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Fungal ear infection: Causes & treatment

Last update on Oct, 03, 2024
Dr. Tom Tedeschi

Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

Fungal ear infections, also known as otomycosis, affect the outer part of the ear in the ear canal. This type of infection is most common in people who have compromised immune systems, those who live in climates with high humidity, and swimmers. Get to know common symptoms and ways to treat and prevent otomycosis.

What is a fungal ear infection?

A fungal ear infection, also known as otomycosis, is an infection of the ear canal. They are generally limited to the ear canal, but they can affect the middle ear in rare cases. While otomycosis is typically not severe, it can be a recurring problem

What are the symptoms of a fungal ear infection?

The most common fungal ear infection symptoms are:

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What causes a fungal ear infection?

A fungal ear infection happens when the delicate balance of microbes in the ear canal is disrupted, which can be caused by both internal or external factors—or even a combination.

A warm, humid climate is the most common external factor for getting fungal ear infections. Swimming and other water-based activities can also cause them; exposure to water without protection has the potential to introduce fungi into the ear canal and eardrum (also known as the tympanic membrane).

Injuries to the skin of the ear canal can also cause a fungal ear infection; they could be caused by frequent headphone use, ear plugs, using hard objects to scratch the ear or hearing aids with an occlusive earmold.

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Prevention is key

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Who is at risk of getting a fungal ear infection?

Fungal ear infections are common in people of all ages because the ear canal provides an ideal environment for fungi to grow. However, there are some factors that could make you more likely to get one. Immunocompromised people are more likely to develop otomycosis and complications of the infection. People with diabetes, lymphoma or AIDS or those undergoing chemotherapy or radiation therapy have a higher fungal ear infection risk.

How do you get diagnosed with a fungal ear infection?

Learning how to diagnose a fungal ear infection is necessary in treating the infection effectively—but it’s best done by a professional. An ear exam performed by a doctor or other healthcare provider is the first step in getting an accurate diagnosis. Lab tests are also used to identify the fungi most commonly found in otomycosis (Aspergillus and Candida)—and that will confirm the diagnosis.

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How to treat a fungal ear infection

There are a number of ways to treat fungal ear infections, from home remedies to medicine to medical procedures. There is no single best treatment for otomycosis and the following list of remedies may be used in combination—but be sure to ask your doctor first.

It’s important to note that it is common for these infections to recur and, to avoid that, you should seek medical care that can identify and treat the underlying causes. Read on for a list of remedies.

Removing debris and fungal matter can be an effective first step in treating a fungal ear infection. An ear rinse is a cleaning of the ear canal using swabs, a syringe or a suction. This is a procedure that can only be performed by a trained doctor, nurse or audiologist with ear care training. 

Your doctor might prescribe antifungal medications to clear up a fungal ear infection. A course of oral antifungal medication can be especially effective for more acute cases of otomycosis, particularly if the eardrum is perforated. It’s important to take the full dose of your fungal ear infection medicine, even if the symptoms clear up, to prevent the infection from coming back.

Ear drops are often an effective treatment, especially in combination with some of the other treatments in this list. Like the antifungal medication listed above, it’s important to use the ear drops for fungal ear infections exactly as prescribed by a doctor.

In many cases, a doctor may prescribe a cream or ointment to help cure a fungal ear infection. Clotrimazole is the most widely used topical cream with a high success rate, and it also helps to prevent recurrence. You may need to use this cream for a few days or up to four weeks.

A fungal ear infection home remedy may be appropriate in mild cases. Some options that may be effective include diluted hydrogen peroxide, carbamide peroxide or a rubbing alcohol and white vinegar mixture. However, it’s still best to consult with a medical professional before using any kind of home remedy. Without confirmation from a medical professional that an infection is bacterial, it can be difficult to treat the problem effectively. 
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Experiencing symptoms of otomycosis?

If you’re noticing symptoms of bullous myringitis, visit your doctor.

How do you prevent fungal ear infections?

Some factors that lead to fungal ear infections might be out of your control, like narrow ear canals, needing to wear hearing aids with an occlusive earmold, or a weakened immune system. However, there are things within your control when it comes to how to prevent fungal ear infections.

First, it’s important to keep the moisture level in your ear canal low. Avoid overuse of hydrogen peroxide or ear drops and be careful about getting soap or shampoo in your ears, as these factors can reduce the amount of healthy bacteria in your ear canal, putting you at higher risk of a fungal ear infection. Limiting your use of headphones and ear plugs, and avoiding putting things in your ears—good ideas for general ear health—is just as vital in preventing a fungal ear infection.

Frequently asked questions about fungal ear infections

While it’s not common, there are some extreme cases in which a fungal ear infection can spread to the brain. An invasive and life-threatening form of fungal infection, known as skull base osteomyelitis or malignant otitis externa, may develop in immunocompromised patients. Symptoms include intense ear pain, persistent discharge, facial palsy, deafness, hoarseness and difficulty swallowing. See a doctor immediately if you notice these symptoms.

Dizziness is not a symptom of a fungal ear infection. 

A fungal ear infection can cause temporary hearing loss; it usually resolves once the infection is treated.

Tinnitus, or ringing in the ears, is a common symptom of a fungal ear infection and is also likely to resolve after treatment. 

A fungal ear infection cannot spread directly to another person. However, the fungus that causes the infection can spread during water-based activities.

If you or a family member has symptoms of an ear infection and you’re concerned that it may be bacterial, make an appointment to be seen by a medical professional. Lab tests and a professional exam are the only way to determine an effective treatment for fungal ear infections—and to keep them from coming back. 

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