For most ear infections, it’s wise to take earbuds out until the ear has healed. Anything sealed into a sore ear canal keeps it warm, damp and in contact with germs, which are the conditions that keep an infection going. The kind of headphone matters as much as the kind of infection, though, and some ways of listening barely touch the ear at all.
Which Ear Infection You Have Changes the Answer
Swimmer’s ear (otitis externa) is an infection of the skin lining the ear canal. It usually causes itching, pain when the ear is tugged, swelling and sometimes discharge. An earbud pushed into that canal rests directly on the infected, tender skin. Among people who had used earphones in the past month, about 1 in 5 had had outer ear infection symptoms or a diagnosis.1PubMed Central. Ear Symptoms and Earphone Usage: A Web-Based Survey Study
A middle ear infection (otitis media) sits behind the eardrum, often after a cold, and causes pressure, muffled hearing and pain. Because the eardrum is in the way, an earbud in the canal can’t reach the infection itself. When the inner ear is involved, though, dizziness and balance trouble are common, and headphones may make that discomfort feel worse.2Enticare Ear, Nose, and Throat Doctors. Can I Wear Headphones with an Ear Infection? A perforated eardrum or prescribed ear drops change things again, so ask a doctor before inserting anything into the canal.
You can often make a decent guess before an appointment. Pain that gets sharply worse when you tug the earlobe or press the small flap in front of the canal is a common sign of an outer ear infection, because those movements pull on the inflamed skin. A middle ear infection more often follows a cold and brings a deep, full or blocked feeling with muffled hearing, and tugging usually doesn’t change the pain much. These are clues, not a sure test, and you can have both infections at once, so only an ear exam with a light scope confirms which one it is.
Fever, severe pain, swelling that spreads around the ear, or discharge from the ear call for a medical visit whichever kind you suspect. So do pain that keeps worsening after a day or two, sudden hearing loss, or dizziness.
Why Earbuds Can Make an Outer Ear Infection Worse
Earbuds block the ear canal off from outside air, raising the temperature and humidity inside it.3Clinical Epidemiology and Global Health. Perception of earbuds side effects among teenager and adults in Eastern Province of Saudi Arabia: A cross sectional study The longer they stay in, and the less clean they are, the bigger that change gets.4Clinical Epidemiology and Global Health. Perception of earbuds side effects among teenager and adults in Eastern Province of Saudi Arabia: A cross sectional study Warm, damp skin is the setting where bacteria and fungi grow best. Following recommended listening-time limits was linked with fewer outer ear infections.5PubMed Central. Ear Symptoms and Earphone Usage: A Web-Based Survey Study
Earbuds also carry germs. Bacteria grow on many earphones, and one study found 24 different germs on them.6Biomedical Science Letters. Colonization of Pathogens in Earphones and Observation of Effective Sterilization Methods and Cycles The most common were skin germs called staph, often a different type from the one already in the wearer’s ear.7Mustansiriya Medical Journal. Bacterial and Fungal Growth in Males Wearing Mobile Earphone Appliances
Then there’s wax. Earbuds can push earwax further down the canal, and buildup is another way infection can develop.8OSF HealthCare. Can earbuds cause ear infection? Wearing them for hours stops wax from draining out naturally, and wax can trap dirt in the canal.9Debrox. Are My In-Ear Headphones Causing Earwax Buildup? In some people, earphone materials can also trigger an allergic skin rash in the ear.10Portuguese Journal of Otorhinolaryngology – Head and Neck Surgery. Ear dermatitis
A swollen canal is already tender, and the pressure of an earbud tip against it can make the pain worse. If you’ve been given ear drops, a tip sitting in the canal can block them from reaching the skin or wipe them away.
Wiping earbuds and assuming they’re clean is a common mistake. Germs gather in the mesh and the grooves of the silicone tip, not just on the smooth outer surface, so a surface wipe misses much of them. A quick rub on your shirt tends to spread germs around rather than remove them. The charging case holds the same germs and can hand them back to the earbuds every time you put them away.
Over-Ear Headphones Are Gentler but Not Risk-Free
Headphones that sit over the ear have less direct contact with the ear canal than earbuds, and may not raise outer ear infection risk as much.11PubMed Central. Ear Symptoms and Earphone Usage: A Web-Based Survey Study In one group of workers wearing headsets all shift, no outer ear infections were found.12PubMed Central. Ear infection and hearing loss amongst headphone users. But in another survey, headphone users had more ear infections, itching and hearing loss than non-users.13Pakistan Journal of Public Health. FREQUENCY AND FACTORS OF EAR INFECTION AMONG SWIMMERS, COTTON BUD AND HEADPHONE USERS
Heat and pressure still matter. Earmuff-style coverings build up heat and humidity around the ear over time.14PubMed. Heat and humidity buildup under earmuff-type hearing protectors Short sessions with breaks let the ear air out. If the cushion presses on a swollen outer ear and hurts, take them off.
Style makes a difference while your ear is sore. Open-back or loosely fitting over-ear designs let air reach the ear and breathe better than tight closed cups. On-ear pads press on the ear flap, which can hurt if you have swimmer’s ear, so a fully over-ear cushion is usually kinder. Cushions touch your skin, so clean them before and after use while you’re infected. Keep the volume low, since an infected ear may already hear poorly and tempt you to turn things up.
Noise-cancelling headphones can let you listen at a lower volume, which is kinder to a sore ear. Some people feel a pressure sensation with noise cancelling, though, and that may bother a congested middle ear. If the ear feels fuller or more painful, turn the feature off.
Listening With a Middle Ear Infection or Dizziness
A middle ear infection often muffles hearing, which tempts people to turn the volume up. That loud sound goes into the healthy ear too. Set the volume low while the infection is active, and accept that sound will seem dull until the fluid clears.
Inner ear involvement often brings dizziness, and headphones may make it feel more intense.15Enticare Ear, Nose, and Throat Doctors. Can I Wear Headphones with an Ear Infection? If you feel off balance, use a speaker instead, which removes that extra input, and sit down while you listen rather than walking around. Dizziness that is severe, keeps coming back, or comes with hearing loss deserves a medical check.
Discharge changes the advice. Fluid draining from a middle ear infection can mean the eardrum has burst. In that case nothing should go into the canal. See a doctor, who may prescribe drops and give rules about keeping the ear dry.
Kids get middle ear infections far more often than adults. Keep their headphone volume low and sessions short, or use a lightweight headset that sits outside the ear.
Ways to Listen That Leave the Ear Canal Alone
Bone conduction headphones rest on the cheekbones in front of the ears and send sound through bone, without pressing in.16PubMed Central. Using a Bone-Conduction Headset to Improve Speech Discrimination in Children With Otitis Media With Effusion That leaves the ear canal open, so they don’t trap moisture the way earbuds do. A bone conduction headset has even been used to help children whose ears were full of fluid hear speech better.17PubMed Central. Using a Bone-Conduction Headset to Improve Speech Discrimination in Children With Otitis Media With Effusion
They have downsides. They usually cost more than basic earbuds. Sound leaks out for people nearby, and the audio quality is thinner, especially in the bass. In loud places people tend to turn them up too high to compensate, which defeats the gentler design. The band still touches your skin, so keep it clean while your ears are healing.
Simpler options work too. A phone or laptop speaker at moderate volume puts nothing near the ear at all. For calls, speakerphone avoids pressing the phone against a sore ear.
If you want to use a single earbud in the healthy ear, that keeps the infected side open to air. Use a clean bud that hasn’t touched the infected ear, and don’t swap it back and forth between ears.
When You Can Go Back to Earbuds
Don’t use earbuds while the infection is active.18OSF HealthCare. Can earbuds cause ear infection? It’s best to avoid them for several weeks afterward too, because the ear can take a while to fully heal.19OSF HealthCare. Can earbuds cause ear infection? Pain usually fades before the canal skin has recovered, so you can feel fine while the lining is still tender. An earbud seals the canal and adds friction, which is exactly what freshly healed skin handles worst.
If you used earbuds during the infection, they may still carry its germs. Replace silicone or foam tips, which are cheap, and clean the case as well as the buds.
When you do restart, start with short sessions and watch whether itching or aching returns over the next day. If symptoms come back, stop using them and check with a doctor. A blocked feeling that lingers may be wax, which a doctor can remove safely.
Keeping Earbuds From Causing the Next Infection
Cleaning earpieces regularly limits how much the ear canal’s warmth and moisture change and cuts the germs that build up on them.20Clinical Epidemiology and Global Health. Perception of earbuds side effects among teenager and adults in Eastern Province of Saudi Arabia: A cross sectional study21Biomedical Science Letters. Colonization of Pathogens in Earphones and Observation of Effective Sterilization Methods and Cycles Avoid keeping the ear canal closed for long periods with earphones.22Portuguese Journal of Otorhinolaryngology – Head and Neck Surgery. Ear dermatitis Take a break every hour or so to let the ear air out.
To clean earbuds, remove the tips and wash them in mild soapy water, then let them dry completely before putting them back. Wipe the hard plastic parts with an alcohol wipe, keeping liquid away from the speaker mesh. Brush wax gently off the mesh with a dry soft brush, and wipe the inside of the charging case too.
Some habits raise the risk. Putting earbuds in right after swimming or a shower means pushing them into damp canals. Wearing them through a sweaty workout and leaving them in afterward does the same. Sharing earbuds swaps ear germs between people, and sleeping in them keeps the canal closed for hours.
People who use earbuds often are more prone to wax buildup that can need a doctor.23Debrox. Are My In-Ear Headphones Causing Earwax Buildup? Hearing aid users, who also wear something in the ear all day, benefit from regular wax checks.24PubMed Central. The clinical implications of ear canal debris in hearing aid users If your ear feels blocked, have it checked rather than digging with swabs. And if your ears itch or get a rash where earbuds touch, the material may be the cause, and a different tip may help.25Portuguese Journal of Otorhinolaryngology – Head and Neck Surgery. Ear dermatitis