Ear Infections and Hearing Loss: What you need to know
Introduction
Most of us have had an ear infection at some point, even if we weren't quite sure what to call it at the time. A dull ache, a feeling of pressure, sounds that seem to arrive wrapped in cotton wool. It's easy to dismiss these things and wait for them to pass.
But ear infections are more common in adults than many people realise, and the way they affect your hearing can vary quite a bit depending on where in the ear the problem originates. Some clear up within a week or two and leave no lasting trace. Others can cause changes to your hearing that linger long after the infection itself has gone.
In this article, we look at the four main types of ear infection, the symptoms to watch out for, when it's worth seeing your GP, and what the connection to hearing loss actually means in practice. If your hearing hasn't been quite right after a recent ear infection, or you've simply been wondering whether it's worth getting things checked, this is a good place to start.
The four types of ear infections
Not all ear infections are the same, and knowing which part of the ear is affected can help you understand your symptoms and have a more informed conversation with your GP. Here's a brief guide to each type.
1. Outer ear infection (Otitis Externa)
An outer ear infection affects the ear canal, which is the short passage running from your outer ear to your eardrum. You may have heard this referred to as "swimmer's ear", though you absolutely don't need to be a regular swimmer to develop one.
The most common cause is moisture getting trapped in the canal, creating a warm, damp environment where bacteria or fungi can thrive. But it can also be triggered by scratching inside the ear, using cotton buds, wearing in-ear headphones for extended periods, or having a skin condition such as eczema or psoriasis in or around the ear.
Common symptoms include:
- Pain inside the ear, which can range from mild to quite intense
- Itching in the ear canal
- A feeling of fullness or blockage
- Discharge that may be clear, yellow, or green
- Muffled hearing
- Tenderness when you touch or move the outer ear
The muffled hearing that comes with this type of infection is usually temporary. It's typically caused by swelling or discharge partially blocking the canal, and it tends to resolve once the infection has cleared.
2. Middle ear infection (Acute Otitis Media)
A middle ear infection takes hold in the small space sitting just behind your eardrum. It has a reputation as a childhood complaint, and while children do get them often, plenty of adults find themselves dealing with one too, usually in the wake of a cold, flu, or a stubborn bout of congestion.
The reason the two tend to go hand in hand comes down to a part of your anatomy most people have never had cause to think about. When you're under the weather, your eustachian tubes (the narrow passages that connect your middle ear to the back of your throat) can swell up or become blocked.
Once that happens, fluid has nowhere to drain and starts to collect behind the eardrum. It doesn't take long for bacteria or viruses to make themselves at home in there.
Symptoms to watch out for include:
- Ear pain that can come on suddenly
- A feeling of pressure or fullness in the ear
- Muffled or reduced hearing
- A raised temperature
- Discharge from the ear if the eardrum perforates
- Dizziness
- Tinnitus (a ringing, buzzing, or humming sound in the ear)
The good news is that hearing loss associated with a middle ear infection is usually temporary. For most people, hearing returns to normal once the fluid and infection clear. If it doesn't, or if your symptoms are severe, that's worth a conversation with your GP.
3. Glue ear (Otitis Media with Effusion)
Glue ear is the name given to a build-up of thick, sticky fluid behind the eardrum. Unlike a standard middle ear infection, it's often painless, which is part of the reason it can be easy to overlook, particularly in adults who might attribute the symptoms to tiredness, distraction, or simply "not hearing properly lately."
It can develop when a middle ear infection doesn't fully clear, or when the eustachian tubes aren't draining efficiently over a longer period. Conditions such as sinusitis, allergies, or nasal polyps can contribute by causing the kind of ongoing congestion that prevents natural drainage.
Symptoms are often gradual, but can include:
- A persistent, low-level hearing loss, often described as sounds feeling muffled or distant
- A sensation of fullness or pressure in the ear
- Difficulty following conversations, especially in background noise
- Tinnitus
- Struggling to catch what people are saying at normal speaking volume
Quite often, glue ear will sort itself out without any treatment at all. For others, it becomes a more ongoing issue that benefits from medical attention. If your hearing still isn't quite right after what seemed like a straightforward ear infection, it's worth going back to your GP rather than simply waiting it out.
4. Inner ear infection (Labyrinthitis and Vestibular Neuritis)
Inner ear infections are a little different from the others. Rather than being directly caused by bacteria or fungi, they're usually the result of inflammation, most often triggered by a viral infection.
Two conditions are often grouped under this heading:
Labyrinthitis affects the cochlea (the part of the inner ear responsible for hearing) and the vestibular system (which controls your sense of balance). Both can be affected at the same time.
Vestibular neuritis involves inflammation of the vestibular nerve rather than the inner ear itself. It typically affects balance without affecting hearing.
Both conditions tend to arrive suddenly and can be quite disorienting.
Symptoms can include:
- Sudden, intense dizziness or vertigo (a spinning sensation that makes it difficult to stand or move normally)
- Nausea and vomiting
- Sudden hearing loss, usually in one ear
- Tinnitus
- A feeling of fullness in the affected ear
- Difficulty concentrating or feeling generally unwell
Most people make a full recovery over the course of several weeks, though progress can feel slow. In a small number of cases, some degree of hearing loss may persist. This is one of the main reasons it's important to have this type of infection properly assessed by your GP rather than managing it at home.
When should you see your GP?
Many mild ear infections will settle on their own within a week or two. But there are situations where it's important not to wait. Contact your GP if:
- The pain is severe, or getting worse rather than better
- You have a high temperature
- Your symptoms haven't improved after a few days
- There is discharge from your ear, particularly if it contains blood or pus
- You experience sudden or significant hearing loss
- You have dizziness or vertigo that comes on suddenly or feels severe
- Your hearing hasn't returned to normal once the infection has cleared
- You have a condition that affects your immune system
When you see your GP, the first thing they'll usually do is take a look inside your ear. They use a small handheld tool called an otoscope, which is really just a tiny torch with a magnifying lens, nothing more intimidating than that.
They'll also want to hear about your symptoms in your own words, how long things have been going on, what it feels like, and whether anything has changed. Depending on what they find, they may do a couple of additional checks or refer you for a more detailed assessment.
Please note, Your Hearing does not provide medical diagnoses. The above is presented as general health guidance, not clinical advice.
What are the treatment options?
Treatment depends on the type and severity of the infection, so your GP is the right person to guide you. The good news is that most ear infections respond well to straightforward approaches.
Common treatment options include:
- Antibiotic ear drops for outer ear infections
- Oral antibiotics for more severe middle ear infections
- Pain relief such as paracetamol or ibuprofen
- A period of watchful waiting for mild infections likely to resolve on their own
- Antihistamines or steroid nasal sprays when allergies are a contributing factor
- Grommets (small ventilation tubes placed in the eardrum) for persistent glue ear
- Vestibular rehabilitation exercises for inner ear infections that affect balance
A few simple ways to reduce your risk
Not every ear infection can be prevented, but there are some straightforward habits worth building.
Keeping your ears dry is one of the most effective things you can do. After swimming or bathing, a gentle tilt of the head to each side can help drain any moisture from the canal before it has a chance to cause problems. Wearing a swim cap or using wax earplugs if you swim regularly can also help.
It's also worth stepping away from the cotton buds. Despite being a familiar bathroom staple, they tend to push wax deeper into the canal and can irritate the delicate skin inside. If your ears feel blocked or uncomfortable, your GP or pharmacist is a much better first port of call.
If you're prone to picking up colds or sinus infections, treating them promptly rather than pushing through can help keep your eustachian tubes clear and reduce the chance of a middle ear infection developing on top. Regular handwashing and keeping a little distance from people who are unwell helps too, since many ear infections start life as a common respiratory virus.
Conclusion
For most people, an ear infection is an uncomfortable few days rather than anything more serious. With the right care, symptoms clear, hearing returns to normal, and life carries on.
But it pays to know what you're dealing with, to understand which symptoms might need more attention, and to resist the temptation to dismiss changes to your hearing as something that will simply sort itself out in time.
If your hearing hasn't fully returned after an ear infection, or you've noticed more general changes in how well you're hearing lately, it's always worth getting a proper assessment. A quick conversation with your GP is a sensible starting point. And if they suggest a hearing check, or you'd simply like peace of mind, we can connect you with a fully qualified, registered audiologist near you.
Whether you'd prefer a visit to a local audiologist or the convenience of a free home visit, we make it straightforward, with no obligation and no pressure.
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