Acute Otitis Externa Treatment

If you have ear pain, itching, discharge or swelling in your ear canal, you may have acute otitis externa, sometimes called an outer ear infection or swimmer’s ear.

Adults aged 18 and over may be able to access assessment and treatment for acute otitis externa through our NHS Pharmacy First service, without needing to see a GP first.

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What is acute otitis externa?

Acute otitis externa is inflammation or infection of the outer ear canal – the tube that runs between the opening of your ear and your eardrum.

It can be caused by a bacterial or fungal infection, irritation or damage to the skin inside the ear. Water trapped in the ear canal, skin conditions such as eczema, and putting objects such as cotton buds into the ear can also increase the risk of developing otitis externa.

You can find more information about outer ear infections on the NHS ear infections information page.

What are the symptoms of otitis externa?

Symptoms of an outer ear infection can include:

• Earache or pain inside the ear
• Itching or irritation in or around the ear canal
• Redness or swelling around the ear canal
• Fluid or discharge coming from the ear
• Dry or flaky skin around the ear
• A feeling of pressure or fullness inside the ear
• Temporary changes to your hearing
• Discomfort when moving your jaw, chewing or speaking

Symptoms can vary from person to person. Our pharmacist can assess your ear and determine whether your symptoms may be caused by acute otitis externa.

NHS Pharmacy First Acute Otitis Externa Service

Our NHS Pharmacy First service allows eligible adults aged 18 and over with symptoms of acute otitis externa to be assessed by a pharmacist.

During your consultation, the pharmacist will ask about your symptoms, when they started, any previous problems with your ears, your medical history and any medicines you are currently taking.

The pharmacist may examine your ear using an otoscope, a small instrument with a light that allows them to look inside the ear canal and assess the affected area.

Following the assessment, the pharmacist will explain the most appropriate treatment. Where clinically appropriate, prescription treatment may be provided directly through the pharmacy. If your symptoms require further investigation or specialist treatment, we will advise you on the appropriate next steps.

You can find out more about NHS Pharmacy First.

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Who can use this service?

Our NHS Pharmacy First acute otitis externa service is available to people who:

• Are aged 18 years or over
• Have symptoms that may be caused by acute otitis externa
• Meet the relevant NHS clinical pathway criteria

Some symptoms and medical conditions may mean that treatment through the pharmacy is not appropriate. If this applies to you, our pharmacist will explain where you should seek further medical advice.

Get help in 4 easy steps

1. Contact our pharmacy

Book an appointment if you are aged 18 or over and have symptoms that may be caused by an outer ear infection.

2. Speak to our pharmacist

Our pharmacist will discuss your symptoms, medical history, previous ear problems and any medicines you are currently taking.

3. Ear examination

Where appropriate, the pharmacist will examine your ear and ear canal and check for signs of acute otitis externa or anything that may require further medical attention.

4. Advice and treatment

We will explain the most appropriate next steps. Where clinically appropriate under the NHS service, treatment may be provided directly from the pharmacy.

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What causes an outer ear infection?

Otitis externa can develop when the skin inside the ear canal becomes irritated, damaged or infected.

Factors that can increase your risk include:

• Getting water in the ear regularly, including through swimming
• Putting cotton buds, fingers or other objects inside the ear
• Scratching or damaging the skin inside the ear canal
• Skin conditions such as eczema, psoriasis or dermatitis
• A build-up of earwax that traps water inside the ear
• Irritation from products or objects used in or around the ear

Keeping your ears dry and avoiding putting objects inside the ear canal can help reduce irritation and the risk of infection.

How is acute otitis externa treated?

Treatment depends on what is causing the inflammation or infection and the severity of your symptoms.

Ear drops or sprays are commonly used to treat otitis externa. Depending on the cause, these may contain an antibiotic, antifungal medicine, steroid or a combination of medicines.

Our pharmacist will assess your ear and determine which treatment, if any, is appropriate for you.

If treatment is provided, it is important to use it exactly as directed and complete the recommended course.

How can I look after my ear at home?

Alongside any treatment recommended by your pharmacist, there are several things you can do to help your ear recover:

• Keep the affected ear as dry as possible
• Avoid swimming while you have an ear infection
• Try to prevent water and shampoo from entering your ear when washing
• Do not put cotton buds, fingers or other objects inside your ear
• Gently wipe away discharge from the outside of the ear if needed
• Use suitable pain relief such as paracetamol or ibuprofen if appropriate for you

Do not try to remove earwax or clean deep inside your ear yourself, as this can damage the ear canal and make your symptoms worse.

For more advice, visit the NHS guide to ear infections.

How do I use ear drops correctly?

If you are given ear drops, using them correctly can help ensure that the medicine reaches the affected part of your ear canal.

• Follow the instructions provided with your medicine
• Lie on your side with the affected ear facing upwards
• Apply the recommended number of drops
• Gently move your ear to help the drops travel into the ear canal
• Remain lying on your side for around 5 minutes to help prevent the drops from running out

Our pharmacy team can show you how to use your treatment correctly if you are unsure.

When should I seek urgent medical advice?

Some ear infections need further medical assessment.

Seek urgent advice from your GP or NHS 111 if:

• You feel generally very unwell
• You have a very high temperature or feel hot, cold or shivery
• There is significant swelling around your ear
• You develop new hearing loss or a significant change in your hearing
• You feel sick, are vomiting or feel dizzy
• Your symptoms are becoming significantly worse
• You have diabetes
• You have a weakened immune system

Severe pain, redness, tenderness or swelling behind the ear can require urgent medical attention.

You can get urgent medical advice through NHS 111 online.

How long does otitis externa last?

Acute otitis externa will often improve within around a week with appropriate treatment, although this can vary depending on the cause and severity of the infection.

If your symptoms are not improving, are becoming worse or keep returning, you may need further medical assessment.

Do I need to see my GP first?

No. If you are aged 18 or over and our pharmacy provides the NHS acute otitis externa service, you can contact us directly for an assessment.

Our pharmacist will assess your symptoms and determine whether treatment through the pharmacy is appropriate or whether you need to be referred to another healthcare professional.

Convenient NHS care from your local pharmacy

Accessing treatment through your local pharmacy provides a convenient way to get professional advice and treatment for common conditions such as acute otitis externa.

Our pharmacist can assess your ear, provide advice and, where clinically appropriate, provide treatment without you needing to see your GP first.

Book an appointment today

If you are aged 18 or over and have symptoms of an outer ear infection, book an appointment with our pharmacy team. Our pharmacist can assess your ear and advise you on the most appropriate treatment or next steps.