Wax leaking from ear
Ear Discharge: Causes, Treatments, and Prevention
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Overview
Ear discharge, also known as otorrhea, is any fluid that comes from the ear.
Most of the time, your ears discharge earwax. This is an oil that your body naturally produces. The job of earwax is to make sure that dust, bacteria, and other foreign bodies don’t get into your ear.
However, other conditions, such as a ruptured eardrum, can cause blood or other fluids to drain from your ear. This kind of discharge is a sign that your ear has been injured or infected and requires medical attention.
In most cases, discharge from your ear is simply ear wax making its way out of your body. This is natural. Other conditions that can cause discharge include infection or injury.
Middle ear infection
Middle ear infection (otitis media) is a common cause of discharge from the ear. Otitis media occurs when bacteria or viruses make their way into the middle ear. The middle ear is behind the eardrum. It contains three bones called ossicles. These are vital to hearing.
Ear infections in the middle ear can cause fluid to build up behind the eardrum. If there is too much fluid, there is a risk of perforation of the eardrum, which can lead to ear discharge.
Trauma
Trauma to the ear canal can also cause discharge. Such trauma can occur while cleaning your ear with a cotton swab if you push it in too deep.
An increase in pressure, such as when you’re flying in an airplane or scuba diving, can also result in trauma to your ear. These situations may also cause your eardrum to rupture or tear.
Acoustic trauma is damage to the ear due to extremely loud noises. Acoustic trauma can cause your eardrum to rupture as well. However, these cases aren’t as common as the others described.
Swimmer’s ear
Otitis externa, commonly known as swimmer’s ear, occurs when bacteria or fungus infects your ear canal.
It usually occurs when you spend long periods of time in water.
Too much moisture inside your ear can break down the skin on the walls of your ear canal. This allows bacteria or fungus to enter and cause an infection.
However, swimmer’s ear isn’t exclusive to swimmers. It can result whenever there’s a break in the skin of the ear canal. This might occur if you have irritated skin as a result of eczema.
It can also occur if you insert a foreign object into the ear. Any damage to your ear canal makes it more susceptible to infection.
Less common causes
A less common cause for ear discharge ismalignant otitis externa, a complication of swimmer’s ear that causes damage to the cartilage and bones in the base of the skull.
Other rare causes include a skull fracture, which is a break in any of the bones in the skull, or mastoiditis, which is an infection of the mastoid bone behind your ear.
You should call your doctor if the discharge from your ear is white, yellow, or bloody or if you’ve had discharge for more than five days.
Sometimes ear discharge may occur with other symptoms, such as a fever. Tell your doctor if you have any accompanying symptoms.
If you experience serious pain, your ear is swollen or red, or you have a loss of hearing, you should see your doctor.
If you have an injury to the ear that causes discharge, that’s another good reason to consult a doctor.
You can connect with an ENT in your area using the Healthline FindCare tool.
Treatment of your ear discharge depends on its cause. In some cases, your condition won’t need medical treatment.
For example, the American Academy of Pediatrics describes a 48-hour “wait-and-see” approach, accompanied by close follow-up, as one option for treating mild ear pain in children.
Signs of an ear infection usually start to clear up within the first week or two, without any treatment. Pain medications might be needed to deal with any pain or discomfort.
If your child is under six months old or has a fever over 102.
2°F, your doctor might prescribe antibiotic ear drops.
Most cases of ear trauma also heal without treatment. If you have a tear in your eardrum that doesn’t heal naturally, your doctor might apply a special paper patch to the tear. This patch keeps the hole closed while your eardrum heals.
If a patch doesn’t work, your doctor might surgically repair your ear using a patch of your own skin.
A doctor should treat swimmer’s ear to prevent the infection from spreading. Typically, your doctor will give you antibiotic ear drops to use for about a week. In severe cases, oral antibiotics will also be necessary.
To avoid ear infections, try to stay away from people who are sick.
According to the Mayo Clinic, breastfeeding may provide infants with protection from ear infections, since they receive their mother’s antibodies in their milk.
They advise that, if you bottle-feed your baby, you should try holding your infant in an upright position rather than letting them drink lying down.
Keep foreign objects out of your ears to avoid rupturing your eardrum. If you know you’ll be in an area with excessive noise, bring ear plugs or muffs to protect your eardrums.
You can prevent swimmer’s ear by making sure to dry your ears after being in the water. Also, try to drain any water by turning your head to one side and then the other. You can also use over-the-counter medicated ear drops after you swim to control and alleviate swimmer’s ear.
Shop for over-the-counter ear drops online.
Shop for ear plugs or muffs online.
Ear discharge: MedlinePlus Medical Encyclopedia
URL of this page: //medlineplus.gov/ency/article/003042.htm
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Ear discharge is drainage of blood, ear wax, pus, or fluid from the ear.
Most of the time, any fluid leaking out of an ear is ear wax.
A ruptured eardrum can cause a white, slightly bloody, or yellow discharge from the ear. Dry crusted material on a child's pillow is often a sign of a ruptured eardrum. The eardrum may also bleed.
Causes of a ruptured eardrum include:
- Foreign object in the ear canal
- Injury from a blow to the head, foreign object, very loud noises, or sudden pressure changes (such as in airplanes)
- Inserting cotton-tipped swabs or other small objects into the ear
- Middle ear infection
Other causes of ear discharge include:
- Eczema and other skin irritations in the ear canal
- Swimmer's ear with symptoms such as itching, scaling, a red or moist ear canal, and pain that increases when you move the earlobe
- Normal ear wax
Caring for ear discharge at home depends on the cause.
Contact your health care provider if:
- The discharge is white, yellow, clear, or bloody.
- The discharge is the result of an injury.
- The discharge has lasted more than 5 days.
- There is severe pain.
- The discharge is associated with other symptoms, such as fever or headache.
- There is loss of hearing.
- There is redness or swelling coming out of the ear canal.
- Facial weakness or asymmetry
The provider will perform a physical exam and look inside the ears. You may be asked questions, such as:
- When did the ear drainage begin?
- What does it look like?
- How long has it lasted?
- Does it drain all the time or off-and-on?
- What other symptoms do you have (for example, fever, ear pain, headache, or hearing loss)?
The provider may take a sample of the ear drainage and send it to a lab for examination.
The provider may recommend anti-inflammatory or antibiotic medicines, which are liquid drops placed in the ear. Antibiotics may be given by mouth if a ruptured eardrum from an ear infection is causing the discharge.
The provider may remove wax or infectious material from the ear canal using a small vacuum suction.
Drainage from the ear; Otorrhea; Ear bleeding; Bleeding from ear
- Ear tube surgery - what to ask your doctor
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Hathorn I. The ear, nose and throat. In: Innes JA, Dover AR, Fairhurst K, eds. Macleod's Clinical Examination. 14th ed. Philadelphia, PA: Elsevier; 2018:chap 9.
Kerschner JE, Preciado D. Otitis media. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 658.
Pelton SI. Otitis externa, otitis media, and mastoiditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 61.
Wareing MJ, Warner E. Ear, nose and throat. In: Glynn M, Drake WM, eds. Hutchison's Clinical Methods. 25th ed. Philadelphia, PA: Elsevier; 2023:chap 22.
Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Discharge from the ear
To the guide
Discharge from the ear often indicates the development of an inflammatory process in the outer or middle ear.
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Ear wax protects against the penetration of pathogens and foreign bodies into the ear canal. Therefore, its formation is physiologically determined and is considered the norm. Other discharge from the ear usually indicates pathology and may contain purulent masses and blood impurities.
Types of discharge
According to their type of discharge are divided into several types:
Purulent discharge
The leakage of pus from the ear canal occurs with inflammation of the outer and middle ear, and is also characteristic of external and acute otitis media with perforation of the tympanic membrane, respectively.
Other causes of purulent discharge can be otomycosis, in which fungal microflora parasitizes in the ear, and furunculosis.
This is the name of the inflammation of the sebaceous glands in the ear canal, accompanied by the formation of a limited cavity (one or more), filled with a purulent secret. The clinical picture may be supplemented by other signs: the development of hearing loss, congestion and pain in the ear on the side of the lesion, a sensation of tinnitus, which is often mixed with dizziness. The physical condition of the patient is aggravated by a runny nose, fever, an increase in local lymph nodes, and pain in the ear region.
Spotting
Discharge from the ear with blood impurities also occurs with the development of an inflammatory process in the middle and outer sections. But the most common cause of such phenomena is trauma to the eardrum or other internal structures, as a result of exposure to mechanical objects that have fallen into the ear canal, or pressure drop.
In the latter case, the cause may be barotrauma, which is often found in novice scuba divers with improper diving to depth due to a sharp change in the difference between external and internal fluid pressure.
Transparent highlights
There are also clear discharges from the ear. A striking example is exudative otitis media, during the development of which fluid accumulates in the middle ear cavity. Rupture of the tympanic membrane leads to the manifestation of the contents. Inflammation for this form of otitis is uncharacteristic.
Cerebrospinal fluid, which is also clear, may leak from the ear. A similar picture can be observed with craniocerebral injuries that led to a fracture of the base of the skull.
Diagnostics
Elucidation of the etiology of this phenomenon is carried out on the basis of the patient's own complaints and instrumental examination data.
As part of the diagnosis, otoscopy is used, the main task of which is to exclude pathology in the ear.
The doctor also performs the toilet of the ear, clearing the ear canal from the contents, using micro-instruments. For a more detailed examination, otomicroscopy is used.
If an inflammatory process is confirmed, discharge from the ear is subject to microbiological examination, which makes it possible to establish the type of pathogen and identify its sensitivity to antibiotics. Head injuries are the reason for performing a computed tomography.
Treatment
Treatment according to the cause of the event:
- Drug therapy - antibacterial drugs in the form of drops;
- Opening of a furuncle with furunculosis. It is carried out under local anesthesia, followed by the toilet of the auditory canal and the appointment of antibiotics;
- Perforation of the tympanic membrane. As a rule, it tightens on its own. In severe cases, with craniocerebral injuries, they seek the advice of a neurosurgeon.
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IMPORTANT!
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.
For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.
Discharge from the ear: causes, what diseases occur, diagnosis and treatment.
Definition
Earwax is a physiological secretion from the ear canal and protects the hearing aid from pathogenic bacteria. It consists of fat, fatty acids and fat-like substances, as well as various mineral salts. Normally, a person produces 15–20 mg of earwax during the month, which looks like a sticky yellow-brown mass. All other discharges are considered pathological and indicate ear diseases.
Types of discharge from the ear
The discharge may be transparent, white, light or dark yellow, greenish (in the presence of pus).
If blood enters the ear secretion, the discharge becomes reddish or brownish in color.
The discharge may be watery in consistency, have a cheesy or flaky texture, and sometimes crusting is possible.
An unpleasant smell of discharge due to the presence of pus in them can serve as a diagnostic sign.
What diseases and conditions cause discharge from the ear
Sulfur plugs . Excessive work of the sulfur glands leads to the formation of a sulfur plug. Most often, this problem occurs in patients with diabetes mellitus, metabolic syndrome, high cholesterol levels in the blood. The formation of sulfur plugs provokes an increased viscosity of sulfur, dry skin, small foreign particles (for example, industrial dust) entering the ear, as well as excessive hair growth in the ear canal. Often, sulfur plugs are observed in people involved in water sports, using hearing aids, miniature headphones.
With improper hygiene measures and independent attempts to remove excess earwax, there is a risk of pushing it deeper into the ear canal, thereby causing a plug to form.
Clinical signs of sulfur plug are pain and stuffiness of the ear, tinnitus, especially painful when sulfur comes into contact with the eardrum, sometimes headache, dizziness, nausea.
Mucopurulent and purulent discharge is a symptom of inflammation of the outer and middle ear. In inflammation external ear (otitis externa) pathological process can develop in the auricle and external auditory canal (up to the tympanic membrane). Most often, external otitis occurs against the background of infection of the ear with bacteria and microscopic fungi. Its first signs are, as a rule, pain in the ear, itching, less often - hearing loss and a feeling of fullness. Mucopurulent discharge appears only with a common form of the inflammatory process throughout the auditory canal.
The source of purulent discharge in the outer ear can also be a boil located in the shell or ear canal. In case of otitis media mucopurulent and purulent discharge results from infection of sterile effusion from inflamed ear tissues.
Since the chamber of the middle ear is closed by the tympanic membrane, purulent discharge may appear in the outer ear only after the formation of a hole in it. This is preceded by severe pain in the ear, fever, hearing loss, and in children - overexcitation, sometimes vomiting.
When mastoiditis (inflammatory lesion of the mastoid process of the temporal bone), purulent discharge from the ear also appears. As a rule, this disease develops as a complication of otitis media and is accompanied by fever, soreness and swelling in the mastoid process behind the ear.
Clear, bloody or purulent discharge occurs with acute infectious myringitis (inflammation of the eardrum), which may be of fungal or bacterial origin. Bubbles filled with blood form on the surface of the eardrum, which then burst. In addition to discharge, ear congestion is observed.
Transparent, colorless or slightly pinkish discharge from the ear may be the result of liquorrhea - the outflow of cerebrospinal fluid.
It enters the auricle in case of skull fractures (often temporal) due to trauma.
In addition, transparent watery discharge sometimes accompanies allergic otitis media , which is also characterized by other signs - itching, ear congestion.
Unaltered blood appears from the ear, usually after injury and rupture of the eardrum .
Such injury can be caused by acoustic and mechanical shocks, as well as by improper hygiene procedures. A ruptured eardrum is always accompanied by severe pain.
The appearance of bloody-purulent discharge from the ear is one of the evidences of the presence of a polyp on the tympanic membrane or mucous membrane of the middle ear . A polyp is an overgrowth of tissue in response to its irritation. The appearance of a polyp is preceded by active inflammation of the middle ear. In addition, polyps can be the result of myringitis, otitis externa, malignant neoplasms.
Perforating the tympanic membrane, the polyp can protrude into the area of the external auditory canal, leading to hearing loss.
Insignificant secretions, sometimes forming crusts and having an unpleasant odor, are characteristic of cholesteatoma - a tumor-like formation formed from the epidermis of the ear canal. In most cases, cholesteatoma complicates chronic purulent epitympanitis and is formed from layers of keratinized epidermis, water, proteins, fats and cholesterol. The formation of cholesteatoma is accompanied by feelings of heaviness and fullness in the ear, headache. If left untreated, it can gradually invade the mastoid process and the cranial cavity.
At otomycosis loose curdled discharge is observed. The main culprits of the disease are molds (often localized in the outer ear) and yeast-like fungi (more often inhabiting the middle ear). Clinical signs of otitis externa in these cases include pain and colored cheesy-necrotic discharge from the ear. Patients complain of tinnitus and dizziness.
Discharge that contains large, fatty flakes, sometimes mixed with pus, is characteristic of seborrheic ear dermatitis . The disease can affect not only the ear, but also the scalp. Clinical signs are severe itching, swelling of the auricle, peeling of the skin and weeping wounds.
Clear discharge mixed with blood (sanitary discharge) indicates bullous or influenza-like otitis media . Bullae (vesicles with fluid) occur on the surface of the ear canal and eardrum. When they burst, the liquid with the ichor flows out through the ear canal into the auricle.
Which doctor to contact for ear discharge
In most cases, ear diseases are characterized by a clear clinical picture, which is based on pain. These patients are treated by an otorhinolaryngologist.
In the presence of a traumatic brain injury, which is accompanied by liquorrhea, urgent hospitalization is necessary.
Otherwise, a poor prognosis is possible.
Discharge from the ear is not always accompanied by pain, in particular with allergic otitis, which is treated by
therapist
,
pediatrician
and
allergist-immunologist
.
Diagnosis and examination of ear discharge
If wax plug is suspected, the doctor performs an otoscopy, during which a build-up of wax in the ear canal is detected. Diagnosis of otitis externa and otitis media is carried out on the basis of patient complaints, otoscopy, palpation of the parotid region. It is recommended to sow discharge from the ear to determine the causative agent of the disease and its sensitivity to antibiotics. Perhaps an audiometric study.
Ear culture, Routine.
Bacteria Identification. Antibiotic Susceptibility and Bacteriophage Efficiency testing
Synonyms: Ear Culture, Routine. Bacteria Identification. Antibiotic Susceptibility and Bacteriophage Efficiency testing. Brief description of the study "Sowing of discharge from the ear on the microflora, determination of sensi...
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Traumatic brain injury, which is accompanied by liquorrhea, is diagnosed using radiography and CT.
X-ray of the skull
X-ray examination of the skull to detect violations of the structure and integrity of the bones of the skull of various nature.
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CT scan of the brain and skull
Scanning of the brain, skull and surrounding tissues, which allows diagnosing various pathologies.
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To diagnose cholesteatoma and mastoiditis, the doctor performs otoscopy and x-rays.
X-ray of the mastoid processes
X-ray examination of the mastoid process of the temporal bone to assess its integrity and identify other pathologies.
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If otomycosis is suspected, endomicroscopic (examination of the ear under an operating microscope) and microbiological examination of ear discharge using microscopy and culture are recommended.
Diagnosis of bullous otitis media includes culture of fluid from the ear, audio and tympanometry, radiation examination methods. It is also possible to use serological methods of blood analysis.
Ear culture, Routine. Bacteria Identification. Antibiotic Susceptibility, enlarged testing
Synonyms: Ear Culture, Routine. Bacteria Identification. Antibiotic Susceptibility, enlarged testing. Brief description of the study “Sowing of discharge from the ear on the microflora and determination of sensitive...
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What to do if there is discharge from the ear
If clear discharge from the ear appeared after an injury, urgent hospitalization is necessary.
If there is an increased excretion of sulfur, you should seek the help of an ENT doctor who will recommend proper care and personal hygiene methods acceptable at home.
It is strongly not recommended to clean the ear canal with the help of items not intended for this purpose.
Treatment for ear discharge
If a sulfur plug is detected, the doctor removes it, after softening it with special preparations. Remove plugs by lavage or aspiration and curettage.
Irrigation is possible only in the absence of contraindications, which the doctor will definitely inform about (perforation of the tympanic membrane, otitis externa).
Treatment for otitis media may include pain relief, physiotherapy, and etiotropic therapy, depending on the causative agent of the disease. The allergic nature of ear discharge requires the use of antihistamines. Cholesteatoma is treated only with surgery.
Sources:
- Clinical guidelines "Acute otitis media". Developed by: National Medical Association of Otorhinolaryngologists. – 2021.
- Morozova S.V. Ear wax: topical issues of norm and pathology in clinical practice. breast cancer. No. 3 (II), 2018, pp. 53–57.
- Clinical guidelines "Chronic otitis media". Developed by: National Medical Association of Otorhinolaryngologists. – 2021.
IMPORTANT!
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.
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