A Guide to Ear Infection in Adults

Medically Reviewed By Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
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Although more common among children, ear infections in adults can be more serious and more likely to require medical treatment. Viruses, fungi, and bacteria can cause ear infections in adults. Some adults with chronic conditions may be more likely to develop them. Experts estimate that 80–90% of children develop a middle ear infection before they start school. However, ear infections in adults are also not uncommon. A 2021 study finds that middle ear infections in adults occur at a rate of about 5.3 per 1,000 adults annually. Researchers also estimate that about 10% of people will experience outer ear infections in their lifetimes.

Read on to learn more about the causes, symptoms, and treatments for ear infections in adults.

What are the types of ear infections in adults?

An adult using eardrops
chameleonseye/Getty Images

Ear infections in adults generally fall into three categories, depending on which part of the ear they affect: inner, middle, and outer.

Inner ear

The inner ear includes the cochlea, which sends information about sound to your brain. It also includes the semicircular canals, which help your body determine its position. Labyrinthitis and vestibular neuritis are two adult inner ear infections that are usually viral. 

Middle ear

The middle ear area includes the eardrum and the space behind it where three bones help conduct sound waves to the cochlea. People with middle ear infections often have an upper respiratory virus that causes part of their ear to become blocked. This blockage then traps fluid behind the eardrum.

Outer ear

The outer ear includes the ear canal and the auricle, the external part many people think of as the ear. Outer ear infections affect adults more often than children and can be very painful without treatment.

People who swim are five times more likely to experience an outer ear infection, sometimes called “swimmer’s ear.” However, swimming is not always the cause — bacteria in the ear cause 90% of outer ear infections.

What are the causes of ear infections in adults?

Viruses, bacteria, and fungi can all cause ear infections in adults. However, different parts of the ear become infected for different reasons.

While viruses commonly cause inner ear infections, doctors often do not know the cause when diagnosing the condition. Therefore, they may recommend resting and staying hydrated instead of prescribing antibiotics. 

The virus that causes chickenpox and shingles can cause labyrinthitis when it reactivates. A middle ear infection can also spread to the inner ear.

Middle ear infections in adults commonly develop due to an upper respiratory virus, influenza, or cold. These viral infections can clog up the eustachian tube, which runs from the ear to the throat. This clog keeps fluid in the ear from draining and can result in a secondary bacterial infection. 

The bacteria Pseudomonas aeruginosa and Staphylococcus aureus are responsible for most outer ear infections in adults. These bacteria can enter the ear canal from several sources:

  • earbuds
  • cotton swabs
  • hearing aids
  • eczema
  • sweat
  • warm weather conditions

What are the symptoms of ear infections in adults?

Symptoms of ear infections in adults depend on which part of the ear is infected.

Inner ear infection symptoms can include:

Middle ear infection symptoms can include:

Outer ear infection symptoms can include:

  • pain when pressing or pulling on the ear
  • itchiness
  • swelling
  • sensation of fullness in the ear
  • mild fever
  • drainage

How do doctors diagnose ear infections in adults?

To diagnose an adult ear infection, your doctor will ask about your symptoms and medical history. They will feel your lymph nodes and look in your ears with an otoscope, a lighted device with a magnifying lens. They may also check to see if your eardrum moves, which helps them determine if it is healthy. 

Depending on the type of ear infection and severity of symptoms, your doctor also might conduct a hearing or imaging test. These additional tests can help them rule out other conditions.

What are the treatments for ear infections in adults?

Treating viral inner ear infections in adults typically involves getting adequate rest, staying hydrated, and taking over-the-counter (OTC) pain medications. In some cases, steroids and vestibular system suppressants may be necessary. If a bacterial infection is the cause, doctors may prescribe antibiotic ear drops or oral antibiotics.

For a bacterial middle ear infection, doctors may prescribe oral or topical antibiotics. Some people experience chronic middle ear infections or fluid remaining in their ear after taking antibiotics. To treat this, a doctor may perform a minor procedure to place tubes in the affected eardrum to allow the fluid to escape. This procedure can also help prevent middle ear infections and make them easier to treat with antibiotic ear drops.

You can often manage outer ear infections with antibiotic ear drops and pain relievers. Your doctor may also need to clean the ear canal to allow topical treatments to work.

What is the outlook for adults with ear infections?

The worst symptoms of inner ear infections often resolve after a few days. However, episodes of vertigo might continue for several weeks.

With treatment, adults with middle ear infections can also see symptom improvement in a few days.

With antibiotic ear drops, outer ear infections can take 7–10 days to improve.

What are the risk factors for ear infections in adults?

Adults who are more likely to develop ear infections may have chronic conditions, such as:

What are some potential complications of ear infections in adults?

Ear infections in adults can spread to other parts of the ear, head, or neck without effective treatment. Ear infections can also cause:

  • mastoiditis, or an infection of the bone just behind the ear
  • permanent hearing loss
  • persistent balance issues
  • long-term vertigo
  • brain abscess

Can adults prevent ear infections?

For adults, preventing ear infections often includes routine best practices for good health. You can help prevent ear infections by:

  • getting your annual flu shot
  • practicing good handwashing and hygiene techniques
  • never using cotton swabs in your ear
  • routinely disinfecting earbuds and hearing aids
  • getting enough rest, eating a balanced diet, and exercising

Other frequently asked questions

Here are a few other commonly asked questions about ear infections in adults. Dr. Nicole Aaronson has reviewed the answers.

How does an adult get an ear infection?

Adults can get ear infections from viral upper respiratory infections or bacteria. Staying up to date on your vaccinations, washing your hands regularly, and disinfecting earbuds and hearing aids can all help prevent ear infections.

Will an ear infection in an adult go away on its own?

While some ear infections may go away on their own, others will require medical treatment. Talk with your doctor to determine the type of ear infection you have and the proper treatment plan.

Summary

While ear infections are more common in children, adults can get them as well. Ear infections can develop in any part of the ear and may cause vertigo, itching, hearing loss, or fever.

While viral ear infections may only require OTC pain treatment, doctors typically prescribe oral or topical antibiotics for bacterial ear infections. With prompt treatment, most ear infections will clear up within a week.

Talk with your doctor if you are experiencing symptoms consistent with an ear infection.

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Medical Reviewer: Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
Last Review Date: 2022 Jul 20
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  3. Labyrinthitis and vestibular neuritis. (2020). https://www.nhs.uk/conditions/labyrinthitis/
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  5. Weigand, S., et al. (2019). Otitis externa: Investigation and evidence-based treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522672