Earache and Ear Care: What Helps, What Harms

What causes earache?

Earache is common and usually not serious. The likely causes include:

• An ear infection, which is especially common in children
• A cold, flu or high temperature
• A sore throat, tonsillitis or quinsy
• Teething or dental problems in children
• Glue ear, or a build-up of earwax
• Something stuck in the ear
• A perforated eardrum, after a very loud noise or an injury

In babies and toddlers who cannot say what hurts, watch for rubbing or pulling at the ear, not reacting to some sounds, being unusually irritable, going off food, or losing balance.

What helps an earache at home?

Hold a warm cloth or flannel against the sore ear. Pain relief such as paracetamol or ibuprofen can be used if it suits you, and a pharmacist can confirm what is right for your age and health. Never give aspirin to anyone under 16. Rest at home if you have a high temperature or feel generally unwell. If there is discharge, wipe it gently from the outside with cotton wool rather than reaching inside.

Most ear infections start to settle within about 3 days, though symptoms can last up to a week.

Why should nothing go into the ear?

This is the part people most often get wrong. Do not put anything into the ear, including cotton buds or your fingers, and do not try to remove earwax yourself. Cotton buds push wax further in and make the problem worse, and they can damage the delicate skin of the ear canal.

There is no evidence that ear candles or ear vacuums remove earwax. Keep water and shampoo out of a sore or infected ear, and do not swim while you have an ear infection. Decongestants and antihistamines are not recommended for ear infections, because the evidence does not show they help.

What can I do about earwax?

Earwax can cause hearing loss, earache, a blocked feeling, ringing in the ears or dizziness. To soften it, lie on your side with the affected ear facing up, put 2 to 3 drops of olive or almond oil in the ear, and stay in that position for 5 to 10 minutes. This can be repeated 3 to 4 times a day for 3 to 5 days, and the wax may take around 2 weeks to clear.

Avoid almond oil if you have a nut allergy, and never put drops in if your eardrum is perforated. Products from a pharmacist usually take about a week to work. If your hearing is still blocked after 5 days, or the ear is badly blocked, see a doctor or nurse, who can remove wax safely by irrigation, microsuction or a small instrument.

When to see a doctor

Get medical advice urgently if you or your child have:

• earache lasting more than 2 to 3 days, or that keeps coming back
• a very high temperature, or you feel generally unwell
• swelling around the ear
• fluid or discharge coming from the ear
• any change in hearing
• something stuck in the ear
• vomiting, dizziness or a severe sore throat alongside the earache
• a child under 2 with pain in both ears, or a baby under 12 months with an ear infection

Treat it as an emergency if a person with earache also has a stiff neck, a rash that does not fade when pressed, becomes very drowsy or hard to wake, or is struggling to breathe. In that case, call Rescue 1122 where available, or go to the nearest hospital emergency department.