Ear Infections in Adults: Symptoms, Treatment, and When to See a Doctor

Ear infections aren't just something kids get. Adults can develop ear infections too, particularly after a cold, sinus infection, or when the ear canal is exposed to moisture or minor injury.

The tricky part is that not all ear symptoms mean the same thing. Some ear infections improve on their own with basic care, while others need prescription treatment or in-person evaluation.

Here's what to know about ear infection adults treatment, when it's worth calling a doctor, and how a lingering cough that won't go away can sometimes be part of the same overall picture.

TL;DR: Key Takeaways

• Adult ear infections can affect the outer ear (otitis externa), the middle ear (otitis media), or, less commonly, involve problems affecting the inner ear.
• Symptoms may include ear pain, a feeling of fullness, decreased hearing, drainage, itching with outer ear infections, or dizziness.
• Not every ear infection needs antibiotics. Some resolve without prescription treatment.
• Antibiotic ear drops may be used for outer ear infections, while oral antibiotics may be appropriate for certain middle ear infections.
• A cough that won't go away can sometimes follow a viral infection that also caused ear symptoms.
• Seek prompt medical care for severe pain, drainage, facial weakness, sudden hearing loss, dizziness, high fever, or symptoms that keep getting worse.

Have ear pain, fullness, or drainage and want a clinician to evaluate you from home? Book a $39 online urgent care visit with August AI. A US-licensed clinician can review your symptoms and determine whether treatment or in-person care is appropriate, with same-day pharmacy pickup available across all 50 states.

The visit does not guarantee a prescription, and medication costs are separate. For severe ear pain, sudden hearing loss, facial weakness, high fever, significant drainage, or dizziness affecting your balance, seek in-person care rather than a telehealth visit.

What are the types of ear infections in adults?

Most ear infections involve the outer or middle ear. Problems affecting the inner ear are less common and can cause hearing or balance symptoms.

Outer ear infection (otitis externa)

This is often called "swimmer's ear," although you don't have to swim to get it. It affects the ear canal, the passage that runs from the outer ear to the eardrum.

Common symptoms include ear pain that gets worse when you pull on the outer ear, itching in the ear canal, redness or swelling in the ear canal, fluid or pus drainage, and a feeling of fullness or reduced hearing.

Outer ear infections often follow moisture exposure, using cotton swabs or hearing aids, or minor injury inside the ear canal.

Middle ear infection (otitis media)

Middle ear infections affect the space behind the eardrum. In adults, they're commonly connected to a recent cold, sinus infection, or other upper respiratory infection.

Symptoms may include ear pain, a feeling of fullness or pressure, decreased hearing, drainage if the eardrum ruptures, and sometimes low-grade fever, dizziness, or ringing in the ear.

Inner ear problems

Inner ear problems are less common and aren't the same as the typical middle ear infections people usually mean when they talk about an ear infection. Conditions affecting the inner ear can interfere with hearing and balance.

Symptoms may include vertigo, which is a spinning sensation, imbalance, nausea, sudden hearing changes, or ringing in the ear.

Sudden hearing loss, severe vertigo, or facial weakness needs prompt medical attention.

Ear infection adults treatment: what actually helps?

Not every ear infection in adults needs antibiotics.

The CDC notes that many ear infections improve on their own without antibiotic treatment, particularly milder middle ear infections. Overusing antibiotics contributes to antibiotic resistance, and taking them for a viral illness won't make you feel better faster.

Treatment approaches for adult ear infections may include:

Watchful waiting. For milder middle ear infections, a clinician may recommend monitoring symptoms and using pain relief while the infection resolves on its own.

Ear drops. Antibiotic ear drops are often used for outer ear infections. Some drops also contain a steroid to reduce inflammation.

Oral antibiotics. These may be recommended for certain middle ear infections, particularly when symptoms are severe, don't improve, or in higher-risk situations.

Pain relief. Over-the-counter pain and fever medications may help with discomfort when used according to their labels.

Warm compresses. Applying a warm cloth to the affected ear may ease pain temporarily.

Ear hygiene. For outer ear infections, keeping the ear dry and avoiding cotton swabs and other objects that could irritate the ear canal helps recovery.

Your clinician will consider your symptoms, medical history, allergies, other medications, and any signs of complications before choosing a treatment.

Cough that won't go away and ear symptoms

An ear infection sometimes shows up around the same time as a lingering respiratory infection.

A cough that won't go away can have many causes, including postnasal drip, allergies, post-viral cough, asthma, or gastroesophageal reflux. When ear symptoms happen at the same time, both may be connected to the same underlying respiratory infection.

For example, a cold or sinus infection can inflame the Eustachian tubes, which connect the middle ear to the back of the nose, leading to middle ear pressure or infection. Postnasal drip can also irritate the throat and trigger persistent coughing.

If your cough has lasted more than about three weeks, is severe, or is associated with concerning symptoms like fever, chest pain, difficulty breathing, unexplained weight loss, or coughing up blood, talk to a healthcare professional. For more on when respiratory symptoms need medical attention, see our guides on sinus infection: when antibiotics actually help and when to see a doctor for flu.

Home care for adult ear infections

For milder ear infections, home care may be enough to get you through the illness while your clinician monitors your progress.

Try to rest and take it easy. Use warm compresses on the outside of the ear for comfort. Take over-the-counter pain relief according to the label instructions. Keep the affected ear dry, particularly for outer ear infections. Avoid putting cotton swabs, fingers, or other objects into the ear canal. Sleep with the head slightly elevated if pressure is worse when lying down.

If you have a chronic condition, take other medications, or have questions about safe use of over-the-counter medications, check with a pharmacist or clinician.

When to see a doctor for an ear infection

Ear infections aren't always predictable, so it's worth reaching out to a clinician when:

• Symptoms are severe or worsening
• You have drainage from the ear
• You have hearing changes
• You have dizziness or balance problems
• You have facial weakness or asymmetry
• You have high fever
• Symptoms are not improving or are getting worse after a few days
• You have a chronic medical condition, weakened immune system, or diabetes
• Ear infections keep coming back

Seek urgent or emergency care if you have severe ear pain that isn't controlled, sudden hearing loss, severe or worsening dizziness, high fever with confusion, or signs of an infection spreading beyond the ear.

If you're not sure whether you need urgent care or an ER visit, see our guide on urgent care vs ER: how to decide in 60 seconds.

Can telehealth help with an ear infection?

For some adult ear infections, a telehealth visit can be a reasonable first step.

A clinician can review your symptoms and history, ask about hearing changes, drainage, or other concerning features, and evaluate whether telehealth is appropriate or whether you need an in-person examination.

A clinician may sometimes diagnose and treat an uncomplicated outer ear infection through telehealth, but an in-person examination may be needed if the diagnosis is unclear, there is significant drainage, or the condition of the eardrum needs to be checked.

Middle ear symptoms can be harder to evaluate remotely because they usually involve looking at the eardrum with an otoscope.

If your clinician can't safely evaluate your symptoms without a physical examination, they may recommend an in-person visit rather than starting treatment based on symptoms alone.

What causes ear infections in adults?

Adult ear infections can be caused by:

• Recent upper respiratory infections
• Sinus infections
• Allergies
• Eustachian tube dysfunction
• Water exposure, particularly for outer ear infections
• Irritation from cotton swabs or hearing aids
• Injury to the ear canal
• Chronic skin conditions affecting the ear canal
• Weakened immune system
• Diabetes
• Certain other underlying conditions

Some people have anatomical or health-related factors that make ear infections more likely.

If you keep getting ear infections, it's worth talking to a clinician about whether there's an underlying cause worth addressing rather than repeatedly treating each infection.

Conclusion

Ear infection adults treatment isn't a one-size-fits-all answer. The right approach depends on the type of ear infection, how severe your symptoms are, whether there are complications, and your overall health.

Not every ear infection needs antibiotics. Some outer ear infections respond to antibiotic drops. Some middle ear infections resolve on their own with home care and monitoring. Others need oral antibiotics or in-person evaluation.

If a cough that won't go away is happening at the same time as ear symptoms, both may be tied to an ongoing respiratory infection. That's also worth mentioning to your clinician.

When symptoms are severe, worsening, or come with warning signs like sudden hearing loss, facial weakness, high fever, or significant dizziness, don't wait it out at home. Get medical care sooner rather than later.