Skin, ears and urinary
Earache & middle ear infections
For earache, blocked ears and ear discharge
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Earache & middle ear infections
We treat earache, blocked ears, ear discharge and more. We also often see children with middle ear infections.
Why it happens
Middle ear infections occur when bacteria or viruses from the nose or throat pass through the Eustachian tube (the tube connecting the ear and nose) into the middle ear and cause inflammation. Children's Eustachian tubes are short and nearly horizontal, which is thought to make middle ear infections more likely after a cold. Other causes of earache or a blocked feeling include earwax buildup, inflammation of the ear canal (which can occur after swimming) and changes in air pressure.
What's happening in the body
From the outside in, the ear is divided into the outer ear, middle ear and inner ear. Outer ear infection is inflammation of the skin of the ear canal. When the skin is damaged by swimming or cleaning the ears, or stays damp because water remains, bacteria and fungi multiply and cause inflammation. Middle ear infection occurs when bacteria or viruses enter through the Eustachian tube, which connects the back of the nose to the middle ear. That's why it often follows a cold. When pus builds up in the middle ear, it presses on the eardrum and causes severe pain. Ear discomfort when flying happens when the Eustachian tube can't adjust to changes in air pressure, creating a pressure difference on either side of the eardrum. With nasal symptoms, inflammation makes the lining swell and blocks the passages of the nose and sinuses, causing congestion and a heavy feeling in the face.
Main symptoms
- Earache (throbbing, worse at night)
- Blocked feeling in the ear, difficulty hearing
- Ear discharge (pus or fluid)
- With fever (especially in children)
- Ringing in the ears
- In young children: touching the ear, fussiness, or crying that won't stop
- May come with dizziness
When you can wait and see
What you can do yourself
- Cool the painful area and rest with your upper body slightly raised
- Be careful not to get water in the ear when bathing or swimming
- Don't poke deep into the ear with cotton buds or similar
- Don't blow your nose hard; blow gently, one side at a time
- Ease the pain with prescribed painkillers
Please consult us
If any of the following apply
- You have earache or a blocked feeling in your ear
- There's discharge from your ear
- Your child keeps touching their ear
Seek care right away
If any of the following apply
- Red, painful swelling behind the ear, or the ear pushed forward
- High fever with severe headache, stiff neck or vomiting
- Difficulty moving one side of the face (possible facial nerve paralysis)
- Dizziness so severe you can't stand, or drowsiness and confusion
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Outer ear infection
Hurts when the ear is pulled, often after swimming or cleaning the ears
We consider keeping the ear dry and treatment as needed
Middle ear infection
Severe earache and fever after a cold, with a blocked feeling in the ear
We decide on treatment after checking the eardrum
Barotrauma (airplane ear)
Ear pain and a blocked feeling during takeoff and landing
If it keeps happening, ask us about prevention in advance
Allergic rhinitis
No fever, clear nasal discharge and sneezing, with itchy eyes
We identify the cause and consider anti-allergy medication
Sinusitis
Colored nasal discharge and facial pain or pressure lasting 10 days or more after a cold
Please consult us if it goes on for a long time
Sudden hearing loss
Suddenly finding it hard to hear in one ear
Early treatment is recommended. Please consult us urgently
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- Onset to day 2
Pain and the blocked feeling get stronger
The basics are keeping water out of the ear and not blowing your nose hard
- Days 3–7
With proper care, it often starts to improve at this stage
Please consult us if the pain gets worse or the fever continues
- 1–2 weeks
Symptoms settle, but a blocked feeling may remain
Fluid may remain in the middle ear, so a follow-up check is useful
- If it goes on for a long time
If hearing difficulty continues, it needs to be assessed
In children especially, hearing problems can affect language development
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
People swim a lot all year round in this region, so outer ear infections (swimmer's ear) are common. Getting into the habit of gently drying your ears after swimming may help.
An examination with an otoscope is often needed, so it may be hard to assess online alone. It's reassuring to check in advance about local ENT services and whether Japanese support is available.
Many people don't know where to go when ear pain starts suddenly at night or on a holiday. We recommend knowing your emergency contacts in advance.
In some countries, ear drops and antibiotics are easy to get at local pharmacies, but some medications can't be used depending on the condition of the eardrum, so it's best not to decide on your own.
Care
What Cotovia can do
- Assessing your symptoms through a consultation
- Prescriptions for antibiotics, painkillers and ear drops (prescribing is at the doctor's discretion)
- Referral to in-person care if the inside of the ear needs to be checked
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Ear examination
Checking the ear canal and eardrum
Nasal examination
Checking swelling of the lining and the state of secretions
Hearing test
Assessing how well you can hear
Allergy blood test
Identifying the cause of nasal symptoms
Treatment options
Ear drops and topical medication
Reduces inflammation of the outer ear
Which medications can be used depends on the condition of the eardrum. Please don't use them on your own
Antibiotics
Used when a bacterial infection is suspected
Not every middle ear infection needs them. The doctor decides whether they are needed
Antiallergy medication and nasal sprays
Eases nasal symptoms
Clearing the nose can help improve ear symptoms
Changing how you blow your nose
Prevents spread to the middle ear
Blowing one side at a time, not too hard, is recommended
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Your medication record and the medication you take
What to tell us
- When it started, and which ear or side of the nose
- Whether you've been swimming or flying
- Whether you have a fever
- Whether you have hearing difficulty, ringing in the ears or dizziness
- Whether you've had the same symptoms before
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Prevent colds and treat a blocked nose early
- Avoid secondhand smoke (it increases the risk of middle ear infections)
- Gently dry your ears after swimming in a pool or the sea
- On flights, clear your ears by yawning or swallowing when the pressure changes
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Children
Signs include touching the ear, being fussy or responding slowly when called. Hearing problems can affect language development
People who fly often
Flying with a blocked nose makes ear pain more likely. Ask us about prevention in advance
People who often swim in pools or the sea
Keeping your ears dry after swimming helps prevent outer ear infections
People with dizziness
It may be an inner ear problem or have another cause. Please tell us about it too
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QMy child has earache at night.
You can start by asking us how to ease the pain. If the inside of the ear needs to be checked, we may guide you to in-person care the next day or later.
QCan a middle ear infection be diagnosed online?
We can assess the likelihood from how symptoms have developed, but checking the eardrum requires an in-person examination. We'll refer you to a medical facility as needed.
QMy ears hurt when I fly.
It may be related to how the Eustachian tube responds to changes in air pressure. It's more likely when your nose is blocked, and you can ask us about prevention in advance.
Common misconceptions
Myth Cleaning your ears often keeps them clean
Fact Earwax protects the ear canal, and cleaning too much can damage the skin and cause inflammation
Myth Wipe out water in your ear with a cotton bud
Fact Putting a cotton bud deep in the ear damages the skin. Tilting your head to let the water drain naturally is recommended
Myth Blowing your nose hard clears it better
Fact Blowing hard can push germs from the back of the nose through the Eustachian tube into the middle ear. Blow gently, one side at a time
Myth Earache will go away if you put up with it
Fact Leaving a middle ear infection untreated can have a lasting effect on hearing
Myth If your hearing suddenly gets worse, you can just wait and see
Fact Early treatment is recommended for sudden hearing loss. How much time passes can affect the outcome
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE