Ear infections are often thought of as a childhood problem, but adults get them too. The causes, symptoms, and treatments are different in adults, and sometimes the underlying issue is more serious. Most adult ear infections are either in the outer ear canal or the middle ear, and knowing which one you have matters for how it is treated.
What Are the Main Types of Ear Infections in Adults?
Adults get two main types of ear infections. The most common is otitis externa, also called swimmer’s ear. This is an infection of the outer ear canal, the tube that runs from the eardrum to the outside of the head.
The second type is otitis media, a middle ear infection. This happens behind the eardrum in the air-filled space that contains the tiny bones of hearing. Middle ear infections are less common in adults than in children, but they still occur and often require different treatment.
How Do You Get An Ear Infection As An Adult? The Main Causes
You get an outer ear infection when bacteria or fungi enter the skin of the ear canal. This usually happens after swimming, which is why it is called swimmer’s ear. But it can also happen from using cotton swabs, fingernails, or other objects that scratch the delicate lining of the canal. Moisture trapped in the ear after showering or sweating creates a perfect environment for bacteria to grow.
Middle ear infections in adults usually start differently. They typically follow a cold, flu, or sinus infection. The infection causes swelling in the Eustachian tube, the small passage that connects the middle ear to the back of the throat. When this tube swells shut, fluid cannot drain from the middle ear. That trapped fluid becomes a breeding ground for bacteria or viruses.
In adults, a middle ear infection can also be a sign of a blockage. A mass, a tumor, or chronic sinus disease can obstruct the Eustachian tube. If an adult has repeated middle ear infections on one side only, a doctor will usually investigate further to rule out these causes.
What Are the Symptoms of an Adult Ear Infection?
Outer ear infections cause pain that gets worse when you pull on the earlobe or push on the small bump in front of the ear. The ear may feel itchy before the pain starts. You might notice discharge, which can be clear, yellow, or pus-like. The ear canal may look red and swollen, and you may feel like the ear is plugged or full.
Middle ear infections cause a different set of symptoms. The pain is deeper and may feel like pressure. You may have hearing loss that feels like you are underwater. Fever is more common with middle ear infections. If the eardrum ruptures, you may see bloody or pus-filled discharge. In that case, the pain often suddenly decreases because the pressure is released.
Adults with middle ear infections often report dizziness or a feeling of imbalance. If you experience severe dizziness, facial weakness, or intense headache with an ear infection, seek medical care immediately. These can be signs of a more serious infection spreading beyond the ear.
How Are Adult Ear Infections Treated?
Treatment depends entirely on the type of infection. Outer ear infections are usually treated with antibiotic ear drops. These drops often contain a steroid to reduce swelling. Keeping the ear dry during treatment is essential. In most cases, you should not swim or get water in the ear until the infection clears.
For middle ear infections, the approach is more cautious. Many middle ear infections are viral and will resolve on their own within a few days. Doctors often recommend pain relief and watchful waiting for the first 48 to 72 hours in adults with mild symptoms. If symptoms worsen or do not improve, antibiotics may be prescribed.
Over-the-counter pain relievers like acetaminophen or ibuprofen are effective for ear infection pain. Warm compresses applied to the outside of the ear can also help. Do not put any drops into the ear if you suspect a middle ear infection and the eardrum may have ruptured. Drops can enter the middle ear space and cause damage to the hearing bones.
When Should an Adult See a Doctor for an Ear Infection?
See a doctor if ear pain lasts more than two or three days. Seek care sooner if you have a high fever, notice discharge from the ear, or experience significant hearing loss. Adults with diabetes, a weakened immune system, or a history of ear surgery should see a doctor at the first sign of infection.
Severe symptoms require immediate medical attention. These include intense pain, swelling behind the ear, drooping of the face on one side, severe dizziness, or confusion. These can indicate the infection has spread to the bone or the brain. This is rare but serious.
Can Adult Ear Infections Be Prevented?
Prevention depends on the type of infection. For outer ear infections, keep your ears dry. After swimming or showering, tilt your head to let water drain out. You can use a hair dryer on the lowest setting held at arm’s length to dry the ear canal. Do not insert cotton swabs into the ear. They push wax deeper and scratch the skin, making infection more likely.
For middle ear infections, prevention focuses on reducing your risk of colds and flu. Washing hands frequently and getting the annual flu vaccine can help. If you have allergies, managing them well can prevent the nasal congestion that leads to Eustachian tube blockage.
Do not smoke and avoid secondhand smoke. Smoke irritates the lining of the Eustachian tube and makes it more likely to swell shut during a cold.
Are Adult Ear Infections Ever Serious?
Most adult ear infections resolve without complications. However, adults are more likely than children to have complications from middle ear infections. This is partly because the anatomy of the adult Eustachian tube makes drainage harder, and partly because an infection in an adult can signal an underlying structural problem.
One serious complication is mastoiditis, an infection of the mastoid bone behind the ear. This causes swelling, redness, and pain behind the ear. It requires intravenous antibiotics and sometimes surgery. Another complication is a brain abscess or meningitis, which is rare but life-threatening.
Chronic middle ear infections can also damage the small bones of hearing or leave a hole in the eardrum. This can result in permanent hearing loss. If you have repeated ear infections, or an infection that does not clear with treatment, ask your doctor about seeing an ear, nose, and throat specialist.
Frequently Asked Questions
Can adults get ear infections without having a cold?
Yes. Outer ear infections often develop from water or minor trauma to the ear canal with no cold involved. Middle ear infections in adults, however, most commonly follow a viral respiratory illness that blocks the Eustachian tube.
How long does an adult ear infection last without antibiotics?
Viral middle ear infections often clear within a few days to a week as the immune system fights off the virus. Outer ear infections and bacterial middle ear infections are less likely to resolve on their own and often require treatment.
Is it safe to fly with an ear infection?
Flying can be painful with a middle ear infection because cabin pressure changes cannot be equalized through a blocked Eustachian tube. If you must fly, use a decongestant before takeoff and landing, and consider delaying travel until the infection clears.
