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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.

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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

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.

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.

Rarity: Common

Top Symptoms: fever, ear canal pain, ear fullness/pressure, jaw pain, ear pain that gets worse when moving

Urgency: Primary care doctor

Relapsing polychondritis

Relapsing polychondritis is an episodic, inflammatory and destructive disorder involving primarily cartilage of the ear and nose. It can also potentially affect the eyes, tracheobronchial tree, heart valves, kidneys, joints, skin, and blood vessels.

You should visit your primary care physician for mild severity of relapsing polychondritis. Medications such as NSAIDs and steroids are generally prescribed.

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Obstruction

An ear foreign body is anything that gets stuck in the ear canal other than earwax. This may include food, toy pieces, beads, buttons, disk batteries, cotton swab, paper, or insects. Foreign bodies are usually trapped in the outer ear canal.

You should visit your primary care physician within the next 24 hours to have the foreign object removed. This is not a medical emergency requiring a visit to the ER, but the procedure should be performed by a medical professional to avoid damage to the eardrum. It is important to remove the object in a timely manner, however, to prevent discomfort and the possibility of an infection.

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.

Those with suspected frostnip should have wet clothing removed. Rubbing affected areas worsens damage to the tissue. You should go to an urgent care. If rewarming can occur without chance of refreezing, it can be tried in the field. At urgent care, the doctors will guide you in gently re-warming the wounded area in 98-102F (37C-39C) water. Further, ibuprofen, antibiotics, and a tetanus shot may be necessary

Rarity: Rare

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

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.

Those with suspected frostbite should have wet clothing removed. Rubbing affected areas worsens damage to the tissue. You should go to the ER by car, immediately. If rewarming can occur without chance of refreezing, it can be tried in the field. There, the doctors will guide you in gently re-warming the wounded area in 98-102F (37C-39C) water. Further, ibuprofen, antibiotics, a tetanus shot, and possibly surgery will be done to treat the pain and dead tissue. IV fluids will also be started. Hydrotherapy will be done daily to help with the wounded area.

Rarity: Rare

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

Lymph node inflammation behind the ear

There are lymph nodes behind the ear. Lymph nodes are where your immune cells live, and when they become enlarged, it could be from a nearby infection, immune response, or even backlog of blood.

You should see your primary care doctor tomorrow for a sick visit. There, the doctor can look at what could explain the enlarged node behind your ear.

Eczema (atopic dermatitis)

Atopic dermatitis, also called eczema, dermatitis, atopic eczema, or AD, is a chronic skin condition with an itchy rash.

AD is not contagious. It is caused by a genetic condition that affects the skin's ability to protect itself from bacteria and allergens.

AD is most often seen in infants and young children. Most susceptible are those with a family history of AD, asthma, or hay fever.

Infants will have a dry, scaly, itchy rash on the scalp, forehead, and cheeks. Older children will have the rash in the creases of elbows, knees, and buttocks.

Without treatment, a child may have trouble sleeping due to the intense itching. Constant scratching may cause skin infections and the skin may turn thickened and leathery.

Diagnosis is made through physical examination, patient history, and allergen skin tests.

AD cannot be cured, but can be controlled through prescribed medications, skin care, stress management, and treatment of food allergies. Those with AD often have allergies to milk, nuts, and shellfish. Keeping the skin clean and moisturized helps prevent flareups.

Cellulitis

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.

Symptoms 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.

Rarity: Uncommon

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

Outer ear pain quiz

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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.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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