Fungal Ear Infection

A fungal ear infection usually involves your ear canal — the tube that starts at your outer ear and ends at your eardrum. Fungi like Aspergillus and Candida cause it.

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

Other names for this condition are otomycosis and fungal otitis externa.

Symptoms of a fungal ear infection

Fungal ear infection symptoms vary but may include:

• Intense itching, pain or burning in your ear
• Discharge that’s yellow, green, black, white or gray
• Flaky skin around your ear canal
• Ringing in your ears
• A feeling of fullness or hearing loss in the affected ear

When Aspergillus causes the infection, you may see yellow or black dots and fuzzy white patches in your ear canal. Signs of a fungal ear infection involving Candida include a thick and creamy white discharge coming from your ear.

Fungal ear infection (otomycosis) causes

The most common fungi that cause ear infections are Aspergillus and Candida. Aspergillus causes about 90% of fungal ear infections, and Candida causes most of the rest.

The infection itself isn’t contagious. But the fungus that causes it can spread from person to person while swimming in infected water.

Risk factors

Earwax protects your ear canal and gives it a water-resistant lining. Anything that reduces the amount of earwax in your ears makes you more likely to get 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 water sports
• Use cotton swabs 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
• Live in a hot, humid area

Sometimes, people develop ear fungal infections after antibiotic treatment to clear an ear infection caused by bacteria. The meds kill the bad bacteria. But in the process, they can also kill the good bacteria that can help get rid of the fungus.

Complications of this condition

Fungal ear infections aren’t usually serious. But they can spread and worsen if they go untreated. The risk is greater in people who have a weakened immune system or chronic skin condition. This can lead to:

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

Treating the issue early helps reduce the risk of infection spreading.

How doctors diagnose this condition

A healthcare provider will view your ears with an otoscope. An otoscope is a handheld magnifying device that providers use to look inside your ear. Sometimes, they can identify a fungal infection just by looking.

They may also run lab tests. To do this, they’ll swab your ear for fluid or discharge. Then, they’ll send a sample to a lab for testing. This can help them know if bacteria or a fungus is causing the infection.

How are fungal ear infections treated?

There are several treatment options. Your healthcare provider can help you determine which one is right for you.

Fungal ear infection treatments include:

• Professional cleanings: Providers use special rinses to remove discharge and other debris from your ear.
• Oral medicines: In addition to antifungal meds like itraconazole, your provider may recommend over-the-counter pain relievers for any discomfort.
• Ear drops: Antifungal ear drops, like fluconazole and clotrimazole, can treat fungal ear infections. Your provider may also suggest aluminum acetate or acetic acid ear drops to reduce inflammation in your ear canal.
• Creams and ointments: If the infection affects the outer part of your ear, your provider may recommend a topical cream or ointment. Examples include clotrimazole, ketoconazole and econazole.

Home remedies

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

One common 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.

Remember that you should only use cotton swabs on the outside of your ear. Never insert them into your ear canal. A cotton swab in your ear can cause damage. It can push the fungus deeper inside your ear and make things worse.

Recovery time

Most fungal ear infections last about three weeks. You’ll need to take all prescribed meds for as long as your provider tells you to, even if your ear starts to feel better. If you don’t, the infection can come back and be harder to treat.

It’s best to avoid water sports while you’re getting treatment. If you go right back to swimming before you’ve healed, the infection could return.

When should I see my healthcare provider?

Fungal ear infections don’t usually go away without treatment. So, you should contact a healthcare provider if you have pain, itchiness, discharge or other symptoms.

If you’re already getting treatment for a fungal ear infection, call your provider if you develop severe pain, dizziness or fever. These could be signs that the infection is spreading or getting worse.

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

Most people respond well to antifungal treatment. With prompt care, fungal ear infections usually don’t cause long-term issues.

But if you have a weakened immune system, the ear infection could linger or come back. Your provider will advise you on the treatments you need if your body is having a hard time fighting off the infection.

Is there anything I can do to feel better?

Ask your provider about ways to reduce your chance of a future fungal infection in your ear. You may not be able to prevent all fungal ear infections, but you can reduce the risk of having to go through the itchiness and pain all over again.

Your provider may advise you to:

• Wear earplugs when swimming, surfing or participating in other water sports.
• Dry your ears with a hairdryer after showering.
• Avoid scratching your ears.

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

Sometimes, healthcare providers can tell the difference just by looking inside your ear. If not, they can run lab tests on ear fluid or discharge to confirm the diagnosis.