Most earache comes from an ear infection and starts to improve within a few days. Until then, paracetamol or ibuprofen and a warm or cool cloth held against the ear are the safest relief, and the most useful rule is the simplest: don’t put anything into the ear, including oil, garlic, cotton buds or ear candles.
Ear pain isn’t always from the ear, though. In adults it often comes from the teeth, jaw or throat. Here’s how to work out the likely cause, what to do at home for adults and children, why traditional ear drops can backfire, and the signs that need a doctor quickly.
Common causes of ear pain
The NHS advises against trying to diagnose earache yourself, but the other symptoms give useful clues:
| What else is going on | Possible cause |
|---|---|
| Fever, a recent cold or flu; a child tugging the ear or irritable | Middle ear infection (otitis media) |
| Recent swimming or water in the ear, eczema in the ear, earplug use, discharge | Outer ear infection (otitis externa) |
| Blocked feeling, muffled hearing, ringing | Earwax build-up, glue ear, or something stuck in the ear |
| Toothache, or pain when chewing | Dental abscess or other tooth problem; jaw joint (TMJ) trouble |
| Sore throat or pain when swallowing | Tonsillitis, sore throat or quinsy |
| Pain during a flight or hill drive | Pressure change |
| A baby with red cheeks, drooling, chewing everything | Teething |
MedlinePlus points out that in adults, ear pain often comes from somewhere else: the jaw joint, an infected tooth or the throat. If your ear looks and hears normally but hurts when you chew, or you grind your teeth at night, the jaw is a likely source. Our post on stopping teeth grinding may help there. Blocked sinuses can also cause ear pressure; see our guide on treating sinusitis.
Safe relief at home
These steps come from NHS and MedlinePlus advice:
- Painkillers. Paracetamol or ibuprofen can ease the pain. Children under 16 should not take aspirin. Check the leaflet, or ask your doctor or pharmacist, if you’re pregnant or have a health condition.
- Warmth or cold on the outside. The NHS suggests a warm flannel over the ear. MedlinePlus suggests a cold pack or cold wet cloth on the outer ear for 20 minutes. Use whichever feels better.
- Sit up. Sitting upright rather than lying flat can reduce pressure in the middle ear.
- Chew or swallow. Chewing can ease pressure pain in adults and older children. Gum is a choking risk for young children.
- For flights, swallow or chew during descent. Babies can feed from a bottle or the breast.
- Keep the ear dry. Keep water and shampoo out of an infected ear and don’t swim until it settles.
The NHS says most ear infections clear up within 3 days, although symptoms sometimes last up to a week. Decongestants and antihistamines don’t help ear infections, according to the same page.
Why not oil, garlic or ear candles?
Pouring warm mustard or coconut oil into an aching ear is a common household habit in India, and garlic-in-oil drops are popular online. The trouble is that you can’t see inside your own ear. If the eardrum has a hole in it, which can happen with an infection, anything you pour in goes straight into the middle ear.
Indian ENT research also links oil drops to fungal ear infection (otomycosis):
- In a study of 100 patients with otomycosis on India’s south-west coast, putting coconut oil in the ear was the most common predisposing factor, found in 42% of cases (International Journal of Microbiology, 2014).
- A study of 350 patients at a hospital in Gurugram found that self-cleaning, putting mustard oil in the ear and using ear drops were all significantly associated with fungal ear infection (Journal of Clinical and Diagnostic Research, 2017).
Other popular fixes don’t do better:
- Garlic. There’s no good evidence that garlic drops or a garlic clove in the ear treat infection, and it carries the same risks as any oil if the eardrum is damaged.
- Ear candles. The NHS says there’s no evidence ear candles or ear vacuums remove earwax. The US FDA has warned of burns to the face, ear canal and eardrum, punctured eardrums and blocked ear canals from their use, and says there’s no valid scientific evidence of any medical benefit (FDA consumer update).
- Cotton buds, hairpins, keys. The NHS warns that fingers and objects like cotton buds push wax further in. Hard objects can also scratch the canal, and the 2014 study above found compulsive ear cleaning with hard objects in 32% of otomycosis cases.
There’s one exception worth knowing. For plain earwax build-up without pain, discharge or a known perforation, the NHS does suggest 2 to 3 drops of plain olive or almond oil, 3 to 4 times a day for 3 to 5 days, lying with the ear facing up. That’s for softening wax, at room temperature, not for treating an infection, and not for anyone with a hole in the eardrum. If your ear hurts, get it checked first.
Do ear infections need antibiotics?
Often, no. The CDC says the body can often fight off a middle ear infection on its own, and a doctor may suggest watching and waiting for 2 to 3 days before deciding on antibiotics. Severe infections, or those lasting more than 2 to 3 days, do need treatment, which is why a check-up matters if things aren’t improving.
Outer ear infections may need prescription ear drops or tablets, depending on the cause, which a doctor or pharmacist can decide. Don’t use old drops from the cupboard or someone else’s prescription.
To lower the risk in children, the CDC recommends keeping up with vaccines, including flu and pneumococcal vaccines, and avoiding exposure to cigarette smoke.
Earache in babies and young children
Young children can’t always say their ear hurts. Watch for tugging or rubbing an ear, fussiness, poor sleep, fever and loss of balance. Babies who are teething can also seem to have ear pain; our guide to safe teething remedies covers that.
Give children’s paracetamol or ibuprofen at the dose on the pack for their age or weight, never aspirin, and get advice early for babies.
When to see a doctor
See a doctor the same day if (based on NHS and CDC advice):
- earache has lasted more than 2 to 3 days, or keeps coming back
- there’s fluid, pus or blood coming from the ear
- you notice hearing loss or a change in hearing, or dizziness
- there’s a fever of 39°C or higher
- a baby under 12 months has earache, especially in both ears
- something is stuck in the ear
- you have diabetes or a weakened immune system
- severe pain suddenly stops, which MedlinePlus says can mean the eardrum has burst
Get urgent help, and call 112 if needed, if:
- there’s swelling, redness or tenderness behind the ear, or the ear is pushed outwards. The NHS describes this as a sign of mastoiditis, which can lead to meningitis if untreated
- a baby under 3 months has a temperature of 38°C or higher (the CDC says to talk to a healthcare provider right away)
- there’s a severe headache, stiff neck, confusion, unusual drowsiness or weakness of the face
- a child is limp, very sleepy or not responding normally
Frequently asked questions
Is it safe to put warm oil in an aching ear?
It’s best not to. If the eardrum is perforated, oil can reach the middle ear, and Indian studies link oil drops to fungal ear infections. Plain olive oil drops are only advised for earwax, not for pain or infection.
How long does earache last?
Most ear infections improve within about 3 days, though symptoms can last up to a week. See a doctor if it’s not better after 2 to 3 days.
Why does my ear hurt when I chew?
Pain on chewing often comes from the jaw joint or a tooth rather than the ear. A dentist can check for a dental cause.
Do ear candles remove wax?
No. The NHS says there’s no evidence they work, and the US FDA has received reports of burns, punctured eardrums and blocked ear canals.
Can I clean my ears with cotton buds?
No. The NHS says cotton buds push wax further in. If wax is blocking your hearing, see a pharmacist or doctor.
This article is for general information and is not a substitute for advice from a doctor. If you have symptoms or a health condition, please consult a qualified healthcare professional.
