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What Causes Ear Bleeding? Your Symptoms Explained

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Bleeding from the ear is hard to ignore. It is important to known which part of the ear is bleeding because the location is a tell for the cause. Bleeding can come from damage to the ear canal skin, ruptured eardrum, especially if there is a foreign object in the ear -, or an infection from the middle ear. Read more below to learn what you should do at home for mild cases, what the major causes are, when to see a doctor and when you need to call 911.

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Bleeding from the ear explained

It's unlikely you can ignore bleeding from your ear. Bloody discharge can originate from the ear canal leading to the eardrum, the eardrum itself, or the middle ear (the part of the ear that lies behind the eardrum). Depending on the cause, which can range from mild to severe, the discharge can be blood alone or blood and other fluids, like pus.

Common accompanying symptoms of bleeding from the ear

If you're experiencing bleeding from your ear, you also experience:

What causes ear bleeding?

The following details may help you better understand your symptoms and if and when you need to see a physician.

Injury

Injuries can easily result in bleeding.

  • Ear canal injury: Bleeding from the ear can come from an injury to the skin of the ear canal. Injuries often occur when an object is inserted into the ear, such as a cotton swab or an instrument to remove earwax.
  • Eardrum injury: A tear in the eardrum can lead to bleeding from the ear. This injury can occur due to increased pressure behind the eardrum with head trauma or a middle ear infection. A foreign object inserted into the ear canal can also rupture the eardrum.
  • Head trauma: Bleeding from the ear can occur due to head trauma, even without perforation of the tympanic membrane, if there is a skull fracture with disruption of the ear canal.

Infectious causes

Ear infections can result in bleeding.

  • Middle ear infection: Usually an infection of the middle ear will not cause discharge unless there is a perforation of the eardrum. However, if ear tubes are in place, bloody discharge from an infection can drain out from behind the eardrum. A middle ear infection can also cause blisters (pustules) to form on the eardrum. Rupture of these blisters causes a bloody discharge.
  • Ear canal infection: A chronic bacterial infection of the ear canal can lead to the development of abnormal tissue that easily bleeds.

Other causes

Other causes of bleeding from the ear include the following.

  • Polyp: Chronic inflammation in the ear can cause a polyp, a type of benign skin growth that often bleeds.
  • Abnormal blood vessels: Ear bleeding can occur due to abnormal superficial blood vessels associated with a genetic disorder.
  • Cancer: Bleeding from the ear could originate from skin cancer on the external ear or in the ear canal if it develops bleeding ulcers. A white bump or scaly patch may be visible.

3 bleeding from the ear conditions

This list does not constitute medical advice and may not accurately represent what you have.

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Traumatic brain injury

A traumatic brain injury (TBI), or concussion, happens when a bump, blow, jolt, or other head injury causes damage to the brain. This can happen commonly as a result of falls, sports injuries, and car or bike accidents. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital, and the worst injuries can lead to permanent brain damage or death.

You should call an ambulance to go to the hospital immediately. There, doctors will examine you and may take images of your head (like a CT scan) to see if there's any bleeding.

Rarity: Common

Top Symptoms: new headache, irritability, clear runny nose, vision changes, general numbness

Symptoms that always occur with traumatic brain injury: head injury

Urgency: Emergency medical service

Swimmer's ear (otitis externa)

Swimmer's ear, or otitis externa, is an infection of the canal which runs from the eardrum to the opening of the ear.

It is caused by anything that introduces bacteria, fungus, or a virus into the canal. Water that stays inside the ear after swimming is a common cause, as are cotton swabs used for cleaning or earpieces that create irritation.

Most susceptible are children, because they have narrower ear canals that do not drain well.

Early symptoms include redness, itching, and discomfort inside the ear canal, sometimes with drainage of clear fluid.

Even mild symptoms should be treated because they can quickly get worse. The infection can spread and intensify, becoming very painful with increased drainage, swelling, fever, and loss of hearing.

Diagnosis is made through patient history and physical examination of the ear canal. Lab tests may be done on a sample of the discharge from the ear.

Treatment includes having a medical provider clean the ear canal of debris and discharge, and a prescription for antibiotic and/or steroid eardrops.

Middle ear infection

Middle ear infection, also called acute otitis media, is a bacterial or viral infection of the air-filled space behind the eardrum. An ear infection is usually secondary to a cold, allergy, or influenza.

Young children are most susceptible due to weaker immune systems and to the small size and shape of the Eustachian tubes in the ears. Children in group care settings are more exposed to colds and flu and therefore more prone to ear infections.

Symptoms include ear pain due to inflammation; drainage of fluid from the ear; and sometimes hearing difficulty. Children may cry, run a fever, and pull at the affected ear.

If symptoms last more than a day, a medical provider should be seen. Long-lasting or repeated ear infections can lead to hearing damage and to speech and learning problems.

Diagnosis is made through physical examination.

Middle ear infections often clear up on their own and antibiotics may only be needed for infants and severe cases. Warm compresses and over-the-counter pain relievers can be used. Do not give aspirin to children.

Foreign body in external ear

An ear foreign body is anything that gets stuck in the ear canal other than earwax. This may include food, toy pieces, beads, buttons, disk batteries, cotton swab, paper, or insects. Foreign bodies are usually trapped in the outer ear canal.

You should visit your primary care physician within the next 24 hours to have the foreign object removed. This is not a medical emergency requiring a visit to the ER, but the procedure should be performed by a medical professional to avoid damage to the eardrum. It is important to remove the object in a timely manner, however, to prevent discomfort and the possibility of an infection.

Rarity: Uncommon

Top Symptoms: ear fullness/pressure, ear discharge, pain in one ear canal, bleeding from the ear, pus leaking from the ear

Urgency: Primary care doctor

Earwax blockage

Ear wax production is a normal process, as the body makes wax to protect the ear from infection. Sometimes ear wax can build up and cover the eardrum, which is a thin layer of skin that stretches across the end of the ear canal and picks up sound from outside. Ear wax buildup has nothing to do with poor hygiene, and it is not possible to prevent a build-up by washing.

You should go to a retail clinic to be treated. You should NOT try removing the wax with cotton swabs, because you run the risk of pushing the ear wax further into the ear canal, and potentially damaging the ear canal or eardrum. A variety of ear drops exist that can be bought at the pharmacy, such as Debrox, Murine, and Cerumenex. You may also use other remedies such as mineral oil, baby oil, or glycerin ear drops instead of brand-name drops.

Cholesteatoma (a non-cancerous growth in the ear)

Cholesteatoma is a type of skin growth located in the ear, behind the eardrum. While it can be present from birth, it is usually caused by an ear infection. Symptoms include dizziness, hearing loss and pressure in the affected ear, and discharge from the affected ear.

You should consider visiting a medical professional in the next week or two to discuss your symptoms. Cholesteatoma can be evaluated with a review of your symptoms and an ear exam. Imaging such as a CT scan may be performed to rule out other conditions. Once diagnosed, it can be treated with ear cleaning, antibiotics, and eardrops. Surgery to remove the growth may be needed in some cases.

Burst ear drum

The ear drum is a thin membrane that vibrates as sound hits it, transmitting that vibration into signals that the brain understands! When it bursts, your hearing is affected. It typically happens after some force to the ear drum, such as a blow to the ear, an exploding firecracker, a fall onto water, or even a sharp object in the ear.

You should go to an urgent care center immediately. There, a doctor can confirm the diagnosis by looking in the ear. Further, he/she can clean out any debris and put in a protective cotton plug. Treatment involves keeping the ear dry to heal along with antibiotic ear drops (ofloxacin 5mL, 2-5 drops) if the ear is contaminated with dirty water or objects. You will then be referred to an otolaryngologist who will follow your recovery.

Rarity: Rare

Top Symptoms: ear canal pain, constant ear pain, ringing in the ears, vertigo (extreme dizziness), hearing loss

Symptoms that always occur with burst ear drum: ear canal pain, recent ear injury, constant ear pain

Urgency: Primary care doctor

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When to seek treatment for blood in the ear

When it is an emergency

Seek immediate treatment if:

  • Your ear bleeding starts after head trauma
  • You have a fever more than 102 degrees Fahrenheit: Along with chronic drainage and bleeding from the ear
  • You have sudden-onset hearing loss or a spinning sensation

When to see a doctor

Even if emergency care isn't necessary, you should see a physician fo ear bleeding unless there is an obvious source, such as a scratch visible in the ear canal. Make an appointment with your physician if you or your child have:

  • A history of chronic ear infections
  • Hearing loss or a spinning sensation
  • Severe and persistent pain [5]
  • A bump or scaly area in the ear: Regardless if it has stayed the same or increased in size over time.
  • Bleeding that persists several days after ear tube placement

Medical treatments

Your physician may prescribe one or more of the following bleeding from the ear treatments, depending on the cause of the bleeding.

  • Antibiotic drops for an infection
  • Laser therapy for abnormal blood vessels
  • Referral for surgical management of cancer
  • Referral for new or replacement ear tubes

At-home treatments

Many causes of ear bleeding will eventually resolve on their own. Some home treatments may also help.

  • Keep the ear dry and clean: Do not go swimming until the bleeding has resolved and dry your ears thoroughly after you bathe.
  • Avoid blowing the nose forcefully: Blowing your nose causes increased pressure behind the ears.
  • Avoid placing any objects in the ear: Especially cotton swabs or Q-tips, which can cause or exacerbate injuries to the eardrum and ear canal

FAQs about bleeding from the ear

What causes bleeding from the ear after a head injury?

Head trauma may cause a perforated eardrum, which leads to bleeding. In addition, a blow to the head can cause a skull fracture. Depending on the bone affected, the fracture can disrupt the ear canal, also resulting in bleeding. You should seek emergency treatment if you notice bleeding from the ear after a head injury.

Can bleeding from the ear be caused by an infection?

Yes, an ear infection can cause bleeding. Bleeding often occurs with an infection of the middle ear — the part of the ear behind the eardrum. A middle ear infection can cause the eardrum to rupture and bleed. Tubes inserted into the ear allow blood and other fluid to drain, and this drainage may increase with the presence of an infection. Less commonly, a chronic infection of the ear canal can lead to the development of abnormal tissue that bleeds easily.

What kinds of injuries cause bleeding from the ear?

A skull fracture can cause bleeding from the ear due to disruption of the ear canal. In addition, a perforated eardrum may cause bleeding. Head injuries or inserting foreign objects into the ear can lead to a perforated eardrum. In addition to bleeding, head trauma or eardrum perforation can lead to symptoms such as hearing loss or a sensation of spinning, depending on the extent of the injury.

Can skin abnormalities cause bleeding from the ear?

Yes, bleeding from the ear may originate from abnormalities of the skin of the outer ear or ear canal. Skin cancer on the ear may present with bleeding as it ulcerates. In this case, a white bump or scaly area may be visible. In addition, abnormal superficial blood vessels in the ear, or telangiectasias, can bleed intermittently [6]. These abnormalities can occur with the genetic disorder, hereditary hemorrhagic telangiectasia.

Can ear tubes cause bleeding from the ear?

Bleeding may occur after ear tubes are inserted to treat chronic ear infections. The bleeding should not last for more than a couple of days. In addition, bleeding from the ear may occur with an ear infection in the middle ear while the ear tubes are in place. Blood and fluid normally build up behind the eardrum during a middle ear infection. Part of the purpose of ear tubes is to relieve pressure from fluid buildup and allow drainage, so bloody discharge is possible.

Questions your doctor may ask about bleeding from the ear

  • Have someone look in your ear with a flashlight. What is seen?
  • Do you hear a ringing or whistling sound no one else hears?
  • Is there anything coming from your ear(s)?
  • Have you noticed a change in your hearing?


Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Bleeding from the ear statistics

People who have experienced bleeding from the ear have also experienced:

  • 13% Ear Canal Pain
  • 10% Pain In One Ear Canal
  • 6% Headache

People who have experienced bleeding from the ear were most often matched with:

  • 46% Traumatic Brain Injury
  • 26% Foreign Body In External Ear
  • 26% Burst Ear Drum

People who have experienced bleeding from the ear had symptoms persist for:

  • 66% Less than a day
  • 22% Less than a week
  • 4% Over a month

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

References

  1. Shargorodsky J. Ear Emergencies. U.S. National Library of Medicine: MedlinePlus. Updated May 17, 2018. MedlinePlus Link.
  2. Miyamoto RT. Eardrum Perforation. Merck Manual Consumer Version. Updated February 2018. Merck Manual Consumer Version Link.
  3. Head Injury. Johns Hopkins Medicine. Johns Hopkins Medicine Link.
  4. O'Reilly RC. Ear Injuries. Nemours: KidsHealth. Updated October 2016. KidsHealth Link.
  5. Ear - Injury. Seattle Childrens Hospital. Updated November 3, 2018. Seattle Childrens Hospital Link.
  6. Edens Hurst AC. Ataxia - Telangiectasia. U.S. National Library of Medicine: MedlinePlus. Updated August 6, 2017. MedlinePlus Link.