The short version
- A wax blockage usually causes fullness and muffled hearing — but little or no pain
- An ear infection more often brings pain, throbbing, discharge, itch or a temperature
- Pain + discharge + feeling unwell points to infection, not just wax
- Wax is treated by removal (microsuction); infection needs assessment first — not wax removal
- For children aged 1–17 with earache, the free NHS Pharmacy First service may be able to help
A blocked-up, muffled ear and a painful, infected ear can feel surprisingly similar at first — but they're different problems with different treatments, and telling them apart matters. Here's how to work out which one you're likely dealing with.
The quick comparison
More likely a wax blockage
- Feeling of fullness or pressure
- Muffled or reduced hearing
- Little or no pain
- Sometimes mild ringing (tinnitus)
- Came on gradually
- No fever, no discharge
More likely an infection
- Ear pain — often throbbing or sharp
- Discharge or fluid from the ear
- Itching in the ear canal
- Feeling generally unwell / a temperature
- Came on quickly
- Pain when you tug the earlobe (outer-ear infection)
Why the difference matters
It matters because the treatments are almost opposite. Wax is a mechanical blockage — the answer is to have it safely removed. Infection is inflammation, usually of the outer ear canal or the middle ear — and the answer is a proper assessment of what's causing it. Attempting wax removal on an actively infected or painful ear is not appropriate, which is exactly why a good clinic always looks in the ear and assesses it before doing anything.
It's also worth knowing that the two can overlap: a heavy wax blockage can occasionally contribute to an infection, and trapped water or cotton-bud use can trigger one. If in doubt, get it looked at rather than guessing.
Other things it could be
- A cold or blocked Eustachian tube — very common, causes fullness and popping, usually settles on its own.
- "Glue ear" — fluid behind the eardrum, especially in children.
- Something stuck in the ear — more common in young children; never try to poke it out.
⚠ Get urgent advice if
- there's severe pain, or pain with a high temperature and feeling very unwell;
- there's blood or pus coming from the ear, or sudden hearing loss;
- there's swelling behind or around the ear, dizziness or facial weakness;
- symptoms are in a very young child, or someone with a weakened immune system.
How each is treated
If it's wax: the safe, modern approach is professional removal by microsuction — a gentle, water-free vacuum technique done while the clinician views your ear canal throughout.
If it's an infection: it needs assessing first. Many ear infections settle with simple self-care and time; some need treatment. For children aged 1–17 with earache, the free NHS Pharmacy First service lets a pharmacist assess and, where appropriate, treat it — without a GP appointment. For adults, our private Ear Infection Clinic offers a same-day assessment.
Not sure? Let us take a look
Whether it turns out to be wax or an infection, we can help you find out. Curo Pharmacy in Blackburn offers professional ear wax removal by microsuction and a private ear infection assessment — and free Pharmacy First earache care for children where eligible.
Ear wax removal Ear infection clinic →Or call us on 01254 660473