Ear Infection Treatment in Patong, Phuket: Swimmer’s Ear and Otitis Media Care 24/7
Same-day video otoscopy, antibiotic and steroid ear drops, oral antibiotics when needed and pain control for swimmer’s ear and middle ear infection. Walk-in clinic or hotel-room visit, 24 hours a day. Clinically reviewed by the Doctor Patong Takecare Clinic medical team.
WhatsApp now, same-day ear exam | Call +66 81 718 9080 | Find the clinic on Google Maps
Ear pain after a day in the sea is one of the commonest reasons travellers walk into our clinic in Patong. The combination of warm salt water, prolonged humidity and overzealous cotton bud use creates near-perfect conditions for the bacteria that cause swimmer’s ear, and a holiday quickly becomes miserable. A ten-minute consultation tells us which type of infection you have and gets the right drops or tablets into you the same visit.
Otitis externa, swimmer’s ear, what we see most
Otitis externa is an infection of the external ear canal, the tube between the visible outer ear and the eardrum. It is the dominant ear infection in adults on holiday in Phuket because every time water enters the canal it dilutes the slightly acidic, waxy lining that normally keeps bacteria in check. Pseudomonas aeruginosa is the most common cause, followed by Staphylococcus aureus, with fungal infection (Aspergillus or Candida) responsible for a smaller share, particularly after repeated antibiotic drop use. The classic symptoms are ear pain that worsens when you pull the outer ear or push on the small flap in front of the canal (the tragus), itchiness inside the ear, a feeling of fullness, reduced hearing on that side, and sometimes a watery or yellow discharge. At examination we typically see a swollen, red, debris-filled canal, and pain on gently moving the pinna confirms the diagnosis.
Otitis media, the middle ear infection
Otitis media is an infection of the middle ear cavity, the air-filled space behind the eardrum that contains the tiny hearing bones. It is more common in children than adults because the eustachian tube, which drains the middle ear into the back of the nose, is shorter and more horizontal in childhood. The usual story is a cold or upper respiratory infection that develops into ear pain, fever, irritability in young children, and reduced hearing on the affected side. On video otoscopy the eardrum looks red, bulging and immobile, occasionally with a small perforation that releases pus into the canal and relieves the pain. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the main bacterial causes, though up to half of middle ear infections in adults are initially viral and settle without antibiotics within 48 to 72 hours.
How we treat ear infections at the clinic
For otitis externa, first-line treatment is a combination ear drop containing ciprofloxacin 0.3 percent and dexamethasone 0.1 percent, four drops twice daily for seven to ten days, or until three days after symptoms resolve. The antibiotic clears the bacteria and the steroid calms the inflammation, which is what makes the ear hurt and feel blocked. If the canal is too swollen for the drops to reach the eardrum, we place a small sponge wick that wicks the medicine inward and removes it at follow-up. Fungal otitis externa is treated with clotrimazole solution. For pain we use paracetamol or ibuprofen, and we ask you to keep the ear strictly dry for seven to ten days, using a cotton ball coated in Vaseline as a plug during showers and avoiding swimming completely. For otitis media in adults with mild symptoms, we usually observe for 48 to 72 hours with pain relief alone, because most settle without antibiotics. When symptoms are severe, bilateral, persisting beyond 72 hours, accompanied by discharge through a perforation, or occurring in immunocompromised patients, we prescribe amoxicillin 500 to 1000 mg three times daily for seven days, or clarithromycin 500 mg twice daily for seven days if you are penicillin-allergic. Children with bacterial otitis media receive amoxicillin at 80 to 90 mg per kilogram per day in two or three divided doses.
Otitis externa versus otitis media at a glance
| Feature | Otitis externa (swimmer’s ear) | Otitis media (middle ear) |
|---|---|---|
| Where the infection is | External ear canal, in front of the eardrum. | Middle ear cavity, behind the eardrum. |
| Typical patient | Adult swimmer, diver, frequent water exposure. | Child, or adult after a cold or flu. |
| Pain trigger | Pain on pulling the outer ear or pressing the tragus. | Constant deep pain, worse on lying flat. |
| Otoscopy | Swollen, red canal with debris or discharge. | Bulging, red, immobile eardrum. |
| Main pathogens | Pseudomonas aeruginosa, Staph aureus, fungi. | Strep pneumoniae, H. influenzae, M. catarrhalis. |
| First-line treatment | Ciprofloxacin and dexamethasone ear drops. | Observation or oral amoxicillin. |
When to see a doctor
Any ear pain that disturbs sleep, persists beyond 48 hours, comes with a fever, causes hearing loss, or produces discharge deserves a clinical examination rather than over-the-counter drops bought blindly. We see a small number of more serious presentations each year, and they are the ones where time matters. The two we never miss are malignant otitis externa, a Pseudomonas infection that spreads from the canal into the skull base in diabetic, elderly or immunocompromised patients and presents with severe, boring, night-waking ear pain and sometimes facial weakness, and Ramsay Hunt syndrome (herpes zoster oticus), where severe ear pain comes with small vesicles in the canal or on the pinna and facial nerve palsy on the same side.
You develop facial droop or weakness on the side of the painful ear. The pain is severe, boring and wakes you from sleep, particularly if you have diabetes or are immunocompromised. You have swelling and tenderness over the bone behind the ear (mastoid). You feel sudden severe vertigo, profound hearing loss or persistent vomiting. You see vesicles or blisters in the canal or on the pinna. Fever stays above 38.5 degrees Celsius with shaking chills. Discharge continues longer than two weeks. These can mean malignant otitis externa, mastoiditis or Ramsay Hunt syndrome, all of which need same-day specialist care.
Your ear hurts when you pull the outer ear, you cannot sleep on that side, you feel blocked or hear muffled, or discharge has started. A ten-minute video otoscopy visit confirms the diagnosis and starts the right drops or tablets the same day. WhatsApp +66 95 073 5550 for a same-day clinic appointment or hotel visit, day or night.
Prevention and early self-care
Swimmer’s ear is highly preventable. After every swim or shower, tilt the head and let water run out, then dry the visible part of the canal with the corner of a towel. Avoid cotton buds inside the canal entirely, since they push wax inward and abrade the skin. Frequent swimmers and divers benefit from custom or soft-silicone plastic earplugs, and a drop of a 1:1 mixture of white vinegar and isopropyl rubbing alcohol in each ear after swimming acidifies the canal and dries residual water, a useful prophylactic provided the eardrum is intact. Leave ear wax alone, since it is the canal’s natural antibacterial defence, and resist the urge to scratch an itchy ear with hairpins, keys or matchsticks. For middle ear infections, hand hygiene, prompt treatment of colds and, in children, keeping up with routine pneumococcal and influenza vaccinations all reduce the risk.
Summary
Most ear infections we see in Patong are swimmer’s ear, treated effectively with combination ciprofloxacin and dexamethasone drops, dry-ear precautions and simple pain relief. Middle ear infections, more common in children and after colds, often improve without antibiotics, but bacterial cases respond well to a short course of amoxicillin. The cases that matter most are the rare, serious presentations: severe boring pain in a diabetic patient, facial droop, mastoid swelling or vesicles in the canal. If anything in that list applies to you, we will see you the same day and arrange hospital transfer if needed.
“Ninety percent of holiday ear pain in Patong is swimmer’s ear, and ninety percent of swimmer’s ear settles within a week on the right drops if the ear is kept genuinely dry. The other ten percent are the cases we look for carefully: malignant otitis externa, mastoiditis, Ramsay Hunt. Those are why we examine every ear, not just hand out drops.”
Doctor Patong Takecare Clinic medical team
Frequently asked questions
How do I know if I have swimmer’s ear or a middle ear infection?
If pulling on the outer ear or pressing the tragus reproduces the pain, and the symptoms started after swimming or showering, you very likely have otitis externa, swimmer’s ear. If the pain came on after a cold, is deeper and constant, comes with fever, and outer-ear movement does not change it, otitis media is more likely. A two-minute video otoscopy at the clinic confirms which one and shows you the canal and eardrum on screen.
How long does it take ear drops to work?
Pain and itch usually start improving within 24 to 48 hours of starting ciprofloxacin and dexamethasone drops. Discharge and the feeling of blockage take longer, typically four to seven days. Complete the full course (seven to ten days) even if you feel better, and continue dry-ear precautions until the course ends, otherwise the infection can rebound within days.
Can I keep diving or swimming during treatment?
No. The ear must be kept dry for the full seven to ten days of treatment, and we ask divers to wait until the canal is fully healed and the eardrum, if perforated, has confirmed closure. Diving with active otitis externa risks pushing infected water deep into the canal under pressure, and diving with otitis media risks ear barotrauma and worsening perforation.
Can the clinic come to my hotel for ear treatment?
Yes. Our doctor and nurse can perform video otoscopy, prescribe and supply ear drops or oral antibiotics, and place an ear wick if the canal is too swollen for drops, all at your hotel anywhere in Patong, Kalim, Kamala, Karon and Surin, day or night. WhatsApp +66 95 073 5550 to arrange a visit.
Should children with ear infections always get antibiotics?
Not always. Many cases of childhood otitis media are viral and improve within 48 to 72 hours on paracetamol or ibuprofen alone. We prescribe amoxicillin straight away when the child is under two with bilateral infection, when there is discharge through a perforation, when fever is high, or when symptoms have not improved after 72 hours of observation. For children under six months we treat immediately on diagnosis.
When is an ear infection a medical emergency?
Facial droop on the side of the painful ear, severe boring pain that wakes you at night especially if you are diabetic, swelling and tenderness over the bone behind the ear, sudden severe vertigo or profound hearing loss, and visible blisters in the canal or on the pinna are all red flags for malignant otitis externa, mastoiditis or Ramsay Hunt syndrome. Call us on +66 81 718 9080 and we will see you the same day and arrange hospital transfer if needed.
Sources
National Institute for Health and Care Excellence. Otitis externa. cks.nice.org.uk/topics/otitis-externa.
National Institute for Health and Care Excellence. Otitis media (acute): antimicrobial prescribing (NG91). nice.org.uk/guidance/ng91.
Centers for Disease Control and Prevention. Ear Infection. cdc.gov/ear-infections.
NHS. Ear infections. nhs.uk/conditions/ear-infections.
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