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Originally published July 7, 2025
Last updated July 7, 2025
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If you’ve ever had an ear infection, you know how painful it can be. Infections of the outer ear cause pain when touching the ear or ear canal and may produce drainage. Infections of the middle ear, meanwhile, create pressure behind the eardrum and muffled hearing. Inner ear infections — though rare — cause dizziness, hearing loss, nausea and sometimes can lead to meningitis.
Identifying the type of ear infection is crucial for proper treatment, says Seiji Shibata, MD, PhD, an otolaryngologist with the USC Caruso Department of Otolaryngology – Head and Neck Surgery, part of Keck Medicine of USC.
“The good news is many middle ear and outer ear infections go away on their own, and most of the time they get better within about three days, even without antibiotics, especially in children,” Dr. Shibata says. This is why physicians often recommend watchful waiting for mild cases, focusing on pain management and monitoring symptoms.
Over-the-counter remedies are effective for pain management. “Tylenol and ibuprofen are most likely going to be very effective,” Dr. Shibata says. Proper hydration is also important, especially for children.
For middle ear infections, applying a warm compress can help with discomfort. For outer ear infections, over-the-counter swimmer’s ear drops or a homemade remedy of equal parts white vinegar and rubbing alcohol can provide relief. The alcohol helps the water evaporate, and the vinegar helps acidify the ear environment, which prevents bacterial growth, he says.
Avoid inserting anything into your ear, he adds. “Using cotton swabs and probing the ears with other items can cause irritation and lead to ear infections, so I advise patients not to do this,” Dr. Shibata cautions.
While many ear infections clear up on their own, Dr. Shibata advises seeing a doctor if pain persists despite medication, or if you experience hearing loss, dizziness, worsening symptoms or unusual drainage. People with diabetes or immunosuppression should be particularly cautious and seek medical attention promptly.
Medical treatment depends on the type and severity of infection. For outer ear infections, your doctor may prescribe antibiotic ear drops, oral antibiotics and sometimes steroids to reduce inflammation. For persistent middle ear infections, your doctor may prescribe oral or antibiotic ear drops, which are effective when there is eardrum perforation. Dr. Shibata points out that doctors are increasingly cautious about overprescribing antibiotics, preferring targeted, individualized treatment to reduce microbial resistance.
For recurring infections, especially in children, ear tubes might be considered. These are hollow tubes placed in the eardrum to prevent fluid buildup in the middle ear. “If a child has more than several ear infections per year, we start considering putting in ear tubes,” Dr. Shibata says. “For infants, toddlers and younger children experiencing recurring infections, ear tubes may be recommended sooner since they need to be able to hear to develop normal speech.”
Though treatment is important, prevention is even better, especially for those prone to recurring ear infections. To avoid outer ear infections, Dr. Shibata recommends avoiding probing the ear, getting annual ear cleaning by a health provider and using the alcohol and vinegar solution after swimming or other exposures that can leave water in the ear. To avoid middle ear infections, try to reduce the risk of upper respiratory infections — and therefore the development of ear infections — through better hygiene practices, including regular handwashing, frequently disinfecting shared surfaces and getting the pneumococcal vaccination and annual flu shots.
With proper care and timely medical attention when needed, most ear infections can be managed effectively.
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