Ear Infection: Pain, Swimming and Colds

Reviewed July 6, 2026 by Sara, licensed pharmacist. This article is general education, not personal medical advice.

Ear pain can feel disproportionate to everything else going on. It may arrive with a cold, after swimming, during a flight, or with a blocked, pressurised feeling and muffled hearing. The useful thing to remember is that ear pain is a symptom, not a diagnosis.

It is also one of the more common reasons people look for advice in summer, after swimming. The outer ear canal, the middle ear, the jaw, the teeth, the throat, and even built-up wax can all be involved. That is why the right product is not always obvious from the pain alone, and why putting drops or cotton buds into the ear can sometimes make matters worse.

A few clues that help

Pain after swimming, itching, or pain when the outside of the ear is touched can point towards a problem in the outer ear canal. Earache after a cold, fever, pressure, or reduced hearing is often seen with middle-ear inflammation, especially in children.

These patterns are only clues. Ear symptoms overlap, and a clinician needs to look inside the ear to know what is happening. Notice any discharge, fever, recent swimming, cold symptoms, hearing change, dizziness, or swelling around the ear and mention them when asking for advice.

A pharmacist can help decide whether self-care is reasonable, whether an earwax product might be appropriate, or whether the symptoms need a clinician to examine the ear. That distinction matters because drops, sprays, and pain relief do very different jobs.

Ear symptoms at a glance

Clue	Possible direction	Practical next step
Earache after a cold with pressure	Middle-ear inflammation may be involved	Watch fever, hearing and the child’s general condition.
Pain after swimming or itching in the canal	Outer-ear canal irritation or infection may fit	Keep the ear dry and avoid cotton buds.
Fullness and reduced hearing without severe pain	Earwax can be one possibility	Ask before using wax products if there is pain, discharge or dizziness.
Discharge, sudden hearing loss or severe dizziness	Needs examination	Do not self-start leftover drops.
Swelling behind the ear or facial weakness	Red flag pattern	Seek urgent medical assessment.

Cold, swimming, wax, or something else?

Ear pain after a cold often comes with pressure, blocked hearing, and sometimes fever because the middle ear can become inflamed when the nose and throat are congested. Ear pain after swimming is more often about the ear canal, especially if touching the outside of the ear hurts or the canal feels itchy. Wax can cause fullness and reduced hearing, but wax treatment is not the answer if there is severe pain, discharge, dizziness, or a possible infection.

The timing helps. Did the pain begin after several days of cough and congestion? Read it together with the cough guide and watch the overall illness. Is there fever or a child who is becoming more unwell? The fever guide may help you decide how urgently to ask for advice. None of this replaces an ear examination, but it helps you explain the story clearly.

Safe first steps

For mild ear pain, rest and appropriate pain relief can be helpful. Paracetamol or ibuprofen may be suitable depending on age, weight, medical history, and other medicines; follow the leaflet and ask a pharmacist when unsure.

A warm (not hot) compress held gently against the ear can ease discomfort for some people, and pain that feels worse when lying down at night can happen, but it should be assessed if it is severe, persistent, or worsening. Keep the ear dry if there is discharge or if it is painful after swimming. Do not insert cotton buds, hairpins, or tissues into the ear canal. They can push wax further in, damage delicate skin, or make an infection harder to assess.

For children, comfort and observation go together. Notice whether the child is drinking, sleeping at least a little, responding normally, and improving with appropriate pain relief. A child who cannot settle, is very drowsy, has swelling around the ear, or seems significantly unwell should be assessed sooner. Ear infections are common, but the child’s general condition still matters.

What not to put in the ear

Avoid using leftover antibiotic drops, someone else’s ear drops, or home remedies without advice. This is particularly important if there is discharge, a possible perforated eardrum, grommets, previous ear surgery, or sudden hearing loss. The wrong product may be ineffective or unsuitable for the eardrum.

Antibiotics are not automatically needed for ear pain or every ear infection. Treatment depends on where the problem is, the person’s age, severity, and clinical examination.

If symptoms start after swimming, keeping the ear dry until it is assessed is sensible. Avoid earbuds, earplugs, and water exposure if they make the pain worse, and do not try to “clean out” the canal to solve the problem yourself.

If drops are prescribed or recommended, technique matters. Many people use ear drops too quickly and then stand up immediately, so much of the product runs back out. Follow the instructions you are given, and ask the pharmacist to show you the position if you are unsure. Correct use is not a small detail; it can decide whether the treatment actually reaches the ear canal.

When to seek medical advice

Arrange medical advice if ear pain is severe, lasts more than a few days, is getting worse, or comes with fever, discharge, significant hearing loss, marked dizziness, swelling around the ear, or a severe headache. Seek prompt assessment for a very young child, a person with diabetes or a weakened immune system, and anyone with previous ear surgery.

Urgent assessment is appropriate for facial weakness, swelling or redness behind the ear, severe dizziness, new sudden hearing loss, or a person who seems seriously unwell.

In Italy, a pharmacist can help with pain-relief choices and can explain when an earwax product or ear drop is not appropriate. If the ear needs to be looked at, the route is the medico di base, paediatrician, continuita assistenziale or ENT specialist depending on urgency. Call 112 for severe emergency symptoms such as loss of consciousness, serious neurological signs, or a person who seems critically unwell.

Frequently asked questions

Can a pharmacist tell if an ear infection needs antibiotics?

A pharmacist can help judge whether symptoms sound suitable for self-care or need an ear examination, but antibiotics depend on the type of infection, age, severity and clinical assessment.

Should I use ear drops for ear pain?

Do not use random or leftover drops, especially if there is discharge, possible eardrum perforation, grommets, previous surgery or sudden hearing loss. The wrong drop can be unsuitable.

Pain after swimming, itching or pain when touching the outside of the ear can point toward the outer ear canal. Keep the ear dry and ask for advice if pain is significant, persistent or worsening.

When is ear pain urgent?

Urgent assessment is needed for facial weakness, swelling or redness behind the ear, severe dizziness, sudden hearing loss, severe headache, or a person who seems seriously unwell.