RFSymptoms: Safety netting advice
AdultsEarache
DATE LAST REVIEWED: 05/11/2026
When to seek further review
- Get medical advice if earache is not improving within 2 to 3 days.
- Seek urgent advice sooner for fluid leaking from the ear, high fever, worsening pain, swelling around or behind the ear, or feeling generally unwell.
- Sudden hearing loss or a new change in hearing needs urgent medical assessment; do not wait for the pain to settle.
- Get urgent advice for severe dizziness, repeated vomiting or an object stuck in the ear.
- For mild symptoms without any of the urgent or emergency warning signs listed here, a community pharmacist can advise on self-care and suitable medicines. Tell them the patient’s age, other medicines and any pregnancy or breastfeeding. They can direct you to another service if needed.
- Pharmacy First can assess earache in children and young people aged 1 to 17 years. Contact the pharmacy first to check that it offers the service. Assessment does not always mean an antibiotic or other prescription is needed.
- Do not wait for the suggested review time if symptoms become worse, new symptoms appear, or you are worried.
- If you need medical advice and are unsure which service can help, call NHS 111. This includes when your GP is closed or you cannot get the help you need. NHS 111 can direct you to an appropriate local service. You can call even if you are not sure whether symptoms are serious.
When to get emergency help
(Immediately dial 999 or go to your nearest Emergency Department)
- New facial drooping, especially with arm weakness or speech changes.
- A painful swelling behind the ear with the ear pushed forward and severe illness; go to the Emergency Department urgently.
- A severe headache with a stiff neck, discomfort in bright light, or a rash that does not fade when pressed with a clear glass. Do not wait for a rash to appear.
- A seizure, collapse or becoming very difficult to wake.
- Severe difficulty breathing, such as gasping or being unable to speak normally.
- New confusion or not making sense when speaking.
- Being very difficult to wake.
- Collapse or loss of consciousness.
- Blue, grey, unusually pale or blotchy skin or lips, especially when feeling very unwell.
How to spot sepsis
Sepsis is a life-threatening reaction to an infection. It can get worse quickly. If someone is seriously unwell and may have sepsis, call 999 or go to your nearest Emergency Department. Do not wait for every sign, a high temperature or a rash.
An unwell child under 5 who has not had a pee or wet nappy for 12 hours needs emergency assessment. If you are unsure and there are no emergency signs, call NHS 111 for advice.
Sources
- NHS - Earachehttps://www.nhs.uk/symptoms/earache/
- NHS - How pharmacies can helphttps://www.nhs.uk/nhs-services/pharmacies/how-pharmacies-can-help/
- NHS - Meningitishttps://www.nhs.uk/conditions/meningitis/
- NHS - Sepsishttps://www.nhs.uk/conditions/sepsis/
- NHS - When to use NHS 111https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-use-111/