Fungal Ear Infection (Otomycosis)

What is a fungal ear infection (otomycosis)?

A fungal ear infection usually involves your ear canal — the tube that starts at your outer ear and ends at your eardrum (tympanic membrane). Funguses like Aspergillus and Candida cause this condition. A fungal ear infection can also affect your middle ear, but this is uncommon.

Ear fungal infections are more likely to occur when the temperatures are warm and the air is humid. In the United States, fungal ear infections are most common during the summer months. They’re also more common in people who swim, surf or participate in other watersports.

Other names for a fungal ear infection include otomycosis and fungal otitis externa.

How common are fungal ear infections (otomycosis)?

Fungal ear infections are less common than bacterial ear infections. Fungal infections of the ear make up about 10% of all outer ear infections (otitis externa).

What are the symptoms of a fungal ear infection?

Ear fungal infections can affect one or both ears. Fungal ear infection symptoms vary from person to person but may include:

• Earache.
• Discoloration (red, yellow, purple or gray) of your outer ear or ear canal.
• Intense itching.
• Flaky skin around your ear canal.
• Pain or burning.
• Headaches.
• Inflammation.
• Discharge that’s yellow, green, black, white or gray.
• Tinnitus (ringing in your ears).
• A feeling of fullness in your ears.
• Hearing loss.

Some people develop:

• Dizziness.
• Fever.
• Severe ear pain.

When Aspergillus causes a fungal ear infection, you may see yellow or black dots and fuzzy white patches in your ear canal. If Candida is the culprit, you might see a thick and creamy white discharge coming from your ear.

If you develop any of the above symptoms, call a healthcare provider. Fungal ear infections aren’t likely to go away without treatment.

What causes fungal ear infections (otomycosis)?

Many different types of funguses can cause ear infections. But the most common fungal ear infection causes include Aspergillus and Candida. Aspergillus causes about 90% of fungal ear infections, and Candida causes the rest.

What are the risk factors for fungal ear infections (otomycosis)?

Earwax (cerumen) protects your ear canal and gives it a water-resistant lining. Anything that reduces the amount of earwax in your ears makes you more vulnerable to fungal ear infections.

You’re more likely to get a fungal infection in your ear if you:

• SCUBA dive.
• Swim, waterski, surf or participate in other types of watersports.
• Use cotton swabs, hair pins or other instruments to clean earwax from your ears.
• Have a weakened immune system.
• Have ear eczema or other skin conditions affecting your ear.
• Have ear injuries and trauma.

Are fungal ear infections contagious?

No, you can’t pass a fungal ear infection to another person. However, the fungus that causes these infections can spread from person to person while swimming in infected water.

Even though fungal ear infections aren’t contagious, you should call a healthcare provider right away if you think you have one. Treating the issue early helps reduce the risk of infection spreading to other parts of your body.

How are fungal ear infections diagnosed?

A healthcare provider will examine your ears with an otoscope. (An otoscope is a handheld magnifying device that providers use to look inside your ear.) They’ll also ask about your symptoms and medical history.

In addition, they may run lab tests to confirm your diagnosis. To do this, they’ll swab your ear for fluid or discharge. Then they’ll send a sample to a lab for further testing.

How are fungal ear infections treated?

There are several options for treating a fungal infection of the ear. Your healthcare provider can help you determine which one is right for you.

Fungal ear infection treatments include:

Cleaning

Healthcare providers can use special rinses to thoroughly clean your ears. This helps remove discharge.

Don’t try to clean inside your ears at home. You should only use cotton swabs on the outside of your ear — never in your ear canal.

Medications

Many people need oral medications to treat ear fungal infections. In addition to antifungal medications like itraconazole, your provider may recommend over-the-counter pain relievers for any discomfort.

Be sure to use follow your provider’s instructions closely, even if your ear starts to feel better. If you don’t, a fungal ear infection can come back and be harder to treat.

Ear drops

Antifungal ear drops, such as fluconazole and clotrimazole, can treat many types of fungal ear infections. Your provider may also recommend aluminum acetate or acetic acid ear drops to reduce inflammation in your ear canal. Be sure to use ear drops exactly as directed.

Creams and ointments

If a fungal ear infection affects the outer part of your ear, your provider may recommend a topical cream or ointment. Examples include clotrimazole, ketoconazole and econazole. You apply these creams and ointments to your external ear rather than inside your ear canal.

Home remedies

Home remedies can help ease fungal ear infection symptoms. But you should always talk to your healthcare provider before trying any treatments at home.

One common fungal ear infection home remedy is diluted hydrogen peroxide. This helps remove discharge and buildup from your ears. You can also try carbamide peroxide eardrops or a 1:1 mixture of rubbing alcohol and white vinegar.

Can I prevent fungal ear infections?

It’s not always possible to avoid fungal ear infections. But there are things you can do to reduce your risk:

• Wear earplugs when swimming, surfing or participating in other watersports.
• Don’t stick cotton swabs in your ears.
• Dry your ears with a hairdryer after showering.
• Avoid scratching your ears.

What can I expect if I have a fungal ear infection?

Most people respond well to antifungal treatment. But if you have a weakened immune system, the ear infection could linger or come back.

It’s best to avoid watersports while you’re undergoing treatment. If you go right back to swimming, for instance, the infection could return.

With prompt treatment, fungal ear infections usually don’t cause long-term complications.

How long does a fungal ear infection last?

Most fungal ear infections last about three weeks. You’ll need to take antifungal medication or use antifungal ear drops until the infection clears up.

When can I go back to work or school?

Fungal ear infections aren’t contagious, so you can return to work, school and other routines as soon as you feel up to it.

When should I see my healthcare provider?

Fungal ear infections don’t usually go away without treatment. So, you should schedule an appointment with a healthcare provider if you develop pain, itchiness, discharge or other symptoms.

If you’re already undergoing treatment for a fungal ear infection, call your provider if you develop severe pain, dizziness or fever.

Is ear fungus serious?

In general, fungal ear infections aren’t serious. But they can spread and worsen in some cases — especially in people who have weakened immune systems or chronic skin conditions.

Fungal ear infections usually cause some degree of pain and discomfort. The best thing you can do is see a healthcare provider at the first sign of trouble.

What happens if ear fungus is left untreated?

Most fungal ear infections don’t go away without treatment. At best, an untreated fungal ear infection will linger or return. At worst, it could spread to nearby tissues or other parts of your head and neck, resulting in:

• Meningitis.
• Mastoiditis.
• Fungal osteomyelitis (very rare, but life-threatening).

How do I know if my ear infection is fungal or bacterial?

Sometimes, health providers can tell the difference just by looking inside your ear. However, they can run lab tests to confirm the diagnosis. They’ll take a sample of any fluid or discharge in your ear and look at it under a microscope.

Why does my fungal ear infection keep coming back?

There are a few reasons why a fungal infection in your ear may linger or return, including:

• A weakened immune system.
• Absence of earwax.
• Sticking cotton swabs in your ear.
• Living in a hot or humid climate.

A note from Cleveland Clinic

A fungal ear infection usually isn’t serious, but it can be quite uncomfortable. These types of infections typically don’t go away on their own. So, if you think you might have a fungal infection in your ear, call a healthcare provider right away. They can confirm your diagnosis and recommend appropriate treatment.