Keep Your Ears Comfortable on Your Next Flight

If you’re someone who dreads “airplane ear” when you fly, there are plenty of tips both adults and children can try to ease the discomfort.  

The pain is caused by the change in cabin pressure during take-off and descent, which creates a difference in pressure between the air inside and outside of your middle ear. 

“This discomfort can be more pronounced if you have a cold or sinus infection because the congestion interferes with airflow through your nose to the ear, making it hard to equalize your ear pressure,” says Ana H Kim, MD. “Other factors that can affect your ability to equalize pressure include allergies, nasal polyps, or a history of ear infections.”  

Children are more prone to ear discomfort because their Eustachian tube (which connects the middle ear to the back of the nose and throat) is in a flat orientation that makes it harder for children to equalize ear pressure. By adulthood, the tube matures to a slanted orientation that eases airflow into the ear and drainage of fluids out of the ear.

Tips for Easing Ear Plane While Flying 

Dr. Kim shares several techniques you can try to relieve the discomfort of airplane ear:

• Swallowing and yawning: Swallowing can help open the Eustachian tube and equalize the pressure in your ear. Try chewing gum, sucking on hard candy, or sipping water during takeoff and landing to encourage swallowing. Yawning can also help. Try yawning intentionally or opening your mouth wide as if you were yawning.
• Pinching your nose and blowing gently: Pinch your nostrils closed with your fingers and then gently blow air into your nose. This can help open the Eustachian tube and equalize the pressure in your ear.
• Using earplugs or special ear pressure-regulating devices: It’s worth trying EarPlanes or similar, which are inexpensive earplugs that act like pressure 'baffles,' reducing the pressure on the eardrum and improving symptoms. I’ve found that some people swear by them, while others find they don’t help.
• If you have a cold, try decongestants: Decongestant nose sprays, including oxymetazoline (like Afrin) or phenylephrine (like Neo-Synephrine or Little Remedies) reduce swelling in the back of the nose at the opening of the Eustachian tube, which improves your ear’s ability to equalize the air pressure. Oral decongestants, like Sudafed, also decrease congestion in the back of the nose, however, these can also contribute to high blood pressure. If you already have high blood pressure or heart disease, ask your doctor if it’s okay for you to use medications like Sudafed.
• Try antihistamines: For those with allergy symptoms and air pressure regulation difficulties, medications like Claritin, Zyrtec, or Allegra may be a good option. Antihistamines are often formulated to include decongestants (such as Claritin-D, Allegra-D, and Zyrtec-D). If you’re unsure whether you can tolerate these medications, check with your doctor.
• Keep small kids comfortable: Since small children may not be able to communicate their pain, it's important to recognize signs of their ear discomfort, such as fussiness, crying, or tugging at the ears. To help prevent and ease this ear discomfort, encourage them to swallow or yawn by using a bottle or pacifier during take-off and landing.
• If nothing helps, ask your doctor about this last resort: If “airplane ear” is a significant problem, a procedure called myringotomy may be considered. This operation puts a hole in the eardrum, which allows instant pressure equalization between the middle ear and the outside world. This approach is so effective in eliminating Eustachian tube problems while flying, it was performed on World War II pilots to treat the problem! The downside is that having a hole in your eardrum means keeping water out of the ear while the hole remains. For patients who regularly fly and have difficulty, we sometimes need to resort to this solution, which also involves placing a tube in the eardrum to keep the hole open.