Ear Discharge: Causes, Treatment And Prevention
Photo by Senior Airman Christopher Toon, U.S. Air Force, Public domain, via Wikimedia Commons
Ear discharge (otorrhea) is any fluid that drains from the ear. The drainage can be watery, bloody, or thick and white, like pus. Depending on the cause, people may also have ear pain, fever, itching, vertigo, ringing in the ear (tinnitus), or hearing loss.
A small amount of earwax coming out of the ear is normal. Earwax is made by glands in the ear canal and helps trap dust and protect against germs.
Other discharge can be a sign of infection or injury. See a doctor if discharge lasts more than a few days, or right away if you have warning signs (listed below).
Sometimes thick fluid collects in the middle ear, behind the eardrum. This fluid is common in children and can come with ear infections and hearing loss.
Causes of Ear Discharge
Many children have fluid build up behind the eardrum at some point, often after an ear infection. This is called otitis media with effusion. There may be no signs of infection, such as a fever, but the child may rub their ear or have trouble hearing.
NIDCD explains that a doctor can see the fluid by looking into the ear with a special instrument.
The middle ear can become inflamed and the fluid can get infected. This is called acute otitis media. It often follows a cold and can cause ear pain, fever, and irritability in children.
Sometimes fluid lasts longer and becomes thick and sticky, reducing hearing, which can make it harder for children to learn. This is often called glue ear.
According to the Merck Manual's guide to ear discharge, the most common causes are:
- Acute (sudden) middle ear infection (otitis media) with a ruptured eardrum
- Chronic otitis media (with perforation of the eardrum, cholesteatoma or both)
- External ear infection (otitis externa)
In some people with otitis media (usually children), the eardrum ruptures, releasing the infected fluid collected behind it. The hole usually heals, but sometimes a small hole remains. A perforation can also result from an injury or ear surgery. When a hole remains, people are at risk of chronic middle ear infection, which can lead to ear discharge.
Causes of severe, but rare, ear discharge include
- Ear canal cancer
- Skull base fracture
- Necrotizing (malignant) external otitis
- Cholesteatoma (a noncancerous growth of skin-like tissue in the middle ear)
The ear canal passes through the base of the skull. If a severe head injury fractures that part of the skull, blood or clear cerebrospinal fluid may leak from the ear. Discharge after a head injury is an emergency.
Necrotizing, or malignant, external otitis is a severe form of outer ear infection that mainly affects people with diabetes, older adults, or people with a weakened immune system (for example, from HIV infection or cancer chemotherapy). Despite the name, it is not cancer.
Some people with chronic otitis media develop a non-cancerous (benign) growth of skin cells in the middle ear (cholesteatoma) that can cause discharge. Although cholesteatoma is non-cancerous, it can cause significant damage to the ear and surrounding structures. In severe cases, a cholesteatoma may cause deafness, facial weakness or paralysis, and complications with the brain such as an abscess and other infections.
When to See a Doctor
See a doctor right away if ear discharge comes with any of these warning signs:
- A recent major head injury
- Vertigo, or trouble seeing, speaking or swallowing
- Hearing loss in the affected ear
- Fever
- Redness or swelling of the ear or the area around it
- Diabetes or a weakened immune system
Without warning signs, see a doctor soon, and keep water out of the ear until you have been checked.
Treatment & Prevention
Treatment for ear discharge is directed at the cause. Some infections need ear drops or antibiotics, so don't try to treat ongoing discharge at home.
Those who have a large perforation of the eardrum are advised to keep water out of the ear. While bathing or washing your hair, you can coat a cotton ball with petroleum jelly and place it at the opening of the ear canal.
An audiologist can also make custom silicone earplugs. They are shaped so that they stay in place and cannot slip deep into the ear canal. People who have a small opening, such as from a ventilation tube, should ask a doctor whether they need to keep water out of the ear. A cholesteatoma is treated surgically.
Many ear infections start with a cold or flu, so wash hands often and stay away from people who are sick. Keep children up to date on vaccines; NIDCD notes that the yearly flu vaccine and the pneumococcal vaccine help prevent ear infections.
Keep babies and children away from cigarette smoke. Don't put a baby down for a nap or for the night with a bottle.
Do not put anything in your ears, including cotton buds, pencils, or any other hard objects. Use earplugs or earmuffs to protect your ears from loud sounds.
To prevent a swimmer’s ear, dry your ears after swimming or shower and wear earplugs if you swim often.
Conclusion
Ear discharge can occur for many reasons, including ear infections, earwax, or an injury. Infection of the middle or outer ear is the most common cause. Fluid behind the eardrum is very common in children and can affect hearing.
Treatment is directed at the cause, so see a doctor about discharge that doesn't clear up, and get urgent care if it follows a head injury or comes with warning signs. Those who have a large perforation of the eardrum are advised to keep water out of the ear.
Sources
- Ear Discharge, Merck Manual Consumer Version
- Ear Infections in Children, National Institute on Deafness and Other Communication Disorders
