Ear infections are noticeably more common during the winter months, affecting both children and adults. While cold weather itself is not the direct cause, winter brings together a number of factors that significantly increase the risk of developing ear infections. Understanding these seasonal triggers can help you recognise symptoms early and know when specialist care is needed.
What are the different types of ear infections?
There are three types of ear infections which affect different parts of the ear:
–Outer ear infection (otitis externa): These affect the outer ear canal and are most often triggered by exposure to water, for example, swimming, although a cotton bud injury can also cause them. These types of outer ear infections can occur at any time of the year and are not usually more common in winter.
–Middle ear infections (acute otitis media): this affects the middle part of the ear behind the eardrum, and is typically triggered by va iral respiratory infection, such as a cold or flu. Middle ear infections are definitely more likely in winter – more on this below.
–Inner ear infections: These can also be caused by a virus affecting the inner ear nerve; similar to outer ear infections, these can occur at any time of the year.
Colds and Flu Play a Major Role in Causing Middle Ear Infections (Otitis Media)
Winter is peak season for viral infections such as colds and flu. These illnesses cause inflammation and congestion in the nose, throat, and upper airways. The ears are connected to the back of the nose by the Eustachian tubes, which help regulate pressure and drain fluid from the middle ear.
When a cold or flu causes swelling in these tubes, they can become blocked. This prevents fluid from draining properly, allowing bacteria or viruses to multiply behind the eardrum, leading to a middle ear infection (acute otitis media). For some people, especially those who suffer repeated winter illnesses, this cycle can occur several times in one season. Symptoms include ear pain, raised temperature and discharge from the ear.
Indoor Living Increases Exposure to Germs
During winter, people naturally spend more time indoors in close proximity to others, whether at home, work, school, or on public transport. This makes it easier for infections to spread. Viruses that affect the upper respiratory tract can quickly move from person to person, increasing the risk of ear infections developing as a complication.
Heated indoor environments can also dry out the nasal passages, reducing their ability to filter and trap germs. When the nose and sinuses are dry or irritated, they become less effective at protecting the ears from infection.
Pressure Changes and Ear Function
Winter often brings frequent pressure changes, particularly during air travel, driving in hilly areas, or even moving between cold outdoor air and warm indoor environments. These pressure shifts can stress the Eustachian tubes, especially if they are already inflamed due to a cold or sinus congestion.
If the ears cannot equalise pressure properly, discomfort, blocked sensations, and fluid build-up may occur. In some cases, this can contribute to infection, particularly if pressure problems are ongoing.
Sinus Congestion and Post-Nasal Drainage
Sinus problems are more common in winter and often go hand in hand with ear infections. Blocked or inflamed sinuses can increase mucus production, which may drain toward the ears and throat. This can irritate the Eustachian tubes and increase the likelihood of middle ear infections, especially in people prone to sinusitis.
Why Children Are More Affected
Children are particularly susceptible to ear infections during winter. Their immune systems are still developing, and their Eustachian tubes are shorter and narrower than those of adults. This makes it easier for infections to reach the middle ear and harder for fluid to drain. Exposure to germs in schools and nurseries further increases the risk during colder months.
When to Seek Specialist Advice
While mild ear discomfort may resolve on its own, you should seek medical advice if symptoms persist or recur. Warning signs include ongoing ear pain, hearing loss, fluid discharge, fever, balance problems, or repeated infections throughout winter.
At London ENT, specialists can assess whether ear infections are being caused by recurrent infections, sinus problems, pressure regulation issues, or underlying ENT conditions. Early diagnosis and appropriate treatment can help prevent complications and reduce the likelihood of repeat infections during future winters.