Remedies: Herbal Ear Drops for Infections

Tony Cenicola/The New York Times What alternative remedies belong in your home medicine cabinet?

More than a third of American adults, and more than one in 10 children, use some form of complementary or alternative medicine, according to a government report. Natural remedies have an obvious appeal, but how do you know which ones to choose and whether the claims are backed by science? In this occasional series, Anahad O’Connor, the New York Times “Really?” columnist, explores the claims and the science behind alternative remedies that you may want to consider for your family medicine cabinet.

The Remedy: Herbal ear drops.

The Claim: They relieve pain from ear infections.

The Science: As many parents know, ear infections can be one of the most painful — and common — conditions that afflict children. Millions of cases are diagnosed every year, and some studies show that about 90 percent of all children in the United States experience at least one episode of acute otitis media, as the condition is known scientifically.

But treatment is controversial. Many doctors write antibiotic prescriptions even though medical experts say they do almost nothing to help, and in some cases may do more harm than good.

Depending on a child’s age and symptoms, medical experts advise parents to take a wait-and-see approach, in part because almost two-thirds of children recover from pain and fever within 24 hours of diagnosis. In the meantime, some doctors prescribe anesthetic medications like antipyrine combined with benzocaine to help ease the pain, but studies suggest that herbal ear drops may be just as effective, with minimal side effects.

In one study, published in The Archives of Pediatrics and Adolescent Medicine in 2001, a team of pediatricians recruited 103 children ages 6 to 18 with earaches resulting from acute otitis media. The subjects were randomly split into groups and assigned to be treated with either anesthetic ear drops or an herbal ear drop known as Otikon, which contains extracts of antibacterial and anti-inflammatory agents like garlic, calendula, St. John’s wort and mullein (a flowering plant) in an olive oil solution. At the end of the study, the researchers found reductions in ear pain in both groups, and concluded that the herbal ear drop was just as effective as the anesthetic one.

A similar study appeared in 2003 in the well-respected journal Pediatrics. This time, the scientists used an herbal ear drop that contained the same ingredients as in the earlier study, as well as lavender and vitamin E. The scientists recruited about 180 children ages 5 to 18, then randomly assigned them to numerous groups. Some of the children received the herbal ear drops alone (three times a day, five drops at a time), and others received them in combination with the antibiotic amoxicillin. Other children were treated with anesthetic ear drops, with or without antibiotics.

Ultimately, the patients who were given the ear drops alone had greater pain relief than those who took them with the antibiotic. The scientists concluded that in many cases, the pain caused by acute otitis media may subside with the simple passage of time. But in cases where “active treatment” is needed for pain relief, an herbal ear drop may be just as good as one that requires a prescription.

The Risks: In the studies, no side effects were noted. But parents should always consult with a doctor before deciding on a course of treatment.

Comments are no longer being accepted.

The point is being missed! It’s the warmed olive oil poured into the ear, not the additives that soothe the otitis. I am 63 when I was 7 my pediatrician “prescribed” the olive oil treatment (hell, my parents had no money & 3 kids in 1955). I suffered from chronic otitis. The warmed olive oildr0ops did the trick. I cd feel the change as they dripped in. I dont believe in alternative medicine or holoistics but this simple dr prescribe solution worked. Dont get carried away with what is allegedly in the oil, it is merely the oil.

None of the studies described above are placebo controlled–that is, it was never shown that an herbal remedy is better than nothing at all!

I suffered from earaches as a child and even as a teen. My mother’s effective remedy was drooping warmed olive oil in the ear canal.

It worked, and I used the same remedy when my daughter had earaches.

Is it just the warm olive oil that does the soothing?

I recommend reading the original articles, which are both available free online, and in particular look at the two figures. In the first article, anaesthetic drops and the herbal mixture are indistinguishable. In the second, the outlier is the one antibiotic group; again, anesthetic drops alone were indistinguishable from the herbal concoction. Since there was no placebo group in either study, it is impossible to know if either ‘remedy’ actually helped at all.

Only 147 children received the herbal mixture in the two studies combined; this number is too small to rule out an uncommon side effect. Also, the lack of a subsequent re-challenge means that any allergic-type reaction developing from first exposure to either type of drops could not have been identified in these studies.

Parents who feel they have to do something might want to consider giving olive oil drops alone, as they might be just as “effective”, and have the evident advantages of less chance for local adverse effects than olive oil combined with other stuff, while costing essentially nothing.

In summary, it is important to ponder what the Pediatrics article’s authors concluded, namely: “On the basis of our findings that the group with the most significant treatment effects (NHED with topical anesthetic) explained only 7.3% of the total pain reduction, we propose that sometimes the general practitioner or pediatrician needs to give the human body a chance to repair itself.”

The Risks: With supplements, there are no goverment strength standards, and no government purity standards.

And if the supplement is manufactured in China, it could contain just about anything.

>As many parents know, ear infections can be one of the most painful — and common — conditions that afflict children.

And adults? I’ve been bugged by my ears for months.

To relieve the pain of an earach, have the child lie on her side with her ear on a heating pad on low heat … small children are especially fond of using a heating pad covered with fake “fur.” This is extremely effective for most children (and adults !!) in a very short time. with a soft cover … small children love fake “fur”. The results are often remarkable, and no drugs or chemicals are required, nor is any foreign matter introduced into the ear. If it doesn’t work — no harm, no foul. Of course, never leave a small child alone with an electric heating pad.

Always consult a doctor first? Right – just to use an herbal ear drop? Get a grip people. If the child has no fever, or a sore throat or drainage from the ear, seeing a doctor right away is not silly, it can be very dangerous (see MD’s that just provide an antibiotic for no reason.) Try the ear drops and save not just money but possible dangerious secondary effects from unneeded meds. Of course, if the pain gets worse or does not clear up after a day or two, then the advice is correct.

Where do you buy this stuff? Google is giving me nothing.

I am happy to see that most of those making comments on this article are more knowledgeable about what makes good science than the author of the article and the medical journals which she quotes.

David Chowes, New York City December 30, 2010 · 3:08 pm

Yes, many symptoms go into remission without any intervention. So, if a child or adult has an ear pain, wait the 24 hours… And see… Unless it is acute and extremely painful.

As far as antibiotics and “alternative medacine” goes: thorough and scurpulous scientic studies should be done and, the efficacy and benefit/risk ratio should be assessed.

If you use herbal or GNC-type products and the pain dissipates, it is natural to believe that the treatment worked. The same can be said about antibiotics.

Old world remedy: Heat a containers worth of salt in a pan or in the oven till hot. Put it in a sock… or other suitable cloth receptacle. Lay the sock on a pillow, and have the child lay on his side, placing his ear directly on the sock. (Using common-sense, the heat level should be hot… but not too hot to cause a burn)

The heat sometimes will not only relieve the pain (caused usually by pressure), it hopefully will induce the fluid that may have built up in the inner ear… to drain. If it does drain, the relief is almost instantaneous. If it doesn’t … there was no harm caused in trying. Though, it often works. I’m not an ear doc, but it worked for my son when he was little… and it can work equally as well upon adults.

The alternative to the heated salt is a heating pad. Same process, using common-sense of course. No need to burn off ears. An aid in making the child comfortable and facilitating the keeping of the ear on the heat is the prior administration of a small hot lemon drink…, a water, honey, lemon, and “spirits” concoction.

Disclaimer: Please note that this suggestion is not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider. Because after all, your child’s earache may just be in his head.

I’m 55, and my mother also poured warm olive oil in my ears when they hurt. Worked every time.

I’m just baffled by the lack of a placebo treatment. If doctors gauged the children’s pain within a few hours of treatment, we can probably assume the treatment was effective.

But the other component of the “placebo effect” is simply that (1) patients seek treatment when their discomfort is greatest and (2) most maladies improve on their own, so generally patients will feel better after the period of treatment.

For years when I got the earache I used Natra-Bio’s Earache Drops (which are taken under the tongue). It worked every time for me and for everyone I recommended them to. They worked, but to my knowledge, Natra-Bio stopped selling them.

Or you could go to an osteopathic physician and have them treat the underlying problem. I have been doing this for 20 years with much success.

Agree with #2. Placebo effect was not ruled out.

my mother poured couple of drops of my own urine in my ear to cure infections. Grew up in Turkey where we didn’t run to the doctor for every minor issue.

opinionatedus illegitimitatus December 30, 2010 · 4:04 pm

A lot of verbiage, but aren’t we just sort of left with the comment, “Do i punt now, Doc?”

opinionatedus illegitimitatus December 30, 2010 · 4:07 pm

# 18–you can thank God you didn’t have a urinary tract infection–now that’s what i’d call “suicide.”

Note also from the 2001 Paper: “This work was supported by David Naker, MPharm, from Healthy-On, who created and supplied the herbal extract, naturopathic ear drops, Otikon.”

Conflict of interest much?

I don’t think any has mentioned that the second paper has two of the same authors. So, this has not been reproduced by another group

Double-blind? They say the studies were. However, I wonder how they managed to make the antibiotic drops, which usually smell like buffer solution, smell like the lavendar extract…

And all without establishing either treatment actually worked with a control, as noted by earlier commenters. It’s really kind of laughable. Or it would be if the premier newspaper in the USA weren’t trumpeting it as truth in their “Really?” column.

Really?

Dr. Reeves (above comments) hit it on the head. This is a poorly designed study which was poorly abstracted by the author of this article. Also please consider that it is tissue that is covered by mucosa, not the squamous epithelium which covers the ear canal and outside of the ear drum, that absorbs topical analgesic and other medication. The study referenced here is not even appropriate in theory because of the squamous/mucosa absorption issue. Warmth via drops instilled into the ear or by heating pad etc. will give the pain killing effect at no cost and no risk.

Okay, olive oil for the pain, but what about the infection? I’ve suffered from ear infections since I was 3 years old (I’m now in my 40’s), and it wasn’t until my late teens (and many many doctors later) that I was diagnosed with a cholesteatoma. Seeing a doctor first to make sure there is nothing else going on should always be the first step. Don’t risk your childrens hearing. Maybe the infection will clear up by itself, maybe it won’t. You can always opt to use the other method but nothing should keep you from seeing the doctor. I still get infection and I go to my ENT.

Argh…of course I meant anesthetic drops, but the point is still valid.

Also, I guess this isn’t the “Really?” column, just the author of it.

Whoa. I would be very careful about putting certain herbs (and yes, antibiotics and other chemicals) into ears because of the risk of hearing damage.

For example, one study suggests that tea tree (aka melaleuca) oil, which is thought to have anti-bacterial and anti-fungal properties, and which some people do indeed put into their ears, might well cause damage to the cochlear nerve. (Zhang SY, Robertson D. A study of tea tree oil. Audiol Neurol. 2000;5:64-68.)

Herbal products are not necessarily inoccuous. In addition to damaging the nerves involved in hearing, some might interfere with endocrine functioning, just for example, possibly causing breast growth in boys (Henley D, Lipson N, Korach K, Bloch C. Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils. New England Journal of Medicine, Feb. 1, 2007).

Not all herbs are alike. I am more than disappointed that the author of this article refers to “herbal ear drops” so casually, and makes no mention of the suspected dangers to hearing that some herbs may pose.