Can I fly with an ear infection?

Why does an ear infection make flying hurt more?

Your middle ear stays at the same pressure as the cabin through the eustachian tube, a small passage that opens when you swallow or yawn. When the tube is blocked, the pressure inside your ear can't keep up with the cabin. That is ear barotrauma.

MedlinePlus lists congestion from colds, allergies, and upper respiratory infections as things that raise the risk. A middle ear infection often comes with that congestion, so the ear has a harder time equalizing. MedlinePlus also lists changes in altitude as a risk factor for ear infections.

• Common signs of barotrauma: ear pain or discomfort, a full or stuffy feeling, slight hearing loss, and dizziness.
• Signs it is more severe or lasting: more ear pain, a feeling of pressure as if underwater, moderate to severe hearing loss, and sometimes a nosebleed.

Should I postpone my flight?

If the trip can move, waiting until the infection clears is the lower-risk choice. MedlinePlus advises avoiding altitude changes while you have an upper respiratory infection or active allergy symptoms. The NHS lists a sudden change in air pressure, such as during a flight, and ear infections as causes of a perforated eardrum.

The NHS says ear infections often get better on their own within 3 days, though symptoms can last up to a week. If you were prescribed antibiotics, MedlinePlus says to contact your provider if they don't seem to be working within 48 to 72 hours. So a flight a few days out may be fine once symptoms have settled, while a flight on day 1 of a painful infection is the one most worth rethinking.

Ask a doctor before you fly if the ear is very painful, you have a high fever, you have had ear surgery recently, or the person flying is a baby or young child.

If I have to fly, how can I protect my ears?

These steps come from MedlinePlus guidance on ear barotrauma. They help the eustachian tube open so pressure can even out.

• Swallow and yawn often: chew gum or suck on hard candy.
• Try a gentle pop: breathe in, then pinch your nostrils, close your mouth, and breathe out gently. Do not blow hard.
• Stay awake for landing: MedlinePlus advises not sleeping as the plane prepares to land, so you can keep swallowing and equalizing.
• Consider a decongestant before the flight: MedlinePlus says decongestant pills or nasal sprays taken before an altitude change can help with barotrauma. The NHS says decongestants don't help the ear infection itself, so this is only about the pressure change. Check the label and ask a pharmacist if you take other medicines or have a health condition.
• Treat the pain: acetaminophen or ibuprofen can ease ear infection pain and fever. Follow the label dose, and don't give aspirin to children.

What about flying with a child who has an ear infection?

Young children are the group where it is most worth calling the doctor before the trip. Babies can't tell you how much it hurts, and MedlinePlus notes that infants with an ear infection may be irritable, cry and not settle, have a fever, or sleep poorly. MedlinePlus says to tell a provider right away if a baby under 6 months has a fever, flight or not.

If you do fly, MedlinePlus suggests that infants and small children nurse or take sips of a drink, since swallowing helps the ears equalize.

Be careful with cold medicines. The FDA says children under 2 should not be given any cough and cold product that contains a decongestant or antihistamine, and many of these products are labeled not to be used under age 4. Ask your child's doctor or a pharmacist before giving one for a flight.

How do I know if my eardrum ruptured?

A ruptured or perforated eardrum is a hole or tear in the eardrum. The NHS says it can happen after an ear infection, an injury, a loud noise, or a sudden change in air pressure such as during a flight, and symptoms usually start suddenly.

One clue with an ear infection: MedlinePlus says severe ear pain that suddenly stops may mean the eardrum has ruptured. Other signs are below.

• Fluid, pus, or blood leaking from the ear
• Hearing loss in that ear
• Ringing or buzzing in the ear
• Ear pain, itching, dizziness, or fever
• What not to do: the NHS says not to get the ear wet or put anything in it, such as cotton swabs or ear drops, unless a doctor recommends them. Get it checked.
• The good news: the NHS says a perforated eardrum usually heals on its own within 2 months, and hearing usually returns to normal.

Can I fly with a perforated eardrum?

The NHS says flying is generally safe with a perforated eardrum. If you had surgery to repair it, wait until your surgeon tells you it is safe to fly.

While it heals, the NHS advises keeping water out of the ear, not putting anything in the ear unless a doctor says to, and not blowing your nose too hard because that can damage the healing eardrum. For that reason, check with a doctor before using the pinched-nose pop if you know you have a hole in your eardrum.