Outer Ear Pain Causes & How to Treat Outer Ear Infections
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Outer ear pain can most commonly be caused by environmental conditions such as water exposure or extreme cold weather that can lead to frostbite of the outer ear. Other causes for ear tragus pain include irritation from obtrusive objects like cotton swabs or fingers. Read below for more information on causes and treatment options.
Outer ear pain symptoms
Outer ear pain usually begins as mild discomfort, often worsened by pulling on the ear or pushing on the bump (tragus) in front of the ear. At the onset of outer ear pain symptoms, the appearance of the ear usually does not change. Your ear may not look red, swollen, or deformed, so initial symptoms may be easy to dismiss. However, the outer ear is more than just the cartilaginous, fleshy part used for earrings. The outer ear is also composed of a canal that runs from the eardrum to the outside of the head.
Common characteristics of outer ear pain
Outer ear pain symptoms may present with:
- Itching inside the ear canal
- Slight redness inside the ear
- Some drainage of clear, odorless fluid from the ear
More severe symptoms
Outer ear pain and its associated symptoms can progress to include the following if left untreated.
- Redness and swelling of the ear
- Pain that radiates from the ear to the face or neck
- Decreased or muffled hearing
- Excessive fluid drainage or pus
6 Outer ear pain causes
The majority of outer ear pain stems from infection of the outer ear canal or otitis externa. The following details may help you better understand your symptoms and if and when you need to see a physician.
Irritation of the outer ear can result in pain.
- Scratches or abrasions: Cleaning your ears excessively with cotton swabs or scratching inside the ear with a finger can result in breaks in the skin that allow bacteria to grow.
- Sensitivity: Jewelry or hair products can cause allergy irritation to the skin and promote infection.
Conditions that result in excess moisture inside the ear canal create an environment ideal for bacterial growth.
- Environmental: External factors such as swimming and perspiration put moisture directly into the ear canal. Repeat exposure can result in bacterial growth and future infection.
- Structural: Some people have narrow ear canals that make drainage of moisture more difficult and promote bacterial growth and infection.
- Devices: Gadgets you put directly into your ears, such as headphones or hearing aids, can also cause blockages that trap excess water.
Swimmer's ear (otitis externa)
Swimmer's ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.
It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.
Most susceptible are children, because they have narrower ear canals that do not drain well.
Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.
Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.
Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.
Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.
Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving
Urgency: Primary care doctor
Relapsing polychondritis is a disorder in which defects develop in cartilage and other tissues throughout the body, including the ears, nose, eyes, joints, and respiratory tract. It is considered a rare condition.
Symptoms vary widely by case, but you may experie...
Mild frostbite of the ears
Frostbite is tissue damage caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports. It is also more likely in those who are intoxicated or have a mental disorder.
Top Symptoms: swollen ear, ear numbness, outer ear pain, ear redness, turning blue or purple from coldness
Symptoms that always occur with mild frostbite of the ears: cold ears
Urgency: Hospital emergency room
Mild frostnip of the ears
Frostnip is damage of the outermost layers of the skin caused by exposure to the cold (at or below 32F or 0C). It is most commonly found in people doing leisurely activities like camping, hunting, or snow sports.
Top Symptoms: ear numbness, outer ear pain, ear redness, turning blue or purple from coldness, cold ears
Symptoms that always occur with mild frostnip of the ears: cold ears
Urgency: In-person visit
Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.
The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.
Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.
Symptoms arise somewhat gradually and include sore, reddened skin.
If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.
Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.
Diagnosis is made through physical examination.
Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.
Top Symptoms: fever, chills, facial redness, swollen face, face pain
Symptoms that always occur with cellulitis: facial redness, area of skin redness
Urgency: Primary care doctor
Eczema (atopic dermatitis) is a non-contagious chronic skin condition that produces an itchy rash. It is caused by a genetic condition that affects the skin's ability to protect itself from bacteria and allergens. The most susceptible are those with a family hi...
Outer ear pain treatments and relief
When to see a doctor
See a physician if you suspect you have an ear infection. Your doctor will help you address any infection you may have and allow your ear to heal.
- Drainage or cleaning: Your doctor will use suction or a small device to drain water and clear away debris, earwax, or extra skin. Proper cleaning allows antibiotic eardrops to move freely through all infected areas of the ear. Depending on the extent of blockage or swelling, your doctor may insert cotton or gauze in the ear to promote drainage instead.
- Ear-drops: Your doctor will prescribe ear-drops with a combination of ingredients that fight bacteria and fungi. Drops will also reduce inflammation and help restore your ear's normal pH balance. Make sure to use your eardrops as prescribed.
- Pain medication: To ease the outer ear pain symptoms, your doctor may suggest over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin). Do not use headphones, hearing aids, or earplugs until pain or discharge has stopped.
Outer ear pain prevention
To prevent outer ear pain symptoms, try to stick to the following in your routine.
- Keep your ears dry: Dry your ears after exposure to moisture from swimming or bathing. Tip your head to the side to help water drain from the ear canal and wipe the outer ear slowly and gently with a towel.
- Do not put foreign objects in your ear: Do not attempt to scratch or dig out earwax with objects such as cotton swabs (Q-tips) or paper clips. These items may not only irritate or break the skin in your ear but can also pack the material deeper into your ear canal, worsening blockage and moisture buildup.
- Protect your ears from irritants: Be conscious of the type and quality of jewelry and piercings you use on your ears. Try to protect your ear canal from hair sprays and dyes by using cotton balls.
Questions your doctor may ask about outer ear pain
- Is there anything coming from your ear(s)?
- Any fever today or during the last week?
- Do you use a hearing aid or wear earplugs?
- Do you often come into contact with hot tubs, swimming pools, or other sources of standing water?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Dr. Gambrah-Lyles is a resident pediatrician at the Children's Hospital of Philadelphia. She is a graduate of the University of Pennsylvania Perelman School of Medicine (2019). She graduated cum laude and received her undergraduate degree in Biochemistry and Spanish from Washington University in St. Louis (2013). Her research explores the intersections between neurology, public health, and infectious disease. She has investigated nutrition and cerebral palsy in Botswana, and completed a year-long project in Brazil, researching growth and developmental outcomes of Zika virus infection in pediatric patients as a Doris Duke International Scholar. Dr. Gambrah-Lyles speaks four languages, loves staying active, and enjoys sharing her love for medicine through teaching and writing.