Why Am I Having Ear Drainage?

Ear exam
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Ear drainage can be a sign of several conditions, depending on what type of fluid is coming from the ear. Discharge from the ear is most commonly ear wax, however it can also include blood, clear, or milky white liquid. It can also be a combination of the three.

Ear wax is yellow to orange-brown in color and is generally not a medical problem. Other types of drainage, however, can indicate conditions that may require medical attention.

Not all cases do—familiarize yourself with the different types below to see if you need to be seen by a doctor.

Overview

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

Less common causes for experiencing ear drainage includes:

  • Malignant otitis externa
  • Cancer
  • Psoriasis
  • Polyps
  • Fungal infection

In general, you should not worry about any of the above rationale for having fluid draining from your ears. Your doctor, however, will consider these if your ear discharge is not related to a common cause.

Excess Ear Wax

Ear wax is the most common substance seen coming from the ear. It is normal for a small amount of ear wax to be seen in the outer ear canal. To keep this at bay, some ENT doctors recommend using a washcloth or tissue over your little finger to clean the outer ear canal only.

Using Q-tips at any time for the removal of ear wax is not recommended. Using a Q-tip can not only push the ear wax in further, but can also cause trauma to the ear drum.

Large amounts of ear wax coming from the ear may indicate a blockage or a problem with ear wax overproduction. If this is the case, the ear wax may be removed by a physician.

You should never remove ear wax without consulting your doctor first. Ear drops that can dissolve ear wax may be used if needed. Ear wax can also be flushed out using warm water and a syringe, but this should only be done as instructed by your physician.

Ruptured Ear Drum

In most cases, a ruptured ear drum (or perforated ear drum) is not a medical emergency; however, it should be checked out by a doctor. The ear drainage in this condition is usually clear but may also be bloody and whitish-yellow. Typically, there is only a small amount of drainage.

The most common causes of a ruptured ear drum include:

Signs that you might have a ruptured ear drum include:

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

If you think you have a ruptured ear drum, understand that most are not a medical emergency and usually heal on their own. It is important, however, to schedule an appointment with your doctor, as they may want to check for an active infection and prescribe an oral antibiotic.

If no active infection is identified, your doctor may only prescribe antibiotic ear drops to help prevent an infection from occurring.

If after a few weeks your ear drum has not healed, you will need to discuss other methods to repair your ear drum with your doctor, preferably an ENT. A tympanoplasty (medical repair of the eardrum in a doctor's office) may be necessary, but they may also want to try a one percent topical sodium hyaluronate solution which has been shown to help in the healing of ruptured ear drums.

Clear Ear Drainage

Clear, and sometimes slightly blood-tinged, ear drainage can be caused by skin problems in the ear, such as eczema or swimmer's ear.

In this case, the ear drainage is the result of a weeping wound and should resolve within a few days.

In rare instances, clear ear drainage can be the result of a cerebral spinal fluid (CSF) leak. Leaks most commonly occur due to traumatic injuries or surgeries or as a result of chronic ear disease, including chronic middle ear infections or cancer.

Large amounts of clear drainage may actually be cerebral spinal fluid and can indicate damage to the skull, brain, or spine. Do not move someone who is on the ground after falling victim to a head or neck injury; instead, call emergency medical services. Any traumatic injury should have emergency medical attention.

Bleeding

Bright red ear drainage is generally the result of a serious condition and should be seen by a doctor. Bloody ear drainage can be the result of a foreign object in the ear, which is fairly common in children or a head injury.

There are also certain medical conditions, such as cancer, that may cause bloody ear drainage. People who are on blood-thinning medications, such as aspirin or Coumadin (warfarin), may be more likely to have bloody ear drainage.

Infection

Aside from ear wax, blood, and clear ear drainage, you may also experience white, yellow, or foul-smelling drainage. These types of ear drainage always need to have a doctor to evaluate.

This is usually a result of some sort of active infection that needs to be evaluated. If the drainage is a result of a bacterial infection, antibiotics will be required.

Treatment

If you suspect that the ear drainage is a result of an ear emergency, you may want to solve the problem on your own but you need to avoid the following:

  • Do not try to blindly clean out your ear with cotton swabs or any other object.
  • Do not wash out or place any medicine in your ear until you have seen a doctor.
  • Do not try to shove gauze or other items into your ear to prevent the drainage.

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

  • Severe pain that won't subside
  • A persistently high fever
  • A significant amount of bright red blood coming from the ear
  • A significant blow to the head
  • Sudden hearing loss
  • A sharp object that has caused bloody drainage

Over-the-counter acetaminophen can be used to control pain and fever. Also, be sure to see a doctor if the drainage does not go away after about five days or if you cannot get the drainage to stop. The majority of cases are not serious, but it's important to see your physician if you have any of the above symptoms.

A Word From Verywell

Seeing fluid draining from your ear can be frightening. Most cases will not be an emergency. However, in many cases it will be useful in following up with your doctor to ensure proper treatment. Fortunately, aside from traumatic injury, side effects like tinnitus or hearing loss will not be permanent and will improve with time and proper treatment.

Sources:

American Academy of Otolaryngology - Head and Neck Surgery. Perforated Ear Drum.

Bauer, CA & Jenkins, HA. (2015). Cummings Otolaryngology: Otologic Symptoms and Syndromes. 6th ed. 156, 2401-2410.e1

Strother, C.G. & Sadow, K. (2016). Evaluation of otorrhea (ear discharge) in children. http:/www.uptodate.com (subscription required).

Tucci, D.L. (2016). Otorrhea

University of Maryland Medical Center. Ear Discharge—Overview.

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