For most earaches, over-the-counter pain relievers like ibuprofen or acetaminophen are the fastest and most effective first step. These won’t cure an underlying infection, but they’ll reduce pain and inflammation while your body fights it off or while you decide whether you need medical care. Beyond pain relievers, what else you should take depends on what’s causing your ear pain.
Over-the-Counter Pain Relievers
Ibuprofen (Advil, Motrin) is often the best first choice because it reduces both pain and inflammation. Acetaminophen (Tylenol) works well for pain alone. You can use either one following the label directions, and for severe earaches, some people alternate between the two since they work through different mechanisms. For children, use the pediatric versions and dose by weight, not age.
These medications typically start working within 20 to 40 minutes and can make a significant difference, especially for nighttime ear pain that disrupts sleep. Don’t skip them in hopes that antibiotics alone will handle the problem. Pain relief is a core part of earache treatment regardless of the cause.
Warm Compresses for Quick Relief
A warm compress held against the ear provides surprisingly effective relief while you wait for pain medication to kick in. Use a warm water bottle, a heating pad set on low, or a warm damp cloth placed over the affected ear. There’s no strict time limit, but avoid falling asleep with a heating pad against your skin. Many people find that alternating 15 to 20 minutes on and off works well.
Numbing Ear Drops
Some pharmacies sell ear drops containing benzocaine, a topical anesthetic that numbs the ear canal. These can offer temporary relief, but they come with important safety concerns. The FDA has warned that benzocaine can cause a rare but serious condition that reduces the oxygen-carrying capacity of your blood. Products containing benzocaine should not be used on children younger than 2 years old. For older children and adults, follow label directions carefully and treat these as a short-term bridge, not a long-term solution.
Never put any drops in your ear if you see fluid draining from it or suspect a ruptured eardrum. That drainage could mean there’s a hole in the eardrum, and drops can pass through into the middle ear and cause further problems.
When Ear Pressure Is the Problem
If your earache feels more like pressure or fullness, especially during a cold or after flying, the issue is likely a blocked tube that connects your middle ear to the back of your throat. In this case, pain relievers alone won’t address the root cause.
Nasal decongestant sprays containing oxymetazoline (Afrin) or phenylephrine (Neo-Synephrine) can help open that tube and relieve the pressure. These are particularly useful for flying with a cold: use the spray about an hour before takeoff and again an hour before descent on longer flights. The critical rule is to limit use to 3 days or fewer. Beyond that, your body becomes dependent on the spray and congestion rebounds worse than before.
Swallowing, yawning, and chewing gum also help equalize ear pressure. For young children who can’t do these on command, offering a bottle or pacifier during altitude changes accomplishes the same thing.
Earwax Buildup
Sometimes what feels like an earache is actually impacted earwax pressing against the eardrum. Over-the-counter earwax removal drops containing 6.5% carbamide peroxide can soften and help break up the blockage. Use them twice daily for up to four days. If the problem persists beyond that, see a doctor for professional removal rather than continuing to treat it yourself.
Don’t use cotton swabs to dig out wax. They push wax deeper and can scratch the ear canal or puncture the eardrum.
What About Antibiotics?
Many people assume an earache means they need antibiotics right away, but that’s not always the case. A significant number of ear infections are viral, and antibiotics do nothing against viruses. Even bacterial ear infections often resolve on their own within a few days.
The CDC supports a “watchful waiting” approach for children 6 months and older when symptoms have lasted less than 2 days, the pain is mild, and the temperature stays below 102.2°F. This means managing symptoms with pain relievers for 2 to 3 days to give the immune system time to clear the infection before resorting to antibiotics. If symptoms don’t improve or worsen within that window, antibiotics are typically prescribed.
For adults, the same general principle applies. Most ear pain from a cold or upper respiratory infection will resolve as the illness passes. Antibiotics are reserved for cases where symptoms are severe, persist beyond a few days, or involve high fever.
Swimmer’s Ear Is Different
If the pain started after swimming, showering, or spending time in humid conditions, and it gets worse when you tug on your outer ear, you likely have swimmer’s ear (an infection of the ear canal rather than the middle ear). This type of infection typically requires prescription ear drops that combine an anti-inflammatory steroid with an acidic solution to kill bacteria. Over-the-counter swimmer’s ear prevention drops can help dry out the ear canal after water exposure, but once an infection has set in, you’ll need a prescription.
While waiting to see a doctor, pain relievers and warm compresses are your best tools. Keep water out of the affected ear.
Olive Oil and Home Remedies
Warm olive oil dropped into the ear is a traditional remedy that some people find soothing. There’s limited clinical evidence that it treats the underlying cause of ear pain, but it can soften earwax and may provide mild comfort. The key safety concern: never put olive oil or any other liquid in your ear if you have or suspect a perforated eardrum. Signs of perforation include sudden sharp pain followed by relief, fluid draining from the ear, or a noticeable drop in hearing.
Sleep Position Matters
Earaches tend to feel worse at night, partly because lying flat increases pressure in the middle ear. Elevating your head with an extra pillow can reduce that pressure. If only one ear hurts, sleeping on the opposite side keeps the painful ear facing up, which is generally more comfortable and may promote better drainage. A small study found that middle ear pressure is measurably higher when lying down compared to sitting upright, which explains why nighttime earaches can feel so much worse than daytime ones.
Signs You Need Medical Attention
Most earaches are manageable at home for a few days, but certain symptoms signal something more serious. The American Academy of Otolaryngology identifies these red flags: blood or pus draining from the ear, sudden or rapidly worsening hearing loss, dizziness or vertigo accompanying the ear pain, ringing in only one ear, or a fever reaching 102.2°F or higher. Any of these warrants prompt medical evaluation rather than continued home treatment.
For children under 6 months, ear pain should always be evaluated by a doctor rather than managed at home. The same goes for earaches that persist beyond 2 to 3 days without improvement, regardless of age.