Adult Earache in London: Infection, Wax or Something Else?

An ear that hurts can mean infection, wax, an irritated ear canal or pain referred from the jaw or teeth. Those need different treatments. Earache alone cannot tell you whether antibiotics or ear drops will help: a clinician needs to look in the ear, especially if hearing has changed or fluid is coming out. Severe pain with swelling behind the ear, new facial weakness or feeling very unwell needs urgent assessment. For straightforward adult earache in London, an in-person GP examination is usually more useful than a prescription by phone.

How can I tell what is causing the pain?

Pain deep in the ear after a cold, with fever or reduced hearing, may be a middle-ear infection. Pain when you pull the outer ear or press the small flap at its opening, especially after swimming, can point to an inflamed ear canal. Wax often gives a blocked sensation and reduced hearing, though it can also hurt. Jaw-joint pain, teeth and sore throat can all be felt in the ear even when the ear itself looks normal. These are clues, not a diagnosis. An otoscope examination lets a clinician see the ear canal and eardrum. NHS: ear infections

When is earache urgent?

Seek urgent help if you develop swelling around or behind the ear, discharge from the ear, new hearing loss, dizziness or vomiting, a very high temperature, or feel generally unwell. Get advice promptly if you have diabetes or a weakened immune system. New facial weakness, severe headache with confusion, or sudden hearing loss should not wait for a routine appointment. NHS: earache

If you are unsure how urgently you need care, use NHS 111. For a medical emergency, call 999. Private GP care is not a substitute for emergency services.

Do I need antibiotics?

Not automatically. Many ear infections settle without antibiotics. The right treatment depends on whether the problem is in the middle ear or ear canal, whether the eardrum is intact, and your general health. Ear canal infections may need prescribed drops rather than oral antibiotics; wax or referred jaw pain needs a different approach altogether. Do not put leftover drops, oil or cotton buds into a painful ear when there is discharge or a possible perforation. NHS: ear infections

NICE’s acute otitis media antibiotic guideline is written for children and young people, not a blanket rule for adults. That is another reason not to borrow an antibiotic rule from a child’s earache guide. NICE NG91

What can I do tonight while arranging an examination?

Paracetamol or ibuprofen may help if it is safe for you to take them. Hold a warm flannel against the ear. Keep water out if the ear is discharging, and do not push a cotton bud or another object into the canal. If the pain lasts more than 2 to 3 days, hearing changes, or symptoms worsen, get assessed. NHS: earache

What happens at an in-person appointment?

A GP asks when the pain began, whether there was a cold, swimming, jaw pain, discharge or hearing change, and checks the ear canal and eardrum with an otoscope. They may also look at the throat and jaw. You leave with a diagnosis or a clear next step, suitable pain relief, treatment if indicated, and advice on what to watch for. A phone call can help triage symptoms, but it cannot replace looking in the ear.

What does a private GP visit cost?

The value of an in-person assessment is not simply a prescription. It is knowing which part of the ear hurts, whether the eardrum is intact, and whether the pain is coming from somewhere else. The Online GP lists an in-person consultation in Marylebone at £220. A telephone consultation is £59, but a painful ear with hearing change or discharge may require an in-person examination. The clinician will discuss any separate tests or treatments before arranging them. See the in-person appointment or telephone appointment.

If you want help choosing the right appointment, contact the team or call +44 20 3951 3429. Do not wait for a private slot if the urgent signs above are present.

Frequently asked questions

Q: Can earwax cause earache?

A: Yes. Wax can cause a blocked feeling, discomfort and reduced hearing. An ear examination checks whether wax is the cause and whether the eardrum can be seen.

Q: Does an adult ear infection always need antibiotics?

A: No. The cause and site of the problem matter. Some infections settle, some ear canal infections need drops, and other causes of pain do not need antibiotics at all.

Q: Can a GP diagnose earache over the phone?

A: A phone consultation can assess urgency, but it cannot show the clinician your ear canal or eardrum. A new painful ear with discharge or hearing loss usually needs an in-person examination.

Q: When should I seek urgent help?

A: Get urgent advice for swelling behind the ear, discharge, new hearing loss, severe illness or symptoms that are getting worse. New facial weakness or sudden hearing loss should not wait for a routine appointment.

This is general information, not a personal diagnosis. Written and reviewed by the clinical team at The Wellness. Updated September 2026.