Earache and Ear Infection Online Doctor: When to See a GP and What Helps
Earache has a way of taking over your day. It's the kind of pain that wakes children at 2am, ruins meetings, and makes you wonder whether to push through or seek help. If you're reading this with a heat pack against the side of your head, the answer is usually "see a GP sooner rather than later". Earache is rarely something to ignore, and when an earache doctor assesses it early, decisions about pain relief, fluid in the middle ear, and antibiotics tend to be cleaner. This guide explains what's likely going on, what helps at home, when to seek urgent help, and what telehealth can and can't do for ears. If this is a medical emergency, call 000 immediately.
The ear has three parts, and pain in any of them (or pain referred from nearby structures) can show up as "an earache". The cause changes the management, so it's worth being precise about what's likely going on.
Outer ear (otitis externa). This is inflammation of the ear canal, often called "swimmer's ear". The ear canal becomes inflamed and sometimes infected, usually after water exposure, hot humid weather, or trauma from cotton buds. The pain is typically worse when you tug on the earlobe or chew. The ear canal may look red and swollen, and there's sometimes a discharge. According to healthdirect, otitis externa is common in Australian summers but can occur year-round.
Middle ear (otitis media). This is the classic "ear infection" most parents recognise. Fluid builds up in the middle ear, often after a cold, and bacteria or viruses cause inflammation. Symptoms include deep ear pain, fever, hearing change, and in children, irritability and pulling at the ear. Acute otitis media is one of the most common presentations to GPs in young children.
Inner ear. Inner ear problems present more often as dizziness, vertigo or hearing change than pure earache. Conditions like vestibular neuritis or Meniere's disease are less common but more serious.
Referred pain. Sometimes the ear is fine and the pain is coming from elsewhere: the jaw joint (TMJ dysfunction), a sore throat, dental problems, sinusitis, or in older adults occasionally something more serious. A good earache assessment includes the surrounding structures.
The reason this matters: outer-ear and middle-ear infections are managed very differently, and "ear pain that's actually a sore throat" needs a different plan again. A GP consult, in person or online, is how that gets sorted.
Earache is one of the most common reasons children see a GP. The Royal Children's Hospital fact sheet on ear infections is a useful resource for parents.
In children under two, middle-ear infections are common: eustachian tubes are shorter and more horizontal, which makes fluid build-up more likely. A non-verbal toddler with a middle-ear infection may not say "my ear hurts". The signs to watch for are unsettled sleep, pulling or rubbing at the ear, fever, fussiness around feeding, and sometimes fluid or pus visible at the ear. Children under 2 with significant ear pain or fever should be seen sooner rather than later. Telehealth is a reasonable starting point but in-person otoscopy is often needed.
In school-aged children, middle-ear infections are still common, often following a cold. Many cases settle without antibiotics within 48-72 hours. Pain relief is the priority. Recurrent or severe episodes warrant GP follow-up and sometimes ENT input.
In teenagers and adults, the picture shifts. Outer-ear infections (swimmer's ear) become more common, particularly in summer. Middle-ear infections still occur but are less frequent than in young children. Adult earache that's persistent, severe, or accompanied by hearing loss in one ear is worth taking seriously, especially in older adults.
A general rule: in any age group, earache that's not improving over 48-72 hours, or that's severe, or that comes with red-flag features below, deserves a GP review.
Most mild earaches will improve with simple measures while you decide whether you need to be seen. The healthdirect ear infection guidance lists the standard supportive measures.
Pain relief. Paracetamol and ibuprofen, both available over the counter (Schedule 2) for most adults and children, are the mainstays. Use age-appropriate doses, follow the packet instructions, and don't double up across products. For most people these are far more effective than people expect. If you're caring for a young child, the Royal Children's Hospital pain management guidance is a good reference.
Warm compress. A warm (not hot) flannel held against the affected ear can be soothing. Wrap it well and keep it warm rather than hot.
Elevation. Sleeping with the affected ear up, propped on pillows on the unaffected side, can ease middle-ear pressure and help children sleep.
Hydration. Plenty of fluids if there's fever, particularly in children. Check for wet nappies in babies as a hydration marker.
Avoid putting anything in the ear. No cotton buds, no ear candles, no home-made drops. The ear canal is delicate, and "DIY" ear care has caused more punctured eardrums than it has fixed earaches. If you swim regularly and get repeat outer-ear infections, your GP can advise on prevention strategies.
Rest and time. Many earaches are viral and self-limiting. The right plan for a mild earache is often pain relief, rest, and a 24-48 hour review.
What home care can't do is make a clinical assessment of whether antibiotics are needed, whether the eardrum is intact, or whether there's an alternative cause. That's the point at which a GP consult earns its keep. Bulk billed for eligible patients with a valid Medicare card. Strict eligibility criteria apply.
Most earaches are not emergencies, but some warrant prompt attention. See a GP urgently (or attend an emergency department) if any of the following apply:
- High fever in a child, particularly under 2 years.
- Severe pain not relieved by paracetamol or ibuprofen.
- Sudden hearing change or sudden hearing loss in one ear.
- Dizziness, vertigo, balance change alongside the earache.
- Fluid or blood draining from the ear: this can indicate a perforated eardrum or significant infection.
- Significant swelling, redness or pain behind the ear (over the mastoid bone): this can be a sign of mastoiditis, which is uncommon but serious.
- Confusion, severe headache, neck stiffness, or repeated vomiting alongside the earache: these can indicate spread to surrounding structures.
- A child under 2 with significant ear pain or fever.
- Anyone who is immunocompromised: diabetes, chemotherapy, immunosuppressant medications.
- Swimmer's ear that's worsening despite pain relief, or with significant swelling of the ear canal.
If symptoms escalate rapidly, call 000 or attend your nearest emergency department. For winter respiratory symptoms alongside the earache, see our companion guide on cold and flu and the online doctor. For after-hours questions, our piece on after-hours doctor services is a good starting point.
This is the question most patients want a clear answer to, and the honest answer is: not every ear infection needs antibiotics, and the decision belongs to a clinician who's assessed you.
In adults, many cases of acute middle-ear infection are viral and resolve without antibiotics. In children, evidence-based guidelines from the Therapeutic Guidelines and reviewed by the RACGP support a "watchful waiting" approach for many mild-to-moderate cases: pain relief and review in 48 hours, with antibiotics reserved for specific situations like children under 6 months, severe symptoms, bilateral infection in young children, perforation with discharge, or those not improving on review.
When antibiotics are appropriate, GPs choose first-line antibiotics based on the likely organism, your allergy profile, and current Australian prescribing guidelines. We don't name those medicines here because the right choice is a clinical decision and varies by patient. The GP will explain what they've prescribed, how to take it, what side effects to watch for, and when to follow up.
Outer-ear infections (otitis externa) are usually treated topically rather than with oral antibiotics, often combined with cleaning of the ear canal. Again, the right approach depends on the assessment.
The principle behind this is antibiotic stewardship, championed in Australia by NPS MedicineWise. Antibiotics save lives when they're needed, and prescribing them when they're not contributes to resistance, which makes them less effective for everyone. A good clinician will explain why they have, or have not, prescribed antibiotics, and that explanation is part of caring for you, not gatekeeping.
See a GP about your earache
Telehealth has limitations for ears that are worth being honest about. A GP cannot perform otoscopy (looking inside the ear canal at the eardrum) over a video call. That is the single most useful examination for distinguishing outer-ear from middle-ear infection.
What a telehealth GP can do is substantial:
- Take a careful history of the symptoms and timeline.
- Assess your overall clinical state: fever, fluid intake, energy, breathing.
- Look at the outer ear, the area behind the ear, and the side of the face on video.
- Review your past medical history, current medications, and any recent investigations.
- Provide pain-relief advice, prescribe topical or oral medications when clinically appropriate, and arrange an in-person review or otoscopy if needed.
- For follow-up of a previously diagnosed ear infection, telehealth can confirm whether things are settling or whether a different plan is needed.
A reasonable rule of thumb: telehealth is well-suited for assessing whether you need to be seen in person, for follow-ups, for clearly mild cases, and for organising pain relief and a medical certificate if needed. For moderate or severe earaches in young children, for new severe pain in adults, for any of the urgent red-flag features above, an in-person assessment with otoscopy is usually the right next step. A good telehealth GP will say so honestly.
Abby Health is an online-first clinic where Australian GPs see earache and ear infections every day. Bulk billed for eligible patients with a valid Medicare card. Strict eligibility criteria apply.
In a typical earache consult, the GP will take a full history, ask about timeline and severity, assess fever and overall state, look at what can be seen on video, review your record, and make a clinical plan. If antibiotics are appropriate, they'll be prescribed via Medicare-rebated electronic prescribing. If pathology, imaging or in-person otoscopy is needed, the GP will arrange it. If it's a mild self-limiting case, you'll leave with a clear pain-relief plan and a safety-netting conversation about when to come back.
300+ clinicians available seven days a week (Abby Health internal data, Q1 2026), Australia's largest online-first clinic (Abby Health internal data, Q1 2026), with same-day appointments available most days. Three in four patients see the same doctor again on follow-up, a 71% rebook rate (Abby Health internal data, Q1 2026), which matters for ear infections that need a 48-72 hour review.
Bulk billed for eligible patients with a valid Medicare card. Strict eligibility criteria apply. To book, see schedule an appointment or our piece on what is bulk billing in Australia. For winter respiratory symptoms, see cold and flu online doctor. If this is a medical emergency, call 000.
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