Ear pain: causes, home care and when to see a doctor

In short

• Ear pain is often caused by an ear infection, but other causes include earwax, a stuck object, a perforated eardrum, toothache, a sore throat and a cold or flu.
• The NHS advises not to try to diagnose the cause yourself, and says most earaches get better on their own.
• Over-the-counter pain relief and a warm cloth can ease pain. Do not put anything in the ear, and keep water out.
• Mild middle ear infections are often watched for 2 to 3 days before deciding on antibiotics. Severe infections need them right away.
• Swelling around the ear, fluid draining from it, or a change in hearing are reasons to be seen quickly.

Common causes

• Ear infection: the NHS says earache is often caused by one, and a middle ear infection often follows a cold or sore throat.
• Earwax build-up or an object stuck in the ear.
• A perforated eardrum.
• Referred pain: toothache or a dental abscess, a sore throat or tonsillitis can all be felt in the ear even when the ear itself is healthy.
• Glue ear, a build-up of fluid behind the eardrum.

Because so many conditions can cause it, the NHS warns against diagnosing the cause yourself. A clinician looks inside the ear with a lighted instrument called an otoscope, which is how an ear infection is usually diagnosed.

What to do at home in the first hours

1. Pain relief.Over-the-counter acetaminophen or ibuprofen can help, following the label. The NHS says children under 16 should not take aspirin.
2. Warm cloth.A warm, clean cloth held against the ear may ease pain. Skip it if there is fluid or pus draining from the ear.
3. Keep it dry.Keep water out of the ear while it hurts.
4. Leave the ear alone.Do not put anything inside the ear, such as cotton swabs, and do not try to remove earwax.
5. Be patient, but watch.Most earaches improve by themselves. See a clinician if the pain lasts beyond 2 to 3 days.

Do not put drops or home remedies in the ear without advice from a clinician. If the eardrum has a hole in it, some drops can do harm, and you cannot tell by yourself whether it does.

Do you need antibiotics?

Not always. The CDC says many mild middle ear infections improve without antibiotics because the immune system can often fight them off. A provider may suggest watchful waiting, which means waiting 2 to 3 days to see whether antibiotics are needed, or delayed prescribing, where a prescription is written but you wait 2 to 3 days before filling it.

The CDC says severe middle ear infections, and infections that last longer than 2 to 3 days, need antibiotics right away. A provider decides after examining the ear. Antibiotics do not work on viruses, and taking them when they are not needed carries risks of its own.

Children

Young children cannot always say that their ear hurts. Look for tugging or rubbing at the ear, crying more than usual, trouble sleeping, irritability, fever, fluid draining from the ear, balance problems or trouble hearing.

• Pain relief: for children 6 months or older, acetaminophen or ibuprofen is fine; for children younger than 6 months, only acetaminophen. Ask a provider about the right amount for your child's age and size.
• Never give aspirin to children. It can cause Reye's syndrome.
• Call a provider right away for a baby under 3 months old with a fever of 100.4 degrees F (38 degrees C) or higher.
• Ask a pediatrician about hearing and ear tubes if infections keep coming back. Children who get infections often may need small tubes placed in their ears.
• Babies around cigarette smoke have more ear infections, so keep smoke away from them.

Prevention and ear care

• Wash hands often and limit contact with sick children, since many ear infections follow colds.
• Get the yearly flu vaccine and the pneumococcal vaccine your provider recommends.
• Do not put a baby down for a nap or the night with a bottle.
• Do not clean inside the ear canal with cotton swabs or other objects.

When to see a doctor, and red flags

See a clinician if ear pain lasts more than 2 to 3 days, keeps coming back, or you or your child feel generally unwell. The NHS also lists swelling around the ear, fluid coming from the ear, hearing loss or a change in hearing, something stuck in the ear, and a very high temperature as reasons for urgent care. The CDC adds a fever of 102.2 degrees F (39 degrees C) or higher and pus or fluid from the ear, and says to see a provider for any symptom that is severe or concerning.

Red flags: call 911 for ear pain with a stiff neck and severe headache, confusion, a drooping face, or swelling behind the ear along with a high fever. Get same-day care for ear pain after a head injury or with blood coming from the ear.

Questions to ask your clinician

• Is this an ear infection, or is the pain coming from somewhere else?
• Is my eardrum intact, and is it safe to use ear drops?
• Do I need antibiotics now, or can we wait and watch?
• How should I safely deal with earwax?
• Should my hearing be checked afterwards?
• What can I do to stop infections from coming back?

Questions and answers

Sources

1. NHS — Earache
2. CDC — Ear Infection and Antibiotics
3. MedlinePlus — Ear Infections
4. NIDCD — Ear Infections in Children

Sources checked on 29 October 2026.