What is Otitis Externa?
Otitis externa is inflammation or infection of the ear canal, the narrow passage leading from the outer ear to the eardrum. It is sometimes called “swimmer’s ear” because trapped moisture can encourage bacteria or fungi to grow.
Acute Otitis Externa
The most common type. Often develops after water exposure, use of cotton buds, minor trauma, or flare-ups of skin conditions like eczema.
Chronic Otitis Externa
Symptoms last more than 3 months. Often linked to underlying skin problems or repeated irritation.
Bacterial vs Fungal
Most cases are bacterial, but fungal infections can occur, particularly after recent antibiotic drops or prolonged moisture.
What Causes Otitis Externa?
Common causes include:
- Water trapped in the ear
- Cotton buds or inserting objects into the ear
- Ear eczema or psoriasis
- Irritation from hearing aids or earphones
- Excess wax or aggressive wax removal
- Bacterial or fungal overgrowth
- Allergic reactions to hair products, earplugs or ear drops
What Are the Common Symptoms of Otitis Externa?
- Ear pain, often worse when touching or pulling the ear
- Itching in the ear
- Ear discharge
- Muffled or reduced hearing
- Swelling or redness of the outer ear
- A feeling of fullness
- Tenderness around the ear or jaw
- Mild fever (less common)
Children may show irritability, ear pulling, or disturbed sleep.
How Is Otitis Externa Diagnosed?
Diagnosis is usually based on your symptoms and the appearance of the ear canal.
During an online GP consultation we can:
- Assess your symptoms
- Determine whether it is bacterial, fungal or irritation
- Advise on the most effective treatment
- Provide prescriptions for antibiotic or antifungal drops
- Guide on pain control and self-care
- Recommend in-person examination or microsuction if needed
You may need to be seen in person if symptoms are severe, persistent, recurrent, or associated with hearing loss or significant swelling.
How Long Does Otitis Externa Last?
- With treatment, symptoms often improve in 48 to 72 hours
- Full recovery usually occurs within 1 to 2 weeks
- Mild cases may improve more slowly if underlying skin conditions are present
Is Otitis Externa Contagious?
No, otitis externa is generally not contagious. It is caused by local infection or irritation in the ear canal.
How to Feel Better and Recover Quickly
Self-Care at Home
- Keep the ear dry
- Avoid swimming until fully recovered
- Do not use cotton buds
- Take paracetamol or ibuprofen for pain
- Apply a warm compress for comfort
- Avoid earphones or hearing aids until pain settles
Prescription Treatment
- Antibiotic ear drops: for bacterial infections, especially if pain, discharge or swelling persists
- Antifungal ear drops: if fungal infection is suspected
- Steroid ear drops: to reduce inflammation and itching, particularly with eczema
- Oral antibiotics: rarely needed; may be used if infection spreads or you have diabetes, reduced immunity, or severe swelling
- Ear cleaning (microsuction): may be needed if debris or wax blocks the canal; cannot be done remotely
Treatment from a GP
A GP can:
- Prescribe the appropriate ear drops
- Advise on pain and itch relief
- Identify underlying skin conditions
- Provide fit notes for work or study
- Guide when in-person assessment is needed
When Referral Is Needed
You may need ENT or specialist assessment if:
- Symptoms last more than 3 months
- Repeated or frequent episodes occur
- Symptoms return after treatment
- Hearing does not return to normal
- Fungal infection does not respond to treatment
- Swelling keeps recurring
- You have diabetes or reduced immunity
- Malignant otitis externa is suspected (rare but serious infection spreading to the bones at the base of the skull)
When to Seek Urgent Medical Help
Go to A&E or urgent care if you have:
- Severe ear pain not eased by pain relief
- Swelling spreading to the face or neck
- High fever
- Weakness of facial muscles
- Sudden hearing loss
- Severe headache or dizziness
- Symptoms in someone with diabetes or reduced immunity
- Redness or swelling spreading beyond the ear
Call 999 if symptoms are severe or life-threatening.
How Dr.Online UK Can Help
We offer:
- Same-day online GP appointments
- Expert assessment and personalised guidance
- Private prescriptions when clinically appropriate
- Referral letters if needed
Clear advice on whether you need in-person care
