Sofie Wise

Dr. Umer Khan

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About Author — Medically reviewed by Dr Umer Khan, MD who is a Board Certified physician practicing in Pennsylvania. His special interests include wellness, longevity and medical IT.

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.

How Long Does an Ear Infection Last?

Different types of ear infections occur within the ear, relating to each of the ear’s three sections – the outer ear, middle ear, and inner ear. Each section of the ear has a unique function and form and the answer to "how long does an ear infection last" depends on which section of the ear is infected.

  • Inner ear infections tend last the longest with symptoms often persisting for several months.
  • Middle ear infections shouldn’t last more than one or two days.
  • Outer ear infections can last for a week or longer.

Inner Ear Infections (Labyrinthitis)

The inner ear, also known as the labyrinth, is comprised of sections. The Cochlea measures the frequency of sound waves and sends electrical signals to the brain that get interpreted as sound.

Due to this additional function of the inner ear, infections here can cause vertigo, problems with balance, and falling. When the inner ear is infected, it causes a condition known as labyrinthitis that describes swelling and irritation of the inner ear.

Causes of inner ear infections are most commonly viral, but in rare scenarios bacterial infections that preexist in the middle ear can spread into the inner ear. Viruses that lead to infections in the inner ear are predominantly cold and flu viruses, although other viruses such as measles, mumps, herpes, and glandular fever can also cause infections.

Symptoms of inner ear infections share some commonality with middle and outer ear infections such as pain in the ear, fever, and reduced hearing. Nausea and tinnitus can also occur during an inner ear infection. Inner ear specific symptoms include vertigo and loss of balance, which can be severe enough to cause falling.

How Long Do Ear Infections Last (inner ear)?

Unfortunately inner ear infections last longer. Severe symptoms usually clear within 7 days, but complete recovery may take as long as 2 to 3 months. Older adults may have dizziness symptoms that last even longer.

Treatment

Inner ear infection treatment is mostly management and relief of symptoms during the infection.

  • Keep still and get lots of rest.
  • Avoid bright lights, television, or reading during symptom attacks.
  • Balance therapy
  • Get help moving about if you’ve lost balance.
  • Pain medications such as over-the-counter acetaminophen or ibuprofen can be taken to relieve pain.
  • Antihistamines can be taken to help with allergies, which may be part of the underlying cause of infection.
  • Antiemetics can be taken to help manage nausea and vomiting.
  • Additional medicines such as sedatives and steroids can help some people suffering from an inner ear infection.
  • Antibiotics might be needed if the infection is bacterial. Always consult with a doctor before using antibiotics.

Middle Ear Infections (Acute Otitis Media)

The middle ear is an air-filled reservoir behind the eardrum that contains a series of small bones called ossicles. The middle ear is connected to the back of the throat by a small tube known as the Eustachian tube, which provides pressure regulation and drainage of normal secretions and debris.

An infection in the middle ear, known as acute otitis media, is the most common type. This is particularly common amongst children between 3 months and 3 years of age, because their Eustachian tubes are less well developed and more prone to blockage.

Causes of middle ear infection are predominantly related to preexisting infections such as the common cold or flu.

Respiratory infections cause dysfunction of the Eustachian tubes resulting in a damp and dirty middle ear. The wetness created in the middle ear during Eustachian tube dysfunction provides a prolific environment for invasive microorganism to reproduce.

The common cold and flu are both viruses, but bacterial infections can occur in the middle ear too. Allergies, smoke, fumes, and other environmental toxins can have effects on the Eustachian tubes similar to the cold and flu and thus also may lead to middle ear infections.

Symptoms of middle ear infections include:

  • Ear pain (dull and continuous or sharp and sudden)
  • Following a sharp stabbing pain, warm discharge via the ear canal
  • Feeling like your ear is clogged
  • Nausea
  • Reduced hearing

In children symptoms may slightly differ and may include:

  • Fever over 100 °F
  • Poor appetite
  • Increased irritability
  • Headaches
  • Pulling (or scratching) at the ear

How Long Do Ear Infections Last (middle ear)?

Severe symptoms usually last for less then one to two days. If such symptoms last longer than one to two days, then it is important to consult with a doctor. If symptoms do not go away and are left untreated, they can lead to complications and in rare cases more serious health issues

After an ear infection clears up, fluid may remain in the middle ear and cause some of the more mild symptoms and can persist for several weeks to months. This condition is diagnosed as otitis media with effusion.

How Long Can an Ear Infection Last In Children (middle ear)?

Symptoms in children usually resolve within 24 hours. If fever and sharp pain don’t resolve in 48 to 72 hours then the National Institute on Health suggests starting your child on antibiotics by consulting a doctor.

Treatment of middle ear infections

Treatment begins with a wait-and-see approach as recommended by the American Academy of Pediatrics and the American Academy of Family Physicians. A prescription from a doctor is needed for antibiotics so if you think your infection is bacterial contact a doctor here.

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Outer Ear Infections (Acute Otitis Externa)

The outer ear is comprised of the pinna (the fleshy part of the ear outside the head) and the ear canal (a 2 to 3 cm tube that propels sound towards the eardrum).

The eardrum is a membrane between the middle and outer sections of the ear that causes the ossicles to vibrate when sound is brought in through the ear canal. Infections in this sector of the ear, known as acute otitis externa, mostly affect the ear canal.

Causes of outer ear infections are considerably different than the causes of middle ear infections. Bacterial infections are the most common type of infection in the outer ear, although fungal and viral infections (more rare) occur as well.

An outer ear infection is generally caused by:

  • Too much moisture in the ear
  • Scratches, abrasions, or other irritations to the ear canal
  • Sensitivity reactions such as eczema

Outer ear infections are commonly referred to as "Swimmer’s Ear" due to swimming (particularly in dirty water with high bacteria counts) resulting in an outer ear infection.

Although swimming is a common cause of infection, excess water in the ear canal after showering, sweating, or from excessively humid weather can also lead to an outer ear infection.

Irritations to the ear canal can result from using or misusing a number of common products. These include:

  • Headphones
  • Hairspray
  • Jewelry
  • Hearing aids
  • Ear plugs
  • Using cotton swabs, fingers, or other probes to clean wax from the outer ear (cleaning excess wax with such objects is not the recommended method).

Symptoms of outer ear infections have some overlap with middle ear infections including:

  • Pain
  • Reduced hearing
  • Purulent discharge
  • Possible fever
  • Feeling of a clogged ear

Symptoms that are unique to outer ear infections include:

  • Extra pain in response to pulling on the pinna (or while chewing)
  • Visible redness or swelling of the ear canal (in rare and extreme cases redness and swelling of the pinna).

How Long Do Ear Infections Last (outer ear)?

With proper treatments an outer ear infection should clear up in 7 to 10 days. If ear drops are used they are usually applied for a slightly longer period of time, 10 to 14 days.

If an outer ear infection is left untreated, then not only can it can last much longer, but it can lead to dangerous complications where the infection spreads to the base of your skull, brain, or cranial nerves.

Treatment

Treatment of outer ear infections include a number of options:

  • Debridement is the extraction of material from the ear using a suction tool. This helps clear out bacteria or fungus as well as excess earwax buildup or foreign objects.
  • Altering the pH of the ear canal can help kill unwanted bacteria and resolve an ear infection. Over-the-counter drops exist for this purpose, or do-it-yourself options include mixing drops out of vinegar and hydrogen peroxide (Caution: if there is a perforation in the eardrum then consult a doctor before inserting fluids into your ear canal as they might get into your middle ear).
  • Antibiotics can be effective in treating outer ear infections only if it is caused by bacteria.

Even for bacterial infections, antibiotics should be reserved for more severe or persistent cases Always consult a doctor before using antibiotics.

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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 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 you think you have symptoms of labyrinthitis (inner ear) then it is best to contact a doctor right away.

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
  • Permanent hearing loss
  • Eardrum perforation
  • Facial nerve paralysis
  • Occasionally, 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.

PlushCare takes content accuracy seriously so we can be your trusted source of medical information. Most articles are reviewed by M.D.s, Ph.D.s, NPs, or NDs. Click here to meet the healthcare professionals behind the blog.

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