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Sofie Wise

Sofie Wise

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About Author — Sofie hopes to create a more sustainable healthcare system by empowering people to make conscious health decisions. Her interests include cooking, reading, being outdoors and painting.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

Ear Infection in Adults: When to Contact a Doctor

Your ears are made up of three main cavities: the Inner Ear, the Middle Ear and the Outer Ear. Each section has its own function and structure:

  • Outer Ear: The outer ear is made up of the pinna and the ear canal. The pinna is the part of the ear that we see on the outside of our heads. It is made up of cartilage and soft tissue and is responsible for collecting and guiding sound vibrations from the outside world into the ear canal.
  • Middle Ear: The middle ear begins at the eardrum, which sits at the end of the ear canal. The eardrum is made up of three small bones, called ossicles. When sound waves hit the eardrum, it moves, causing the ossicles to vibrate and translate the sound waves into mechanical vibrations. The middle ear is connected to the upper respiratory tract by a tube called the eustachian tube, making it particularly susceptible to ear infections.
  • Inner Ear: The inner ear contains a bony, snail-shaped structure called a Cochlea. The Cochlea is filled with fluid and small hair-like nerve cells that vibrate when the mechanical energy of the eardrum is transferred. These nerve cells send signals to the auditory nerve, which in turn allows us to hear.

Unfortunately, because the ears are filled with fluid and connected to the respiratory tract, they are an ideal environment for potential infections. Ear infections are most common in children, but adults are still susceptible to them. Let’s take a closer look at the types and symptoms of ear infections in adults.

What is an Ear Infection?

Ear infections in adults manifest in a couple of different ways, depending on which part of the ear is infected. The most common areas to get infected are the middle ear and the outer ear.

Middle ear infections, also known as otitis media, are caused when fluid is trapped behind the eardrum. The fluid causes the eardrum to bulge, creating a feeling of fullness inside the ear.

Outer ear infections, also known as otitis externa, often begin as an itchy rash and evolve when as the ear becomes painful, tender, red or swollen.

Inner ear infections, the least common type of ear infection, are usually caused by inflammation of inner ear nerves, rather than the presence of an actual bacterial infection.


Causes of Ear Infections in Adults

Ear infections can be caused by the presence of a cold or other respiratory infection, the presence of extra water or fluid in the ear, bacterial infections, and viral infections. Some of the most common causes of ear infections in adults include:

  • The common cold – A cold can move to one or both ears through the eustachian tubes, which are connected to the middle ear. The infection irritates the eustachian tubes and causes them to swell, which prevents the ears from draining properly. When the fluid inside your ears can’t drain properly, it builds up against the eardrum and creates pressure and pain inside the ear.
  • Water in the ear – The presence of water in the ear, often referred to as swimmer’s ear, creates a breeding ground for bacteria in the outer ear. When the outer ear is irritated because of a scratch or being touched, the water in the ear makes it extra susceptible to infection.
  • Bacterial infections – Similarly to the common cold, bacterial infections can cause ear infections when they travel to the ear(s) through the eustachian tube(s). The presence of bacteria inflames the eustachian tubes and causes them to swell, preventing the ears from draining properly. When the fluid is trapped in the ear, it builds up against the eardrum and creates pressure inside the middle ear.
  • Tissue irritants – This comprises anything put into or around the outer ear area. When a foreign object scratches or touches the ear, it leaves the ear susceptible to any bacteria that may have been present on that object. If the ear is already susceptible to an infection (because of fluid, etc.) these irritants can create an outer ear infection. Q-tips and fingers are both common examples of irritants that can cause an ear infection.

Risk Factors of Ear Infections

  • Anatomy – Some people just happen to be born with an inclination for ear infections thanks to certain anatomical abnormalities having to do with the eustachian tubes. The reason that children are more likely than adults to have ear infections is because their eustachian tubes are smaller and more horizontal than the tubes in most adults’ ears. If an adult has smaller eustachian tubes, or their tubes have not developed at a proper slope, the tubes are less able to drain fluid and the ears are more susceptible to infection.
  • Smoking – Smoking or being around secondhand smoke increases the chance of an adult getting an ear infection.
  • Allergies – Having seasonal or year round allergies puts you at risk for adult ear infections.


Common Symptoms of an Ear Infection in Adults

Symptoms of ear infection in adults depend on which part of the ear the infection is located in. The symptoms can differ from person to person based on the severity of the infection, but most people will experience the same general suite of symptoms in each respective ear section.

Inner Ear Infection:

  • Dizziness – Because inner ear infections are caused by inflammation of the inner ear nerves, it can create a feeling of imbalance that leads to the sensation of dizziness.
  • Nausea – This is another feeling that can arise from the imbalance caused by inflammation of the inner ear nerves.
  • Vomiting – One of the most severe symptoms of inner ear infections, vomiting can also be a consequence of the imbalance caused by inflammation of the inner ear nerves.

Middle Ear Infection

  • Fullness in ear – This feeling of pain inside the ear is caused by the buildup of fluid inside the eardrum. The eardrums starts to bulge, creating a feeling of fullness inside the ear.
  • Earache – Another symptom that arises from the bulging of the eardrum is the feeling of pain inside ther ear.
  • Fluid drainage from ear – Sometimes, the fluid trapped inside the eardrum starts to overflow. When this happens, fluid may start draining from the middle ear to the outer ear.
  • Fever – Often the infection causes a fever to manifest in the rest of the body.

Outer Ear Infection

  • Itchy rash – Often, outer ear infections manifest as a rash of small red bumps on the visible part of your ear.
  • Pain – An outer ear infection can cause pain both inside the ear as well as outside, as the rash is often painful to touch.
  • Tenderness – The rash can also cause a feeling of tenderness on the outer part of the ear.
  • Swelling – Often the outer part of the ear becomes swollen with the infection.
  • Redness – The rash can also cause general redness around the outer ear.

Ear Infection Treatment in Adults

Treatment of ear infections in adults depends on which part of the ear is infected.

Inner Ear Infection Treatment

Inner ear infections are very uncommon and usually go away on their own, but medications can help manage the symptoms if they ever do occur. Some options for managing the symptoms include vestibular therapy, which focuses on improving balance, over-the-counter antihistamines (Benadryl or Claritin), or prescription medications like involuntary nervous system blockers (i.e. Atenolol), and sedatives.

Middle Ear Infection Treatment

Treating middle ear infections usually involves antibiotics. The antibiotics may be prescribed in the form of oral medication or ear drops. Many doctors will also recommend taking a medication to manage the pain of the infection, such as over-the-counter anti-inflammatory drugs and pain relievers.

If you are also experiencing cold or allergy symptoms, the doctor may also advise taking a decongestant like Sudafed or earache drops, an antihistamine like Benadryl or Claritin, or using a steroidal nasal spray like Flonase.

One helpful technique for alleviating middle ear infection symptoms is called autoinsufflation, which is meant to help unblock your eustachian tubes. You do this by pinching your nose, closing your mouth and exhaling gently. The motion sends air through the eustachian tubes to help drain them.

Another technique that you can do at home is to apply a warm compress to the ear. This can help alleviate the feeling of pressure building up. For best results, use the compress for 20-minute periods while resting.

Outer Ear Infection Treatment

The first step in treating an outer ear infection is to carefully clean the affected area. After cleaning, you should apply both antimicrobial and an anti-inflammatory medications to the ear.

A doctor may prescribe antibiotics if they believe the infection is bacterial. If the infection is viral, you will need to continue tending to the irritation on the ear and wait for the virus to resolve itself. Depending on the type of virus, more specialized treatment could be necessary.


Ear Infection Prevention

Cleaning and drying the ear properly after swimming or bathing is key to preventing fluid-borne ear infections. Experts also recommend using earplugs when swimming to avoid getting water in the ears in the first place. Towel drying the ears and hair directly after swimming can also help prevent infection.

Using cotton swabs or other objects to clean out the ears is ill-advised. These can injure the ear canal and eardrum, leading to an ear infection.

Regular handwashing can help prevent the spread of bacteria that could cause an ear infection. Avoiding putting your fingers in your ears can also help prevent the spread of these infection-causing germs.

Another great way to prevent ear infections is by treating seasonal allergies, colds and skin conditions as soon as possible, as these conditions often lead to ear infections later on.

When to Contact a Doctor

If you think you are experiencing ear infection symptoms, and the symptoms last longer than one or two days, you should consult with a doctor. Sometimes ear infections do resolve on their own after a couple of days, but if the pain worsens or lingers, you should seek medical attention. Additionally, if you have fluid draining from your ear or your hearing is impaired by any of the symptoms listed above, you should see a doctor as soon as possible.

If properly treated, ear infections will not lead to any other complications. If left untreated, however, your ear infection can, in rare cases, pose more serious health issues, including:

  • Mastoiditis – a rare inflammation of a bone that is adjacent to the ear
  • Hearing loss
  • Eardrum perforation
  • Facial nerve paralysis
  • Meniere’s disease – a disease that manifests as symptoms of vertigo, hearing loss, pressure in the ears and ringing in the ears.

Letting an ear infection go on without treatment can lead to permanent hearing loss and possible spread of the infection to other parts of your head. If you suspect you might have an ear infection, consult with your doctor or visit an urgent care center to get treatment as soon as possible.

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