Ear pain? Here’s why OTC eardrops may be futile for viral infection (2024)

• Written by Nandita Narayanan

Former airline operations manager Sunita Ranjit Pillai, 42, had flown down from the US with her kids to visit their hometown in Ernakulam, Kerala for the summer. After visiting places and returning home, her four-year-old daughter, Krishna, couldn’t stop wailing and had her ears covered at most times indicating ear pain. “Since we were in a remote area, meeting a doctor would have taken a long time. I resorted to using over-the-counter ear drops in her ears that (OTC) I had on me to stop the crying. Krishna stopped crying,” she explains. A few hours later, she started crying again and she developed a high fever with a cold the next day. They visited the doctor andKrishna was diagnosed with viral fever and was taking medication. Her ear pain also subsided the next day, and her fever took a few more days to subside.

A child experiences ear pain predominantly for two main reasons: a cold/viral infection or a bacterial/fungal infection. Hence, parents would not be able to differentiate between the two infections and would opt to use OTC ear drops, which are ineffective in case of viral infection.

Most parents procure over-the-counter ear drops to temporarily ease their child’s ear pain when they are down witha cold or fever. Experts stress that this quick fix should not be considered a one-stop solution for persistent ear pain, even if it provides temporary relief. According to Dr Himanshu Batra, consultant, pediatrics at Manipal Hospital Dwarka, Delhi, OTC ear drops are ineffective because they can’t reach the middle ear as there is a membrane called the tympanic membrane (eardrum).

Why are OTC ear drops ineffective?

To understand why OTC ear drops are ineffective, especially during acommon coldor a fever, Dr Smita Nagaonkar, consultant and section coordinator, ENT, Sir H.N. Reliance Foundation Hospital, Mumbai, explains how ear pain is caused by the pressure from cold.

“Cold gets trapped in the ear when it travels from the nose and throat to the inner part of the ear through the Eustachian tube from behind the nose. When that tube gets blocked, the ear hurts. Inflammation and too much pressure behind the eardrum can worsen pain, when this trapped fluid gets infected. The infection occurs from behind the nose towards the ear, so the drops put in the front won’t reach the inner ear,” she explains.

Eardrops cannot reach the infection, so oral medication is the only way to treat ear pain. “We prescribe oral antibiotics or painkillers if we suspect an infection. Some nasal sprays are given to tackle the infection,” says Dr Himanshu.

When should OTC ear drops be used?

However, this does not mean that all eardrops are effective. Ear drops that contain antibiotic or anti-fungal properties prescribed by doctors are effective for eardrum or middle-ear-related concerns. “In cases of pus coming out of the ear along with pain,drops with antibiotic properties come into play,” explains Dr Nagaonka.

Dr Manjunath MK, senior consultant ENT surgeon, Gleneagles BGS Hospital, Bangalore, emphasizes that the doctormust investigate how the middle ear has been affected or why the pain is occurring. “A bacterial or fungal infection of the eardrum or ear pain due to excess earwax or any infection can be treated with antibiotics or anti-fungal ear drops,” he says

Do OTC ear drops have side effects?

Dr Nagaonkar explains that OTC can pose some risks if not used properly. “It is possible that parents may not be aware of a child’s ear pain caused by an acute infection and instead use eardrops that contain turpentine oil to clear ear wax, which may not be effective and may cause allergic reactions or symptoms like burning, itching or redness, or headaches,” she says. “It is important to confirm what is appropriate for what condition before using an ear drop. Using OTC to treat ear pain from a viral infection can exacerbate the pain and inflammation, and sometimes lead to a secondary infection as well,” she adds.

She also mentions that though OTC ear drops can be used to clear excessive earwax buildup, Dr Nagaonkar still insists on consulting a doctor before using them as parents may not be able to identify the root cause for the child’s ear pain.

Effective ways to relieve ear pain

Parents should first identify if their child has ear pain.“For children older than two years, it is necessary to touch around the ear to identify ear pain, as they cannot tell where the pain is happening and will cry,” Dr Himanshu explains. Parents are also advised not to use any type of ear drops to relieve pain and to see a doctor immediately to find out the cause.

Dr Manjunath advises using paracetamol syrup.“In case their kids experience ear pain at night or when they can’t access a medical expert, they must give them paracetamol syrup. They must, however, see the doctor the next day,” he adds.

Takeaways

• Over-the-counter (OTC) eardrops are not recommended by experts to relieve ear pain as they do not reach the middle ear.
• Ear pain that occurs during a cold and fever are treated through oral medication.
• Ear drops are only effective if there’s a bacterial or fungal infection
• Experts advise not to resort to ear drops that help to clear ear wax to treat ear infections.