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  • Writer's pictureDr. Koralla Raja Meghanadh

Fungal Ear Infections (Otomycosis)

Updated: 2 days ago

Dr. K. R. Meghanadh

Causes | Symptoms | Treatment | Home Remedies | FAQs

Fungal ear infections, medically called Otomycosis, occur in the outer part of the ear, i.e., the external ear canal. A fungal ear infection usually causes severe itching in the ear canal, followed by pain. In most cases, it is caused due to the use of cotton swabs or earbuds, or any external objects to clean the ear canal. The risk increases if used after showering.

The usual home treatments and known remedies for ear infections can worsen otomycosis.

Outer ear infections are common after middle ear infections. Fungus in the ear (Otomycosis) is more common in humid coastal regions. In such areas, it is the second most common ear infection after middle ear infections. However, the second most common type of ear infection in drier areas is Otitis externa.

Otomycosis causes

Aspergillus Niger(black-colored) or Candida(white-colored) fungi cause the outer ear canal fungal infection. Most cases are because of Aspergillus Niger. The spores of Aspergillus Niger are present in the environment. When the water sits on wax in the ear, it creates a suitable environment for the fungus to grow.

Cotton buds for ear cleaning cause fungal ear infection

Using a cotton earbud or any other external object, especially after a shower, to clean the ear canal can increase the risk of fungal infection. The object can carry fungus, and the wet skin in the ear can be sensitive and easily get ruptured. The ruptured skin gives the fungus a VIP pass to infect the ear.

Otomycosis - Aspergillus Niger fungus(black colored spots) spotted in ear canal, otomycosis causes, otomycosis treatment, otomycosis symptoms, outer fungal ear infection, fungal ear infection picture
Otomycosis - fungal ear infection picture - Aspergillus Niger fungus(black colored spots) spotted in ear-canal using endoscopy

Otomycosis symptoms

The fungus grows and feeds on the wax when conditions are ideal for its growth, for example, when your ear is wet. While the fungus is eating the wax, we experience itchy ears.

After the completion of the wax, fungus encroaches on the ear canal’s skin, causing pain in the ear.

The itching present before can worsen when fungus creeps onto the skin. It could even create perforation of the eardrums leading to deafness. This deafness could be a permanent one.

How to treat fungal ear infection Otomycosis?

Itching in the ear indicates a fungal infection. Consult an ENT doctor and get the fungus cleaned. He will prescribe you anti-fungal eardrops.

As mentioned earlier, perforation of eardrums due to Otomycosis is avoidable by treating the ear with anti-fungal ear drops on time. If not treated on time, the perforation can increase, damaging the ear drum and causing hearing loss. The only resort in such a situation can be major ear surgery, as hearing loss can be permanent.

So if we act on time and reach out to an ENT doctor, we can easily avoid the surgery.

Home treatment for a fungal ear infection that can go wrong

Unfortunately, there are no home remedies for fungal ear infections.

But, there are commonly two remedies used for the in-home treatment of ear infections that end up worsening the condition rather than helping it.

  1. oil as ear drops

  2. self-prescribed antibiotic ear drops

Oil for ear infection

Many assume that itching in the ear could be due to dryness of the skin in the outer ear canal. Although it could be true, the itching can also be due to fungus. When people use oil in case of a fungal ear infection, it will act as food for the fungus and helps it spread faster, worsening the condition.

Antibiotic ear drops for itchy ears

The antibiotic eardrops kill the normal bacteria in the ear canal. Generally, these bacteria and fungi coexist and fight in our ears, controlling each other. Using antibiotic ear drops and killing the bacteria destroys this balance. This environment will make the fungus unstoppable, and the disease will spread faster.

Spike of fungal ear infections during COVID-19

In June, July, August, and September 2021, Dr. K. R. Meghanadh saw an average of 4 patients daily with external ear canal fungal infections called Otomycosis. He used to see around 30 patients per month before this spike.

Dr. K. R. Meghanadh said, “Due to the spike in these months, I wonder if COVID is related to Otomycosis. I observed that only a few were post-COVID, and the number is not significant enough to term this as a post-COVID complication, unlike mucormycosis. I think this is because of the change in lifestyle due to the pandemic. I assume that the time spent in the house has increased and has given people some idle time, leading to increased earbuds usage could be the reason behind this spike. Some doctors say it could be because of the season change. Still, I have not seen such a massive spike in my career due to the change of season. The only difference here is COVID-19 and its changes to our lifestyle. The spike is most probably due to our lifestyle changes.

Using an earbud to clean the ear canal can increase the chance of fungal infection. When the skin inside the ear canal is wet, skin becomes delicate, and using an earbud can easily damage the skin, making it susceptible to infection. Using an earbud after a bath can multiply the chances.

With COVID, people are scared to come to for minor problems to the hospital and tend towards home remedies or self-medication. Not just a couple of them, but alarmingly many patients that came to me have used antibiotic ear drops as self-medication. These antibiotic eardrops kill the normal bacteria in the ear canal. Generally, these bacteria and fungi coexist and fight in our ears, controlling each other Using antibiotic ear drops and killing the bacteria created a more convenient environment for the fungus to multiply. So, we must not self-medicate ourselves with antibiotic ear drops when we have irritation in our ear.”

Otomycosis spike post covid-19, otomycosis causes, otomycosis treatment, otomycosis symptom outer fungal ear infection

The takeaway from this spike

The causes for the Otomycosis spike Dr. K. R. Meghanadh mentioned previously are his opinions and guesses. However, what we know for sure is that this is preventable and treatable without surgery. So, we have two crucial precautions, one for preventing the disease and the other for controlling the perforation and, therefore, a major surgery.

1. Do not use earbuds inside the ear canal.

2. Do not self-medicate with antibiotic ear drops when itchy Consult an ENT doctor, get the fungus cleaned by the doctor, and use anti-fungal ear drops.

Written by

Dr. K. R. Meghanadh


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

Differentiating between a fungal and bacterial ear infection is easy.

A fungal ear infection starts in the outer ear canal and causes severe itching, followed by pain.

Bacterial ear infections usually start in the middle ear and are often caused by the common cold. Symptoms may include ear pain, fever, hearing loss, ear discharge, and ear blockage.

Always consult an ENT doctor, as ear infections can be in many parts of the ear. It is better to leave the diagnosis to experts.

Read our article "what causes ear infection" for more details.

Is fungal ear infection serious?

Yes, fungal ear infections(otomycosis) are serious. It can cause perforation of the eardrum, leading to permanent hearing loss.

Visiting an ENT doctor for treatment is not optional.

How do you get rid of a fungal ear infection?

We cannot eliminate fungal ear infections without an ENT doctor's intervention. This is because it involves cleaning out the fungus from the ear canal, followed by antifungal ear drops prescribed by the ENT doctor. Suppose the fungal infection becomes more severe or spreads to the eardrums. In that case, We may also need major ear surgery to fix permanent hearing loss.

How do you treat otomycosis at home?

Unfortunately, otomycosis cannot be treated at home. So, one must consult an ENT doctor and receive timely treatment whenever symptoms are detected.

Can I put oil in my ear if it hurts?

No, you should not put oil in your ear if it hurts, as it could worsen the condition. Oil can act as a food source for any fungus present in the ear, leading to faster spread and worsening of the situation. So, it is recommended to consult a healthcare professional before using any home remedies or oil for ears.

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