Should I use this page, or skip it?
Use this page if an ear hurts and you want to know whether a pharmacist, GP or 111 is first. Skip it and call 999 if there is swelling around the ear with fever, sudden severe dizziness with vomiting, or a child who is struggling to breathe or unresponsive. This page cannot look in the ear or prescribe drops.
Earache has many causes. An infection is one of them — earwax is another.
What is an ear infection and what does it feel like?
An ear infection is inflammation in the outer canal, the middle ear behind the eardrum, or — less often — the inner ear. Middle-ear infections are especially common in children after a cold. Pain, fever, muffled hearing and a feeling of fullness are typical. Most clear within about three days.
Babies may pull the ear, feed poorly or seem irritable rather than point to the pain. Discharge can mean the eardrum has leaked — that still needs a clinician, not cotton buds.
Can I see a pharmacist first?
Often yes for earache, but not for every age or every ear. In England, Pharmacy First can assess some middle-ear infections. Eligibility applies — ask rather than assuming, especially for babies, who often need a GP. The pharmacist checks for red flags, then treats, advises self-care, or sends you on.
Scotland has NHS Pharmacy First Scotland, Wales a Common Ailments Service, and Northern Ireland Pharmacy First NI. Find a GPhC-registered pharmacy on Pick My Pharmacy.
Do I need antibiotics?
Usually not for a typical middle-ear infection. NICE guidance is that most children improve in about three days without them. Antibiotics can still be right if you are very unwell, symptoms last, there is discharge, or you are at higher risk. Outer-ear infections may need drops rather than tablets.
If you are given a course, take it as directed. Do not share leftover antibiotics. Pain relief is the main home treatment — not leftover eardrops from last winter.
How can I ease it at home?
Paracetamol or ibuprofen from a pharmacy can ease pain and fever. Follow the pack for that person’s age. A warm (not hot) flannel against the ear may help. Wipe away discharge with cotton wool on the outside only.
Do not put cotton buds, oil or objects in the ear. Do not swim until a clinician says it is sensible. Decongestants and antihistamines are not useful for ear infections, NHS advice says.
When is it 111 or 999?
Call 999 for swelling around the ear with fever, sudden severe dizziness with vomiting, or a child who is working hard to breathe or unresponsive. Use 111 if pain lasts more than three days, fluid is leaking, hearing changes suddenly, or a baby is unwell and you cannot get a same-day GP slot.
In England, Scotland and Wales call 111 (NHS 24 in Scotland). In Northern Ireland there is no general 111 — use GP out-of-hours on nidirect. See pharmacy, GP, 111 or A&E if you are stuck on the door.
What is the difference between outer and middle ear infection?
A middle-ear infection sits behind the eardrum and often follows a cold, with earache, fever and muffled hearing. An outer-ear infection affects the canal — itching, pain when the ear is touched, sometimes after swimming. Inner-ear problems can cause severe dizziness and need medical assessment, not cotton buds.
Repeated infections in children should be reviewed by a GP. Temporary muffled hearing is common and usually improves as fluid clears. Persistent hearing problems still need a check, not another wait-and-see weekend with oil.
Who should skip this page?
Skip this page if swelling, severe dizziness or breathing trouble is already happening — that is urgent care, not a long read. It is not an otoscope, not a grommet clinic, and not the right page for earwax you can still hear through. A baby with fever needs the children’s fever pathway too.
Common questions about ear infection
- What are the signs of an ear infection in a baby?
- Babies cannot tell you their ear hurts. Clues include pulling or rubbing the ear, irritability, poor sleep, being off feeds, a temperature, not reacting to quiet sounds, or losing balance. How they look matters more than the ear itself. Use 111 promptly for a baby under 3 months with fever.
- Can a pharmacist treat an ear infection in England?
- Sometimes. Pharmacy First can assess some earache, but eligibility applies — including age — so ask rather than assuming. The pharmacist checks for red flags, then advises self-care, supplies treatment if eligible, or sends you to a GP or 111. Scotland, Wales and Northern Ireland have their own pharmacy schemes.
- Do ear infections always need antibiotics?
- No. NICE guidance is that most children with a middle-ear infection get better in about three days without antibiotics. A clinician may still treat if you are very unwell, symptoms last, or there is discharge. Follow the course you are given. Do not use leftover antibiotics.
- What is the difference between outer and middle ear infection?
- A middle-ear infection sits behind the eardrum and often follows a cold, with earache and fever. An outer-ear infection affects the canal — itching, pain when you touch the ear, sometimes after swimming. Inner-ear problems can cause severe dizziness and need medical assessment, not cotton buds.
- Can an ear infection cause hearing loss?
- Muffled hearing is common while fluid sits behind the eardrum and usually improves as the infection settles. Persistent hearing problems, especially in children, should be checked. Sudden complete hearing loss is not a wait-and-see symptom — use 111 or urgent care the same day.
- How can I ease earache at home?
- Paracetamol or ibuprofen from a pharmacy can ease pain — follow the pack for age. A warm flannel on the ear may help. Stay upright if pressure feels worse lying down. Do not put drops, oil or cotton buds in unless a clinician has looked in the ear and advised it.