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Ear MediBilbao Salud

Ear Bleeding: Causes, What to Do and When It Is an Emergency

Finding blood in your ear, on a cotton bud or on your pillow is alarming. Most often it comes from a small scratch in the ear canal or from a perforated eardrum during an ear infection, and both usually heal well. Sometimes, though, bleeding from the ear is a sign of a more serious problem, especially after a head injury. This guide explains, from an ENT point of view, the common causes of ear bleeding, what to do and the signs that need urgent care.

Topic
ENT
Updated
Reading time
5 minutes
Reviewed by
Dr. Itziar Gotxi Erezuma · Medical doctor (ENT) · Bizkaia Medical Association no. 484809757

Scratches and injuries to the ear canal

The most common cause of a small amount of blood is a scratch to the ear canal skin. Cotton buds, fingernails, hairpins and earphones can all graze it, especially if the ear is itchy or dry. The bleeding is usually light, stops quickly and may leave a small crust.

Avoid putting anything into the ear while it heals and let the canal clean itself. See ear wax removal at home for safe ways to manage wax.

Perforated eardrum

  • From an infection: pressure from fluid behind the eardrum can make it burst, releasing blood-stained or yellow discharge. Pain often eases suddenly.
  • From injury: a cotton bud or object pushed too far, a slap over the ear or a fall.
  • From pressure changes: flying, diving or an explosion; see ear barotrauma.
  • Symptoms: muffled hearing, ringing, discharge and sometimes dizziness.

Most perforations heal on their own within about 6 to 8 weeks. See perforated eardrum.

Ear infections and skin conditions

  • Middle ear infection: pain, fever and reduced hearing, sometimes followed by discharge with blood if the eardrum perforates.
  • Outer ear infection: pain when touching the ear, itching and discharge; the inflamed skin can bleed; see swimmer’s ear.
  • Boils and spots: a painful lump in the canal that can burst with pus and blood; see pimple in the ear.
  • Bullous myringitis: blisters on the eardrum during a viral infection, which can burst and bleed.

Less common causes

  • A foreign object in the ear, especially in children.
  • Polyps or granulation tissue in chronic ear infections.
  • Cholesteatoma, an abnormal skin growth behind the eardrum that causes smelly discharge.
  • Blood-thinning medicines, which make minor bleeding last longer.
  • Rarely, tumours of the ear canal or middle ear.
  • Injuries to the outer ear or piercings.

Ear bleeding after a head injury

Bleeding from the ear or clear watery fluid draining from the ear or nose after a blow to the head can be a sign of a skull fracture. Other warning signs include bruising behind the ear, drowsiness, confusion, vomiting, severe headache and problems with vision or balance.

This is an emergency: call an ambulance or go to A&E straight away. Do not plug the ear.

What to do if your ear is bleeding

  • Stay calm and sit upright.
  • Place a clean pad or cotton wool loosely at the entrance of the ear to catch the blood; do not push anything inside.
  • Do not use ear drops unless a doctor prescribes them, as some are not safe with a perforated eardrum.
  • Keep water out of the ear when showering.
  • Take simple painkillers if you need them.
  • Arrange for a doctor to examine the ear, even if the bleeding stopped.

How an ENT specialist assesses it

The doctor looks into the ear with an otoscope or microscope to find the source of bleeding, clean the canal gently and check the eardrum. A hearing test may be done if hearing is reduced.

Treatment depends on the cause: antibiotic drops or tablets for infection, removing foreign objects, protecting a perforation while it heals and, if it does not heal, a repair operation called myringoplasty. Any persistent discharge or bleeding is investigated further.

Ear bleeding in children

In children, blood in the ear is most often caused by a middle ear infection that has perforated the eardrum, or by a small object or a cotton bud pushed into the ear. Children with grommets can also have blood-stained discharge during an infection. Keep the ear dry, do not try to remove objects yourself and arrange for a doctor to look in the ear.

When to seek urgent help

  • Bleeding or clear fluid after a head injury.
  • Heavy bleeding that does not stop.
  • Sudden hearing loss, severe dizziness or vomiting.
  • Weakness of the face, severe headache or a stiff neck.
  • High fever, or swelling and redness behind the ear.

Key points to remember

  • Most ear bleeding comes from a scratched canal or a perforated eardrum.
  • Do not put anything in the ear; keep it dry and have it examined.
  • Most eardrum perforations heal on their own within weeks.
  • Bleeding after a head injury is an emergency.

Questions about ear bleeding

These answers are general information and do not replace an examination or individual medical advice.

Is it serious if my ear is bleeding?

Usually not, but it should be examined. It is an emergency after a head injury or with sudden hearing loss, dizziness or facial weakness.

Why is there blood on my pillow from my ear?

Common causes are a scratch in the ear canal or a perforated eardrum from an infection. See a doctor to check the ear.

Can an ear infection cause bleeding?

Yes. If the eardrum perforates, blood-stained discharge can come out.

Can a cotton bud make your ear bleed?

Yes. Cotton buds can scratch the canal or, if pushed too far, damage the eardrum.

Will my hearing come back after a perforated eardrum?

In most cases hearing returns as the eardrum heals over a few weeks.

Should I clean blood out of my ear?

Gently wipe the outer ear only. Do not put anything into the canal.

Sources

  1. NHS · Perforated eardrum
  2. NHS · Ear infections
  3. NHS · Head injury and concussion
  4. MedlinePlus (NIH) · Earache

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.