The most common mistakes people make with an ear infection involve sticking things in the ear canal, using the wrong drops, ignoring worsening symptoms, and getting water in the ear. Many of these habits feel intuitive or helpful but can turn a manageable infection into something much worse. Here’s what to avoid and why it matters.
Don’t Put Cotton Swabs in Your Ear
When your ear feels full or itchy from an infection, the urge to clean it out with a cotton swab is strong. Resist it. Foreign objects pushed into the ear canal are the leading cause of traumatic eardrum ruptures, accounting for about 61% of cases seen in emergency departments. Cotton-tipped applicators specifically are responsible for roughly 45% of those injuries. An infected ear is already inflamed and swollen, which means less room to maneuver and a higher chance of accidentally puncturing the eardrum. A ruptured eardrum during an active infection opens a direct path for bacteria to reach the middle and inner ear, potentially causing hearing damage.
Beyond the perforation risk, swabbing tends to push wax and infected debris deeper into the canal rather than removing it. This can trap bacteria closer to the eardrum and make the infection harder to treat. If you feel drainage or buildup, gently wipe the outer ear with a clean cloth and let your doctor handle anything deeper.
Don’t Try Ear Candling
Ear candles are hollow cones of fabric coated in wax, lit on one end while the other is inserted into the ear canal. Proponents claim the flame creates suction that draws out wax and infection. The FDA considers these products dangerous, noting that holding a lit candle near a person’s face carries a high risk of severe skin and hair burns as well as direct ear damage. There is no evidence that ear candling creates meaningful suction or removes anything from the ear canal. What it can do is drip hot wax onto the eardrum, cause burns to the face and outer ear, and push debris further inside. During an active infection, adding heat and foreign material to an already compromised ear canal is especially risky.
Don’t Use Ear Drops Without Knowing Your Eardrum Is Intact
Over-the-counter ear drops seem harmless, but certain ingredients can cause permanent hearing loss if they reach the middle ear through a hole in the eardrum. When the eardrum is intact, topical drops stay in the outer canal where they belong. But ear infections sometimes cause small perforations you can’t see or feel, and if drops seep through, the consequences can be serious.
The ingredients that pose the greatest risk belong to a class of antibiotics called aminoglycosides, found in some prescription and combination ear drops. Documented cases show that patients who used drops containing gentamicin or neomycin while they had eardrum perforations developed permanent high-frequency hearing loss and balance problems. In one case series, six out of nine patients developed damage to the balance organs on one side, and three had damage on both sides. Some of these patients had used the drops for as little as ten days.
If you have any drainage coming from your ear, a history of ear tubes, or aren’t sure whether your eardrum is intact, don’t use any ear drops until a clinician has looked inside. Safer alternatives exist when a perforation is confirmed, but that’s a decision for your provider.
Don’t Get Water in the Infected Ear
Water sitting in the ear canal creates the perfect environment for bacteria to multiply. This is the exact mechanism behind swimmer’s ear (outer ear infection), and introducing moisture to an ear that’s already infected makes things worse regardless of whether the infection is in the outer or middle ear. The CDC recommends keeping ears as dry as possible during and after any ear infection.
When showering, place a cotton ball coated in petroleum jelly over the ear opening to create a water-resistant seal. Avoid swimming entirely until the infection has cleared. If water does get in, tilt your head to the affected side and gently pull your earlobe to help it drain, then dry the outer ear thoroughly. Don’t use a hair dryer on high heat close to the ear, as this can irritate inflamed tissue.
Don’t Fly If You Can Avoid It
Air travel during an ear infection significantly raises your risk of ear barotrauma. Normally, the narrow tubes connecting your middle ears to your throat equalize pressure during altitude changes. An ear infection causes congestion and inflammation that can block these tubes entirely, trapping pressure differences that stretch or even rupture the eardrum. In rare cases, fluid may ooze from the ear during a flight, signaling a rupture that could require surgical repair.
If you absolutely must fly with an ear infection, take a decongestant before the flight, chew gum during takeoff and descent, and swallow or yawn frequently to encourage your pressure-equalizing tubes to open. For babies and toddlers with ear infections, offering a bottle or sippy cup during altitude changes encourages the swallowing that helps equalize pressure. But postponing the trip is the safest option when possible.
Don’t Ignore Symptoms That Get Worse
Most ear infections improve within a few days, either on their own or with treatment. But an infection that spreads to the mastoid bone (the hard bump behind your ear) becomes a medical emergency. Untreated mastoiditis can lead to meningitis, brain abscess, and dangerous blood clots in the veins near the brain. Intracranial complications occur in 6 to 23% of mastoiditis cases.
Watch for these warning signs that an ear infection is progressing beyond the ear itself:
- Swelling, redness, or tenderness behind the ear that pushes the ear forward
- High fever that develops or spikes after the first couple of days
- Severe headache, stiff neck, or confusion, which suggest the infection may have reached the brain or its lining
- Facial drooping on the affected side, caused by the infection compressing the facial nerve
- New dizziness or ringing in the ear, which can signal spread to the inner ear’s balance and hearing structures
Any of these symptoms warrants immediate medical attention, not a wait-and-see approach.
Don’t Demand Antibiotics Too Quickly
Not every ear infection needs antibiotics right away. For children older than 23 months who are otherwise healthy, have mild pain controlled by a pain reliever, fever below 102°F, and symptoms lasting less than 48 hours, current guidelines support a period of watchful waiting. Children between 6 and 24 months may also be observed first if only one ear is infected. Many of these infections are viral and will resolve without antibiotics.
Unnecessary antibiotic use contributes to resistant bacteria, can cause side effects like diarrhea and allergic reactions, and doesn’t speed recovery when the infection isn’t bacterial. Pain management with over-the-counter pain relievers is appropriate during the observation window. If symptoms worsen or don’t improve within 48 to 72 hours, that’s when antibiotics become the right call.
Don’t Sleep on the Infected Side
Lying flat increases pressure in the middle ear, and lying directly on the infected ear makes it worse. One study found that people with eardrum perforations had measurably higher middle ear pressures when lying down compared to sitting upright. This extra pressure intensifies pain and can slow drainage.
If one ear is infected, sleep on the opposite side so the affected ear faces up, allowing fluid to drain naturally. Propping yourself up on an extra pillow or two also helps reduce pressure. If both ears are infected, sleeping on your back with your head elevated is the most comfortable option. These small adjustments won’t cure the infection, but they can make a noticeable difference in pain levels overnight.
Don’t Pour Unproven Remedies Into the Ear
Garlic oil, hydrogen peroxide, rubbing alcohol, and essential oils all circulate as home treatments for ear infections. While one small study found that a specific naturopathic formula containing garlic, mullein, calendula, and St. John’s wort in olive oil reduced ear pain comparably to anesthetic drops, pain relief is not the same as treating an infection. These preparations were also used on confirmed intact eardrums under medical supervision.
Pouring homemade concoctions into an infected ear carries real risks. Alcohol and hydrogen peroxide can burn inflamed tissue and destroy the delicate skin lining the ear canal. Oils can trap bacteria and block drainage. Any liquid introduced to an ear with an undetected perforation has a path to the middle and inner ear, where even mild irritants can cause lasting damage. Stick with pain relief you take by mouth and leave the ear canal alone until a professional has assessed it.