Introduction

Any persistent earache lasting more than a few hours or even a mild earache persisting over a day requires medical attention. Early treatment is more effective in managing infections rather than waiting for them to worsen.

• Look out for other warning signs like:
• Hearing loss
• Fever
• Weakness
• A general feeling of being unwell or weak

Most ear infections can be treated safely in a doctor's office and do not require hospitalization.

Exceptions for hospital treatment include the following situations:

• Illness in an infant under 3 months
• Illness in an infant becoming lethargic or having a very high fever (104ºF or higher)
• Severe headache, neck stiffness, or neck swelling may indicate a complication of an ear infection and may require immediate attention.

Self-Care at Home

Any severe earache necessitates medical attention. Only a doctor can provide a proper diagnosis of ear conditions such as otitis externa, otitis media, or other less common causes of earache, including non-infectious issues. Attempting self-diagnosis is unwise and potentially risky due to the similarity of symptoms.

Follow-up

Individuals with earaches due to ear infections should follow up with their doctors to ensure complete resolution of the infection.

• A follow-up appointment should be scheduled 1-3 weeks after starting treatment, depending on the severity of the condition and other factors.
• Complete all medications as prescribed and finish the prescription as directed.

NOTE: Ear infections may return if only partially treated. It's essential to complete the full course of treatment even if symptoms improve.

Prevention

Preventive measures are valuable for reducing the frequency of otitis externa. Preventing otitis media is more challenging. Try to avoid the risk factors mentioned under Causes, if possible.

Otitis externa prevention—preventing moisture in the ear:

• Thoroughly dry the ears after swimming or bathing.
• Shake out excess water.
• Use a hair dryer on a low heat setting, held at least 12 inches from the ear.
• Wear earplugs while swimming.

A homemade solution of 1/2 rubbing alcohol, 1/4 white vinegar, and 1/4 distilled water may be used for more persistent cases.

• Apply 3-4 drops in each ear after swimming or bathing.
• Do not use drops if there is a hole (perforation) in the eardrum or if there is a ventilation tube in the ear.
• Discontinue drops immediately if any pain occurs.

Otitis externa prevention—preventing scrapes to the ear canal:

Carefully clean the ears to avoid scraping the ear canal. Do not use objects (e.g., paper clips, bobby pins, or fingernails) that may damage the skin. Most people have self-cleaning ears, and the use of cotton-tipped swabs is unnecessary and potentially harmful.

Otitis media prevention:

• Avoid risk factors (e.g., secondhand smoke, daycare), if possible.
• Treat severe allergies.
• Avoid contact with individuals who have a cold or respiratory infection.
• In severe cases, consider a prolonged course of antibiotics as a preventive measure.

Outlook

• Both of these earache conditions (otitis externa and otitis media) usually respond quickly to proper medical treatment. Pain relief should occur within the first few days of treatment.
• Other symptoms, like hearing loss or ear fullness, may take longer to improve.
• If the infection persists or if frequent, recurring infections occur, consult an otolaryngologist (ear, nose, and throat specialist).