Treating Ear Infections in Adults - Verywell Health
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Ear infections occur when there is fluid buildup in the ear that causes blockages and inflammation. In adults, ear infections are commonly treated with over-the-counter (OTC) pain relievers or prescription medications like antibiotics.
This article will discuss the types of ear infections as well as symptoms and treatment.
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Anatomy of an Ear Infection
The ear is divided into the outer ear, middle ear, and inner ear. Infection can occur in any of these areas, but bacterial infections of the inner ear are extremely rare.
Bacteria, viruses, and fungi can cause infections in the ear. Infections can be brought on by an illness, such as a cold or allergies.
Ear infections generally occur when bacteria, viruses, or fungi gain entry into one of the three areas of the ear and cause infection.
Outer Ear Infections
Outer ear infections are sometimes called swimmer's ear, or otitis externa. This is an infection of the ear canal, the portion of the ear that leads from the outside and stops at the eardrum. The opening of this part of the ear is external and visible.
Outer ear infections are called swimmer's ear because they can sometimes be caused by swimming or bathing in contaminated water.
This is not the only way to get an outer ear infection, however. Bacteria, viruses, or fungi can be introduced to the outer ear in many ways, especially through broken skin, and usually result in an infection when a moist environment aids their growth.
Symptoms of an outer ear infection can include:
- Pain in the ear
- Redness and irritation inside the ear canal
- Itchy ear canal
- Flaky or peeling skin
More severe infections can lead to swelling of the ear canal, which may lead to muffled hearing, a fever, or ear drainage that looks like there is pus in it.
An outer ear infection can be diagnosed through an examination of the ear canal with an otoscope (a special tool with a light on the end that makes it easy to see inside the ear).
Preventing Outer Ear Infections
The best way to prevent outer ear infections is to keep your ears as clean and dry as possible. Never put objects into your ear canal, and gently dry your ears after swimming or bathing. You can do this by tipping your head to the side and allowing the water to run out.
OTC Treatments
Over-the-counter (OTC) pain medications, including Advil or Motrin (ibuprofen) and Tylenol (acetaminophen), may be used to ease the pain associated with an outer ear infection.
You can also use a warm compress to help with pain.
Specific ear drops can be used to treat swimmer's ear, including Debrox swimmer's ear drops, Auro Dri ear drops, and Swim EAR drops, among others.
There are various at-home remedies recommended for swimmer's ear, including rubbing alcohol, vinegar, or baby oil, but you should consult with your healthcare provider before using any of these substances for swimmer's ear.
Prescription Medications
Antibiotic ear drops are often prescribed for the treatment of outer ear infections. Some prescribed ear drops, such as Ciprodex (ciprofloxacin and dexamethasone), combine an antibiotic and a steroid medication to help with inflammation.
Ear drops should be used exactly as prescribed and for the correct length of time.
Oral antibiotics are not usually necessary for the treatment of outer ear infections, but some circumstances may require their use. If you are prescribed oral antibiotics, make sure you take them exactly as they are prescribed unless otherwise instructed by your healthcare provider.
Possible Complications
Complications are rare, but some people are at a higher risk, including those with impaired immune systems, diabetes, or those undergoing cancer treatments that make it difficult for the body to fight off an infection.
If left untreated, outer ear infections can lead to a condition called malignant otitis externa, whereby the infection spreads to nearby tissues and bones, causing severe damage.
Middle Ear Infections
The middle ear is internal. It starts behind the eardrum and goes to the oval window (the area between the middle ear and inner ear). It contains three tiny bones, called the ossicles, that are necessary for hearing function.
The auditory tube (Eustachian tube) runs from the middle ear to the throat. Its function is to ventilate and equalize pressure in the middle ear. Fluid from the middle ear space drains into the throat and is usually swallowed.
Types of Middle Ear Infections
Middle ear infections are called otitis media. When otitis media is accompanied by fluid in the middle ear, ear infections are referred to as serous otitis media, or otitis media with effusion.
Middle ear infections often occur after a cold virus or upper respiratory infection. They are also more common in individuals who suffer from allergies or enlarged adenoids (tissue in the throat and nasal cavity), which can inhibit proper functioning of the auditory tube.
Bacteria, viruses, or fungi often enter through the auditory tube, which can then become swollen and blocked with mucus, preventing drainage and ventilation of the middle ear.
The main symptoms of middle ear infections include:
- Ear pain, which may be worse in the morning or cause difficulty sleeping
- Ear drainage
- Trouble hearing
- Fever
A healthcare provider can diagnose a middle ear infection based on symptoms and an examination, which involves looking at the eardrum with an otoscope (a special tool used to see inside the ear).
OTC Treatments
Middle ear infections can typically resolve themselves, so treatment is focused more on symptom management to provide pain relief.
OTC pain relievers, such as ibuprofen and acetaminophen, can be given to ease the pain associated with a middle ear infection. These medications are also capable of reducing a fever if one is present.
Sometimes using a warm compress and keeping the upper body elevated to help the auditory tube drain can help to alleviate the pain caused by a middle ear infection.
Prescription Medications
Antibiotics are only effective in treating a middle ear infection that is caused by bacteria.
However, it is not always possible to identify the source—whether bacterial or viral—causing a middle ear infection. Your healthcare provider may choose to treat the infection by prescribing an antibiotic or waiting to see if the infection improves on its own.
Possible Complications
Some people can suffer from chronic or recurring middle ear infections. While rare, several complications may occur from persistent or untreated middle ear infections including:
- Mastoiditis: A condition in which the infection spreads to the mastoid bone behind the ear
- Cholesteatoma: A rare condition associated with middle ear infections that causes the skin cells in the middle ear to grow abnormally
- Inner ear infections: Labyrinthitis and vestibular neuritis, which sometimes occur from untreated middle ear infections
- Meningitis: An infection of the meninges, the protective space filled with cerebral spinal fluid that cushions the brain and spinal cord
- Facial paralysis: A rare condition in which the facial nerves are compressed
Inner Ear Infections
The inner ear is located next to the middle ear within the temporal bone. The inner ear contains the semicircular canals, which are essential to balance and equilibrium.
Inner ear infections are much more likely to be caused by a virus than a bacterial infection. They are much less common than outer ear infections or middle ear infections.
The most common inner ear infections include labyrinthitis or vestibular neuritis, which are slightly different conditions.
Labyrinthitis affects the labyrinth, which is a system of fluid-filled sacs that helps you hear and gives you a sense of balance. Labyrinthitis can cause both hearing changes and dizziness, or vertigo.
Vestibular neuritis is an inner ear infection that affects the vestibular nerve and usually causes dizziness and balance issues, but no hearing changes.
There is no specific diagnostic test to identify an inner ear infection, so misdiagnosis or delayed diagnosis is common.
OTC Treatments
Benadryl (diphenhydramine) and Antivert (meclizine) are two OTC medications that may be used to treat the dizziness and nausea associated with an inner ear infection.
OTC medications can help alleviate symptoms of an inner ear infection but do not treat the actual infection.
Prescription Medications
Several different prescription medications may be used for the treatment or management of symptoms caused by an inner ear infection, including:
- Antinausea medications to help control nausea symptoms
- Steroid medications, such as prednisone, to reduce inflammation
- Antibiotics or antiviral medications can be used to treat the infection itself
Possible Complications
Excessive nausea and vomiting may lead to hospitalization and the need for intravenous fluids in individuals with inner ear infections.
Permanent hearing loss or chronic vestibular problems (issues with balance and dizziness) may also be complications of an inner ear infection.
A Word From Verywell
Having an ear infection can be painful and interfere with your ability to function. It's important to remember that almost all ear infections can be cured with prompt treatment. If you have symptoms of an ear infection, meet with a healthcare professional to discuss your condition.
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