. This lets them see whether the eardrum is red, bulging or has fluid behind it, and whether the ear canal is swollen or inflamed. In most cases no other tests are needed. If infections keep coming back or hearing is affected, your GP may arrange a hearing check or refer you for further assessment.

Treatment options

Treatment depends on the type of infection, how severe it is and the age of the person affected.

• Pain relief and time. Many middle ear infections improve on their own within a few days. Simple pain relief such as paracetamol or ibuprofen, used as directed, helps with pain and fever while the infection settles.
• Ear drops. Outer ear infections are often treated with prescription ear drops that reduce infection and inflammation in the ear canal. Keeping the ear dry supports healing.
• Antibiotics. Antibiotics are not needed for every ear infection, and many are viral. Your GP may prescribe them when the infection is more severe, is not improving, or in younger children where the risk of complications is higher.
• Keep the ear dry and avoid cotton buds. Cotton buds can push wax deeper and damage the canal. If the ear is discharging, gently wipe the outer ear only.

Book a GP appointment if:

• ear pain lasts more than two to three days or is getting worse
• there is fluid, pus or blood draining from the ear
• hearing is reduced and does not recover as the infection settles
• your child has repeated ear infections or seems slow to respond to sounds
• you have diabetes or a weakened immune system and develop an ear infection

Can ear infections be prevented?

You cannot prevent every ear infection, but a few habits lower the risk:

• dry your ears gently after swimming or showering, and tip your head to let water drain out
• avoid putting cotton buds or other objects into the ear canal
• keep up with routine childhood immunisations, which protect against some causes of ear infection
• keep children away from cigarette smoke, which increases the risk of middle ear infections
• manage colds and allergies, since these often precede middle ear infections

When to see your GP at CityMed

Most ear infections are straightforward to treat, and seeing a GP early can ease pain sooner and reduce the chance of complications. At CityMed in Auckland CBD, our GPs assess and treat ear infections for adults and children, and can arrange follow up if infections keep returning or hearing is affected. You can book a general medical consultation online or by phone.

Related reading

Ear infections often follow a cold or other upper respiratory infection. For related conditions seen in general practice, see our guides to tonsillitis and strep throat and bronchitis and chest infections.

Frequently asked questions

How long does an ear infection last?

Many middle ear infections improve within two to three days and clear within a week, especially with pain relief. If symptoms last longer or get worse, see your GP.

Do ear infections always need antibiotics?

No. A large share of ear infections are viral or settle on their own, so antibiotics are not always needed. Your GP will advise whether they are appropriate based on the type and severity of the infection and the age of the person affected.

Manage My Health Patient Portal ManageMyHealth™ is a secure health portal that provides 24/7 access to your health records, video consultations, hospital letters, referrals, appointment bookings, repeat prescriptions, and direct messaging with your doctor

Is it safe to fly with an ear infection?

Flying with a blocked or infected ear can be painful because of pressure changes. If you have an ear infection and need to fly, ask your GP for advice before you travel.

Why does my child keep getting ear infections?

Recurrent ear infections are common in young children because of the shape of their eustachian tubes. If they happen often or affect hearing, your GP can assess for fluid behind the eardrum and arrange further review if needed.

How can I avoid swimmer's ear?

Dry your ears after swimming, tilt your head to drain water, and avoid cotton buds. If you are prone to swimmer's ear, your GP can suggest ways to keep the ear canal healthy.

See a GP for ear pain or hearing changes

CityMed GPs treat ear infections for adults and children in Auckland CBD.

Book a general consultation online at citymed.co.nz or phone 09 377 5525.

New patients welcome. Telehealth appointments are also available.

This article provides general health information and is not a substitute for personalised medical advice. For guidance specific to your situation, see your GP.