👂 Sore ear that won't settle?
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Book a Telehealth Consultation →Ear pain has a way of choosing its moment — 2am, a long flight, or halfway through a childcare week. In children it's one of the most common reasons for a GP visit; in adults it's often dismissed as "just a blocked ear" until it isn't. Most earache settles on its own, but some causes need treatment, and a few need it urgently.
This guide covers what's behind ear pain in adults and children, what you can safely do at home, and — the part you came for — exactly when it needs a doctor. For condition-specific details, see our full guide to ear pain treatment.
Most common in kids
Middle ear infections often follow a cold — up to 4 in 5 children have at least one by age 3.
2–3 day rule
Mild earache that's improving within 2–3 days usually resolves on its own.
Discharge = review
Fluid, pus or blood from the ear always warrants a doctor's assessment.
Sudden red flags
Swelling behind the ear, facial weakness or drowsiness need urgent care.
What's causing the ear pain?
Ear pain isn't one condition — it depends a lot on where the problem sits and who's affected.
| Cause | Who it typically affects | Typical signs |
|---|---|---|
| Middle ear infection (otitis media) | Mostly babies and young children, after a cold | Deep earache, fever, irritability, poor sleep, tugging at the ear |
| Outer ear infection (otitis externa / "swimmer's ear") | Adults and children who swim; ear canal users | Itchy, painful canal; pain when tugging the outer ear or pressing in front of it |
| Earwax blockage | All ages | Fullness, muffled hearing, mild ache — sometimes after cotton bud use |
| Referred pain | Mostly adults | Ear looks normal; pain actually from jaw (TMJ), teeth, throat or neck |
| Barotrauma (flying/diving) | Adults and children | Sharp pain during descent or diving, fullness, sometimes muffled hearing |
| Eardrum perforation | All ages, often after infection or injury | Sudden pain relief followed by discharge, hearing loss |
Adults vs children: what's different
| Adults | Children | |
|---|---|---|
| Most likely cause | Outer ear infection, wax, jaw or tooth-related referred pain | Middle ear infection following a cold |
| How it shows up | Clear description of the pain and triggers | Fussiness, tugging the ear, fever, poor feeding or sleep — often no words for the pain |
| Fever | Less common with outer-ear causes | Common with middle ear infections |
| Antibiotics needed? | Sometimes — depends on the cause | More often considered, especially under 2, both ears, or if not improving in 48–72 hours |
| Recurring pattern | Swimmer's ear with repeated water exposure | Glue ear or repeated infections — may need ENT review |
What you can do at home
- Pain relief first. Paracetamol or ibuprofen, taken as directed, is the most effective first step for earache at any age.
- Warmth helps. A warm (not hot) cloth held against the ear, or simply sitting upright, often eases pressure pain.
- Keep fluids up — especially in children. Swallowing can help eustachian tube drainage, and dehydration makes everything worse.
- Nothing in the ear. Ever. Cotton buds push wax deeper and can damage the canal or drum. If the eardrum is perforated, keep water out of the ear until a doctor says it's healed.
- Don't fly if you can avoid it. With an active ear infection, altitude changes can be genuinely painful and slow recovery.
When does ear pain need a doctor?
| Situation | Why it matters | How soon |
|---|---|---|
| Pain lasting more than 2–3 days without improvement | Bacterial infection or a cause needing specific treatment becomes more likely | See a GP |
| Discharge (fluid, pus or blood) from the ear | May indicate perforated eardrum or outer ear infection | See a GP within a day or two |
| Fever, especially in a child under 2, or both ears affected | Guidelines recommend lower thresholds for antibiotics here | See a GP within 24–48 hours |
| Hearing loss or muffled hearing that persists | Could be wax, fluid behind the eardrum (glue ear) or something needing examination | See a GP |
| Ear pain during or after flying or diving that doesn't settle | Barotrauma may need assessment and treatment | See a GP |
| Repeated ear infections, or symptoms not responding to treatment | Recurrent otitis or glue ear may need an ENT specialist referral | See a GP for review and possible referral |
⚠️ A note on "watchful waiting"
For mild middle ear infections without red flags, Australian guidance supports observing for 48–72 hours while managing pain — many resolve without antibiotics. But waiting longer than that without improvement, or waiting while any red flag (below) is present, crosses from "sensible" into "risky". When in doubt, get assessed — a telehealth consultation makes that easy.
What to do — step by step
Manage the pain and watch the first 48 hours
Give paracetamol or ibuprofen as directed, apply gentle warmth, and keep the person comfortable and upright. For a child with mild earache after a cold and no red flags, watching for up to 48–72 hours while treating the pain is reasonable. Keep the ear dry — no swimming, and nothing inserted into the canal.
Book a GP review if the pain isn't settling — or red flags appear
If pain persists beyond 2–3 days, there's fever, discharge, hearing loss, or the affected person is under 2 with bilateral symptoms, it's time for a doctor. An AHPRA-registered GP can assess the pattern, prescribe medication where appropriate (online prescriptions explained here) and advise on next steps. Seeing a GP online works well for most ear complaints — consultations start from $49, and here's how telehealth works if you're new to it.
Follow up, and don't ignore repeat episodes
If treatment isn't working, symptoms keep returning, or hearing stays muffled, ask about further assessment. Recurrent infections or persistent fluid may need an ENT specialist referral — NewTeleDoc can arrange one online for $25 when clinically appropriate. Need time off work or to keep a child home? A medical certificate online starts from $15.
When ear pain becomes an emergency
🚨 Call 000 or go to your nearest emergency department if there is:
- Swelling, redness or tenderness behind the ear, with the ear pushed forward or out — possible mastoiditis
- Facial weakness or drooping on the same side as the ear pain
- Severe dizziness or vomiting with the ear symptoms — possible inner ear complication
- Severe headache with fever and neck stiffness, or unusual drowsiness or confusion
- A baby or child who is very unwell, floppy, hard to wake or refusing all fluids
These signs suggest the infection may be spreading beyond the ear, and they need urgent, in-person care — don't wait for a telehealth appointment.
Can an online doctor help with ear pain?
Often, yes. A GP can do a lot by video or phone: take a focused history, examine the outer ear and surrounding area on camera (especially helpful with a cooperative child on a parent's lap), assess the likely cause, and prescribe ear drops, antibiotics or pain relief where appropriate.
What telehealth can't do is look through an otoscope at the eardrum itself. If the doctor needs to visualise the drum — for example, uncertain diagnosis, suspected perforation or persistent fluid — they'll tell you clearly and arrange in-person care. Our guide on telehealth vs seeing your GP in person explains where each option fits, and what a telehealth consultation costs.
Frequently asked questions
How long should ear pain last before I see a doctor?
If mild earache isn't clearly improving within 2–3 days — or is getting worse — book a GP appointment. Also see a doctor sooner if there's fever, discharge from the ear, hearing loss, or the person is under 2 years old. And any red-flag signs (swelling behind the ear, facial weakness, severe drowsiness) mean urgent care immediately, not a wait-and-see approach.
Should my child take antibiotics for an ear infection?
Not always. Many middle ear infections are viral or settle without antibiotics, and guidelines support watching for 48–72 hours with good pain relief in mild cases. Antibiotics are more likely to be recommended for children under 2, when both ears are affected, with fever or discharge, or when symptoms haven't improved after 48–72 hours. The GP will weigh this up at assessment.
Can I put cotton buds or oil in a painful ear?
No. Cotton buds push wax deeper and can scratch the canal or damage the eardrum. If there's any chance the eardrum is perforated (pain, discharge or recent infection), drops and oils shouldn't go in without a doctor's advice, and water should be kept out of the ear. Leave the canal alone and get it assessed.
Is ear pain with a normal-looking ear serious?
It can be — but it often means the pain is referred from somewhere else, like the jaw joint (TMJ), teeth, throat or neck. That's still worth a doctor's visit, especially if it persists beyond a few days, because the underlying cause needs identifying and treating in its own right.
Can I see an online doctor for my child's ear infection?
Yes — telehealth suits most ear complaints, and a video consultation lets the doctor see the child, guide you through checking for tenderness, and prescribe treatment where appropriate. If the doctor needs to look at the eardrum with an otoscope, or your child has any red-flag signs, they'll arrange in-person care instead. For emergencies, always call 000 or go to an emergency department.
Ear still hurting after 48 hours?
Don't just endure it. Book an online GP consultation from $49 — get assessed, get treatment if you need it, and get a certificate if you're off work.
Book Your Online GP Visit →This article provides general information only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the guidance of a qualified health professional with any questions about your health or a medical condition. If you are experiencing a medical emergency, call 000 or attend your nearest emergency department.