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Health education · EarsPrevention and overall health
Ear pain or a blocked feeling in the ear can have several causes. A middle ear infection, an outer ear infection and an earwax blockage can cause similar symptoms but need different care.
An ear exam makes it possible to tell them apart and choose the right treatment.
The ear
The outer ear includes the visible ear and the ear canal. The eardrum separates it from the middle ear, which is connected to the back of the nose and throat by the Eustachian tube.
Simplified diagram, not to scale.
Types of ear infections
An infection behind the eardrum, more common in children, especially after a cold.3 Most are caused by cold viruses. Before age 5, the Eustachian tube is shorter, narrower and more horizontal, which makes it easier for nasal secretions to move up.2
It affects the ear canal, in front of the eardrum. Water left in the ear or an injury, for example from a cotton swab, can cause it.2,5
A build-up of fluid behind the eardrum, without infection.2 This fluid can remain for weeks or months after a middle ear infection.1
Prolonged fluid behind the eardrum can affect learning and language development. Follow-up matters if a child’s hearing seems affected.2
Infection or earwax?
Earwax is normal: it cleans, lubricates and protects the ear canal. If it builds up and hardens, it can form a blockage.6
| Problem | Where is it? | Possible signs |
|---|---|---|
| Acute otitis media | Behind the eardrum | Pain, sometimes fever, often after a cold.3 |
| Otitis externa | In the ear canal | Pain when the ear is touched, swelling, sometimes discharge.2,5 |
| Glue ear | Fluid behind the eardrum | Reduced hearing, full ear, little pain.2 |
| Earwax blockage | Wax built up in the canal | Reduced hearing, ringing or buzzing, sometimes dizziness or pain.6 |
These clues are not enough to make a diagnosis. A blocked ear is not necessarily earwax: examining the canal and eardrum is essential.
Assessment
The professional asks how long symptoms have lasted and about pain, fever, discharge and hearing changes. Then they examine the canal and eardrum with an otoscope.
A red eardrum alone is not enough to diagnose acute otitis media.1 If hearing loss persists, an audiology assessment may be recommended.
Treatments
Antibiotics are not always needed. For a child 6 months or older who is mildly ill, with a fever under 39 °C, mild pain and good general condition, 24 to 48 hours of observation may be offered, with planned follow-up.1
An antibiotic is indicated in particular if the fever reaches 39 °C or higher in a child who seems quite ill, if pain is significant, if the eardrum is perforated with pus draining, or if the condition does not improve or worsens within 24 to 48 hours.1
Observation does not apply to babies under 6 months, children with weakened immunity, or those with ear tubes or repeated ear infections.1
Treatment often includes cleaning of the canal by a professional and drops suited to the cause (antibiotic, corticosteroid or acidic solution), while keeping the ear dry.5
If you have ear tubes or an eardrum that seems perforated, ask your pharmacist or the professional following you before using drops.3
Ear washing (irrigation) may be needed when the blockage causes symptoms. Beforehand, the wax can be softened with 2 or 3 drops of olive oil or mineral oil, morning and evening, for 3 to 7 days, or with a solution recommended by the pharmacist.6
Don’t try to remove it with a cotton swab or an object: this pushes the wax deeper into the canal.6
At home
These measures ease discomfort while the infection heals:3
Outlook
With treatment, symptoms of acute otitis media should ease within 24 hours and go away in 2 to 3 days.1 See a professional again if they do not improve after 3 days of treatment.3
Fluid can remain behind the eardrum for weeks or months. This does not mean the infection is still there.1 See a professional if hearing remains reduced.3
Most ear infections heal without problems. More rarely, the infection can spread to nearby structures:1
Repeated ear infections may require a specialist assessment.
Seeking care
If in doubt, Info-Santé at 811, option 1, can guide you.3
Go to the hospital without waiting if there is:3
Sudden hearing loss also needs care without waiting, even without pain. Don’t assume it is earwax: prompt care, ideally within 3 to 5 days, improves the chances of recovery.4
Prevention
A few habits protect the ears:
Middle ear and outer ear infections are not contagious, but the cold that often comes before a middle ear infection is. Handwashing reduces colds, and therefore ear infections.2 An ear infection is not, in itself, a reason to keep a child out of child care.2
Ear infections are among the common health problems the team can assess, depending on the situation. For a blocked ear, a nurse can also examine the ear, check whether there is an earwax blockage and wash the ear when it is indicated and safe.
If you have severe pain, fever, discharge, a known perforated eardrum or ear tubes, contact the clinic before booking an ear wash.
This sheet provides general information and does not replace an assessment by a health professional. Published October 29, 2026.
