Should I use this page, or skip it?
Use this page if an ear hurts and you need a door: pharmacy, GP, 111 or 999. 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.
Pain after a cold is common. Pain with a rapidly swelling, hot ear is a different problem.
What causes earache?
Earache is pain in or around the ear. The most common cause in children is a middle-ear infection after a cold. Earwax, tonsillitis, teething, flying, or an outer-ear infection after swimming can also hurt. Do not diagnose the cause yourself.
A young child may rub the ear, seem irritable, have a temperature, feed poorly or lose balance. The ear can look normal from the outside.
Can I see a pharmacist first?
Yes, for many people. In England, Pharmacy First can assess some earache without a GP appointment if you fit the pathway. Eligibility applies — including age — so ask rather than assuming. Babies often need a GP. The pharmacist checks for red flags, then treats, advises, 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.
How can I ease earache at home?
Paracetamol or ibuprofen can ease pain and fever. Follow the pack for that person’s age. A warm flannel on the ear may help. Staying upright can reduce pressure. Offer fluids if there is a fever. Do not put cotton buds, oil or objects in the ear unless a clinician has looked and advised it.
Do not put cotton buds, oil or objects in the ear. Do not try to scoop out wax. Keep water out until a clinician has checked. Children under 16 should not have aspirin.
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 earache lasts more than two or three days, fluid leaks, hearing changes, something is stuck, or a young child has pain in both ears.
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.
Can I fly with earache?
Usually wait. Pressure changes during take-off and landing can make a blocked or infected ear very painful and, rarely, damage the drum. Speak to a GP or 111 before flying if you or your child have active earache or a confirmed infection. Do not use decongestants just to board unless a clinician agrees.
Swallowing, sucking a sweet (not for young children) or feeding a baby on ascent and descent can help a mildly blocked ear after a cold — not a substitute for advice if the ear is infected.
Does earache always mean an infection?
No. Earwax, a sore throat, tonsillitis, teething, flying, or water trapped after swimming can all hurt the ear. Do not diagnose the cause yourself. A pharmacist or GP can look in the ear. Pain with toothache may be dental, not an infection of the drum.
If something is stuck in the ear, do not dig. Use 111 or a GP. Keep water out until a clinician has checked. Pain that keeps returning belongs with a GP, not another bottle of oil from the cupboard.
What if earache keeps coming back?
Repeated earache in a child should be reviewed by a GP, not managed with another bottle of oil. Persistent muffled hearing after the pain has gone also needs a check. Glue ear is a different problem from an acute infection and is not something to diagnose from this page.
Do not fly with active earache if you can avoid it. Speak to a GP or 111 before a booked flight. Swallowing on ascent can help a mildly blocked ear after a cold — it is not a substitute for advice if the ear is infected.
Who should skip this page?
Skip this page if swelling, severe dizziness or breathing trouble is already happening — call 999. It is not a wax-removal guide, not a flying medical certificate, and not the right page for a baby with fever who needs the children’s fever pathway. Recurrent earache belongs with a GP, not another bottle of oil.
Common questions about earache
- How do I know if my baby has earache?
- Babies cannot say their ear hurts. Clues include pulling or rubbing the ear, irritability, crying more than usual, poor sleep, fever, being off feeds, or not reacting to quiet sounds. These signs still need a clinician if the baby is very young or getting worse. Fever under 3 months is 111 or 999, not a wait-and-see night.
- Does earache always mean an ear infection?
- No. Earwax, a sore throat or tonsillitis, teething, flying, or water trapped after swimming can all hurt the ear. Do not diagnose the cause yourself. A pharmacist or GP can look in the ear. Pain with toothache may be dental, not an infection of the drum.
- Can a pharmacist treat earache in England?
- Yes, for many people who fit the Pharmacy First earache pathway. 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 schemes.
- How can I relieve earache at home?
- Paracetamol or ibuprofen can ease pain — follow the pack for age. A warm flannel on the ear may help. Do not put drops, oil or cotton buds in unless a clinician has examined the ear. Keep water out. Pain relief is the treatment while you wait to see if it settles.
- Do I need antibiotics for earache?
- Many ear infections are viral and get better without antibiotics. A pharmacist or GP decides based on what they see, how unwell you are, and how long it has lasted. Follow the course you are given if one is prescribed. Do not use leftover antibiotics from a previous illness.
- Can I fly with earache?
- Flying with a blocked or infected ear can be very painful because pressure changes on take-off and landing. Speak to a GP or 111 before flying if you or your child have active earache or a confirmed infection. Do not use decongestants just to get on a plane unless a clinician agrees.