Causes and Treatment for Ear Drainage

Ear drainage may be a sign of several health conditions, depending on what type of fluid is coming from the ear. Normal ear discharge, better known as earwax, is amber to orange-brown in color. Other types of drainage, though, may indicate a problem.

This article discusses ear drainage and what different types of ear fluid can mean. It also explains the different causes of ear drainage and when to call your healthcare provider.

Types of Ear Drainage

The type of fluid you see may help you to understand what exactly is going on in the affected ear. Here are some of the more common types of ear fluid you may encounter.

Earwax

Earwax is the most common discharge seen in the ear. Known medically as cerumen, earwax is made up of oil, bacteria, dead skin, trapped water, and hair. It protects the ear from external objects and harmful bacteria.

It is normal for a small amount of earwax to be seen in the outer ear canal. Some ear specialists say to use a washcloth or tissue over your little finger to clean the outer ear canal only.

Sometimes, there may be large amounts of earwax. This may be a sign of a blockage. It also may mean there is a reason why the ear is making too much wax. If this is the case, the earwax may need to be removed by a healthcare provider.

Ear drops that can dissolve earwax may be used if needed. Earwax can also be flushed out using warm water and a syringe, but this should only be done as instructed by a healthcare provider.

Clear

Ear drainage that is clear or slightly blood-tinged can be caused by by skin problems. These problems, such as eczema or swimmer's ear, affect the skin inside the ear. In most cases, the ear fluid is due to a weeping wound. A skin problem should get better by itself within a few days.

Sometimes, clear ear drainage is a sign of a ruptured eardrum. In rare cases, it can be the result of a cerebospinal fluid (CSF) leak. This is the fluid that surrounds the brain and spinal cord. CSF leaks usually happen after a traumatic injury. Large amounts of clear CSF can mean damage to the skull, brain, or spine.

Another reason you may see clear fluid draining from the ear is after a surgery. This also may happen as a result of chronic (long-term) ear disease, including chronic middle ear infections or cancer.

Pus or Cloudy

Ear drainage that is cloudy, whitish-yellow, or pus-like can indicate an ear infection or ruptured ear drum. Pus due to an infection may also have a foul smell.

A chronic ear infection can cause pus or a pus-like drainage to drain from the ear. This refers to an ear infection that is persistent or continues to return.

Bloody

It's likely that bright red fluid draining from the ear is a sign of a serious condition. It should be seen by a healthcare provider. Bloody ear drainage may be caused by a foreign object in the ear, which is fairly common in children, or a ruptured eardrum. It also may be the sign of a head injury.

Some medical conditions, such as cancer, may cause bloody fluid to drain from the ear. People who are on blood-thinning drugs, such as aspirin or Coumadin (warfarin), may be more likely to have bloody ear drainage.

What Causes Ear Drainage?

You may notice discharge from your ear if you have any of the following common conditions:

• Ruptured eardrum
• Swimmer's ear
• Foreign objects in the ear
• Earwax
• Dermatitis
• Trauma (blood or cerebral spinal fluid)

Less common causes of ear drainage include:

• Malignant otitis externa, a complication of swimmer's ear infection
• Cancer
• Psoriasis
• Polyps
• Fungal infection

Because these reasons for ear fluid are rare, they are less likely to be a cause for your concern. A healthcare provider can decide if your ear discharge is related to one of these issues.

Ear Infection

White, yellow, or foul-smelling ear drainage may indicate an ear infection and should be assessed by a healthcare provider. An ear infection in the middle ear is known medically as acute otitis media. An infection in the outer ear (otitis externa) is also known as swimmer's ear.

Other symptoms depend on the type and location of the ear infection. But, in general, symptoms of an ear infection can include mild loss of hearing or muffled sound, fever, headache, earache, ear discharge, appetite loss, itchiness of the outer ear, blisters on the outer ear or ear canal, a buzzing or humming sensation, and vertigo.

Ruptured Eardrum

In most cases, a ruptured (or perforated) eardrum is not a medical emergency. It should, however, be checked out by a healthcare provider. The ear fluid, in this case, is usually clear but may also be bloody and whitish-yellow. Typically, there is only a small amount of fluid.

Signs that you might have a ruptured eardrum include:

• Intense ear pain that suddenly gets better
• Ringing in the ear (tinnitus)
• Hearing loss
• Ear drainage (clear, bloody, or whitish-yellow)

The most common causes of a ruptured eardrum include:

• Barotrauma, caused by rapid pressure changes
• Cholesteatoma, a noncancerous growth behind the eardrum
• Middle ear infections
• Loud noises
• A trauma emergency, such as a sharp pencil or head injury

Although a ruptured eardrum will usually heal without treatment, it's important to schedule an appointment with your healthcare provider.

Treating Ear Drainage

Over-the-counter acetaminophen can be used to control pain and fever. If you think that the ear fluid is not because of an emergency, you may want to solve the problem on your own. Here are a few things you should know:

• Do not try to clean out your ear with cotton swabs or any other object.
• Do not wash out your ear or put medicine in it until you have seen a healthcare provider.
• Do not try to shove gauze or other items into your ear to prevent drainage.

Ear Infections

Middle ear infections are often treated with over-the-counter pain relievers and a wait-and-see approach. If the body's immune system doesn't clear the infection after two or three days, your healthcare provider may prescribe antibiotics.

Outer ear infections are often treated with prescription antibiotic ear drops. In some cases, a medicine that reduces swelling of the ear canal may also be prescribed to treat swimmer's ear. In some cases, oral antibiotics may be needed. Swimmer's ear takes about seven to 10 days to clear up after starting treatment.

Ruptured Ear Drum

Antibiotic ear drops may be prescribed to help prevent a ruptured ear drum from becoming infected. If a ruptured ear drum becomes infected, you may need to be treated with an antibiotic.

If your eardrum has not healed after a few weeks, you will need to talk about other ways to repair your eardrum. Preferably, you would discuss this with an ear, nose, and throat specialist (ENT).

A tympanoplasty may be needed. This is a procedure to repair the eardrum in a healthcare provider's office. They may also want to try a 1% sodium hyaluronate solution, which has been shown to help in the healing of ruptured eardrums.

When to See Your Healthcare Provider

You may feel like you should "wait it out" to see if the drainage clears on its own. In some cases, though, a healthcare provider is your best option. Such cases include:

• Severe pain that won't go away
• A persistent high fever
• A large amount of bright red blood coming from the ear
• Fluid draining after a serious blow to the head
• Sudden hearing loss
• A sharp object that has caused bloody drainage

Summary

There are several reasons why you may see fluid drain from your ear. You're likely familiar with earwax, the most common type of drainage. This causes no real problems unless there is a buildup or the ear is making too much wax.

In other cases, though, fluid leaking from the ear may be a sign of a serious medical issue. Any trauma-related fluid should be viewed as a medical emergency.

It can be frightening to see fluid draining from your ear. Most cases will not be an emergency. In many cases, you should see a healthcare provider to ensure proper treatment. Fortunately, aside from traumatic injury, any side effects like tinnitus or hearing loss will be temporary and improve with time and proper care.