When Is Ear Drainage a Medical Emergency?

Woman with ear pain
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There are a few different types of ear drainage, including blood, clear, or milky white liquid, and, most commonly, ear wax. Drainage may also be a sort of 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 yours does.

Ear Drainage Caused by a 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. There typically is only a small amount of drainage. The most common causes of a ruptured ear drum include:

  • barotrauma (caused by rapid changes in ambient pressure)
  • middle ear infections
  • loud noises
  • trauma (such as a sharp pencil or severe blow to the head)—note that this one is always considered an emergency

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 are suffering from 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 he 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 1 percent topical sodium hyaluronate solution, which has been shown to help in the healing of ruptured ear drums.

Ear Drainage Caused by Excessive Ear Wax

Ear wax draining from the ear is generally normal and does not require medical intervention. However, this can occasionally be caused by an ear wax blockage. Symptoms include a feeling of fullness or pressure in the ear, as well as slight hearing loss. If you have these symptoms, you may need a physician to remove the ear wax.

Ear Drainage Caused by an Infection

Ear drainage caused by an infection can be milky white to yellow and may have a foul odor. Other signs of infection are pain and fever. This is not an emergency, but you do need to see a doctor. Antibiotics will probably be needed to clear up an infection.

Ear Drainage Caused by Head Injuries

This is the most dangerous type of ear drainage and does require immediate medical intervention. Drainage may be clear or bloody. 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.

What Not to Do When You Have Ear Drainage

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.

6 Reasons to Seek Immediate Medical Attention

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. These include:

  1. severe pain that won't subside
  2. a persistently high fever
  3. a significant amount of bright red blood coming from the ear
  4. a significant blow to the head
  5. sudden hearing loss
  6. 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.

    Sources:

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

    Kaur, K., Singh, H. & Singh, M. Repair of tympanic membrane perforation by topical application of 1% sodium hyaluronate. Indian J Otolaryngol Head Neck Surg. 58(3): 241–244. 2006.

    University of Maryland Medical Center. Ear Discharge - Overview.

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