What Causes Ear Infections in Adults?

Two Main Types of Ear Infections

Close-up of ear
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There are two main categories of ear infections that adults can develop -- acute middle ear infections, and outer ear infections. Most ear infections in adults are outer ear infections (otitis externa), but middle ear infections (otitis media) can occur.

Otitis Externa (Swimmer's Ear) in Adults

Outer ear infections are also called swimmer's ear, because it commonly affects swimmers. It occurs when contaminated water enters the outer ear, allowing germs to grow and thrive due to warm, moist conditions.

Symptoms of swimmer's ear include:

  • ear redness
  • itchiness inside the ear
  • flaking of the skin on the ear
  • drainage from the ear which may be pus
  • pain when moving the head or touching the ear
  • fever

Swimmer's ear is fairly easy to diagnose and usually treated with antibiotic ear drops, like Ciprodex. Sometimes pus and debris will need to be cleaned out by your physician. You can prevent swimmer's ear by using ear plugs before swimming or bathing, gently drying your ears with a blow dryer on the lowest setting after swimming or bathing, not inserting objects in the ears, and not swimming in polluted water.

Otitis Media (Middle Ear) Infections in Adults

Middle ear infections are most common in children due to the anatomical difference in the shape and size of the Eustachian tube, the tube that runs from the ear canal to the back of the throat. When fluid or bacteria become trapped inside the ear, an infection can occur.

Adults who have frequent middle ear infections should see an ENT doctor because surrounding tissues in the nose or throat could be blocking the Eustachian tube and preventing drainage. Ear infections often occur after you've had a cold virus, a bout with seasonal allergies, or after flying on an airplane.

It can also be caused by sticking foreign objects, such as Q-tips, in the ear. Symptoms of a middle ear infection include:

Many factors can predispose you to developing an ear infection. Understanding why you are prone to developing a middle ear infection will help you not only treat the ear infection, but also avoid recurrent ear infections in the future. Factors that increase your likelihood of acquiring an ear infections includes:

  • craniofacial (head/face) abnormalities
  • enlarged structures in the ear or throat (such as turbinates)
  • immune system deficiency
  • upper respiratory illnesses (particularly viruses)
  • allergies

Many of the above mentioned risk factors affect the ability of the Eustachian tube to properly function. Middle ear infections in adults are often treated with oral antibiotics. However, recurrent ear infections caused by enlarged structures in the ear or throat, such as (tiny bones inside of the nose), or nasal polyps may have to be surgically removed or reduced in size.

Other methods that you can use to prevent future infections include:

While it is unusual for adults to get ear infections, they can usually be treated without complications. Consult your doctor to come up with a treatment plan that's best for you.


Baylor College of Medicine. Eustachian Tube Dysfunction. Accessed: July 3, 2009 from http://www.bcm.edu/oto/jsolab/eust_tub.htm

CDC. "Swimmer's Ear" Otitis Externa. Accessed: July 3, 2009 from http://www.cdc.gov/healthyswimming/swimmers_ear.htm

Kerschner, J.E. & Preciado, D. (2016). Nelson Textbook of Pediatrics: Otitis Media. Accessed on 5/7/2016 from www.clinicalkey.com (subscription required)

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