What causes earache?

Earache is common, particularly in children, and is often caused by acute otitis media (a middle ear infection). It can also be caused by colds, fluid behind the eardrum, or irritation of the ear canal.

Symptoms may include ear pain, fever, irritability, disturbed sleep, reduced hearing, or in younger children, pulling or rubbing the ear.
Most ear infections improve on their own within a few days without antibiotics.

Early assessment helps identify who can be safely managed with advice and pain relief, and who needs further treatment or referral.

How Rose Pharmacy can help

At Rose Pharmacy, trained clinicians can assess symptoms of earache and suspected ear infection in line with NHS Pharmacy First guidance and national clinical standards.

Our approach is assessment-led, ensuring each child or young person receives safe, appropriate care based on their age, symptoms, and medical history.

NHS Pharmacy First assessment and treatment for earache

NHS Pharmacy First assessment may be available for eligible patients.

If NHS eligibility criteria are met, our clinicians may be able to assess earache under the NHS Pharmacy First service and decide whether advice, treatment, or referral is appropriate.

Most ear infections in children do not require antibiotics. Where NHS treatment is considered, this is based on structured clinical assessment and specific criteria designed to identify those most likely to benefit.

If NHS eligibility criteria are not met

If NHS eligibility criteria are not met, our clinicians may still be able to help.

In these situations, we can offer a separate private consultation, where a clinician will assess symptoms and discuss the most appropriate next steps. This may include:

• advice and reassurance

• pain relief and self-care guidance

• private prescribing where clinically appropriate, or

• referral to a GP or hospital service if further assessment is required

All options, including any costs, are explained clearly so parents or carers can make an informed decision.

When urgent medical care is needed

Some symptoms are not suitable for Pharmacy First management and require urgent medical assessment.

Please seek urgent medical advice if a child or young person has:

• swelling, redness, or tenderness behind the ear

• severe headache, confusion, or drowsiness

• neck stiffness or sensitivity to light

• facial weakness or drooping

• persistent vomiting

• high fever or appears very unwell

• discharge from the ear that is bloody or foul-smelling

• suspected foreign body in the ear

• repeated ear infections over a short period

If serious symptoms are present, our team will advise urgent GP review, A&E attendance, or calling 999 in an emergency.

What happens during a consultation?

During your consultation, a clinician will:

• assess symptoms and medical history

• check for red flags that require referral

• determine whether NHS Pharmacy First management is appropriate

• provide advice on pain relief and self-care

• explain whether treatment, private care, or referral is the safest option

Where pharmacy management is not appropriate, we ensure families are guided promptly and safely to the right level of care.

Self-care advice for earache

Our clinicians may provide advice on:

• regular pain relief where appropriate

• comfort measures to help ease ear pain

• monitoring symptoms over the next few days

• when to return for reassessment

Clear safety-netting advice is given so parents and carers know when to seek further help.

Why choose Rose Pharmacy?

Families choose Rose Pharmacy because we offer:

• calm, child-friendly consultations

• structured clinical assessment using recognised pathways

• clear explanations and transparent care options

• responsible antibiotic stewardship

• safe decision-making, including referral when needed

Book an assessment or speak to our team

If your child has earache and you are unsure what to do, early advice can help.

Visit Rose Pharmacy or speak to a member of our team to arrange an assessment and discuss the most appropriate care.

The age range for this NHS service is 1 to 17 years.

NHS Pharmacy First assessment and treatment are subject to eligibility criteria. Private consultations are separate services and are offered only where clinically appropriate.