Ear Discharge: Causes, Treatment, and More

Many ears naturally produce ear discharge, but it may be worrisome when it becomes pus-like or bloody, or is accompanied by pain.

This type of discharge may be a sign of a mild infection, which may develop complications if left untreated.

Being aware of the possible reasons for ear discharge will help you understand when to wait it out or see a healthcare provider.

In this article, I’ll discuss ear discharge and the different types of ear discharge.

I’ll explain the possible causes and the risk factors.

Then, I’ll talk about how medical providers diagnose ear discharge, the treatment options, and how to prevent abnormal ear discharge.

Finally, I’ll explore when to see a medical provider. 

What is Ear Discharge? 

Ear discharge, also known as otorrhea or drainage from the ear, refers to any fluid that comes out of the ear.

It can have different colors and consistency, usually based on the cause of the discharge.

Types of Ear Discharge

There are different types of ear discharge, including the following.

Waxy 

Waxy ear discharge is the most common type of ear discharge.

It is considered normal and can be white, brown, or yellow.

The glands in the ear canal produce it, and it helps keep the ear clean and protect it from infection.

Ears clean themselves and tools such as cotton swabs should never be inserted into the ear.

Bloody 

Bloody ear discharge can be caused by a minor injury in the ear, like a scratch caused by a fingernail.

It can also be seen in outer ear infections (like swimmer’s ear), after an injury, or due to a ruptured eardrum.

Cloudy 

Cloudy ear discharge, also called ear pus, is a thick opaque white-yellow fluid.

It typically contains dead white blood cells and is a sign of an ear infection or foreign body in the ear canal.

Usually, it’s accompanied by symptoms like ear pain.

Watery 

Watery ear discharge is usually a clear fluid.

Occasionally, it may have tinges of blood depending on the cause.

The common cause of this discharge is water that accumulates in the ear immediately after an activity like swimming or having a bath.

However, watery fluid draining from the ear after serious head trauma and accompanied by other head injury symptoms may be a sign of a complication and requires immediate medical attention. 

Causes

Ear discharge has varying causes ranging from mild to severe, which include:

Ear Wax 

Ear wax, also known as cerumen, is waxy oil produced by the gland in the ear canal.

Ears clean themselves, so wax usually moves to the ear opening on its own, but in some people, the glands produce excess that may harden and block the ear canal.

This blockage is one of the most common causes of hearing loss and ear discomfort.

Blockage is much more common in those who use cotton swabs or other objects to attempt to clean their ears.

Many people’s first instinct is to use cotton swabs to remove wax, but that pushes it further inside or may accidentally injure the eardrum or ear canal.

Instead, excess ear wax can be removed by dissolving the wax with ear drops, or a medical provider can use warm water and a syringe to flush it out.

Middle Ear Infection 

A middle ear infection, also known as otitis media, is an infection of the middle ear.

It is common among children and is often caused by a cold or viral respiratory infection.

It typically causes infected fluid to build up behind the eardrum, which can pressure the eardrum, causing it to ache.

Most inner ear infections do not cause any drainage from the ear.

But, in some cases, the eardrum may develop a hole allowing pus leak.

If a child has ear tubes in, they will often have ear drainage when they have an ear infection.

Swimmer’s Ear 

Swimmer’s ear, also known as otitis externa, is an infection in the outer ear canal.

It is most often seen in children and happens when water is trapped in the ear after swimming. 

The trapped water keeps the ear environment moist, which allows certain bacteria and fungi to grow.

Some of the symptoms include ear discharge, ear pain, and pain with pulling on the outer ear.

Ruptured Eardrum 

A ruptured eardrum, also known as a perforated eardrum, occurs when there is a hole or tear in the eardrum.

It can happen due to extremely loud noise, sudden change in air pressure (like in a flying plane), a hit to the ear, inserting something too far into the ear, or an ear infection that puts pressure on the ear. 

Some of the symptoms include ear discharge, pain, a ringing sound (also known as tinnitus), and even hearing loss.

Although it is not a medical emergency and typically heals on its own, a medical provider should still weigh in. 

Injury 

Injuries to the ear can damage the outer or inner ear.

Loud noises, change in ear pressure, contact sports such as wrestling, improper use of cotton swabs, foreign objects in the ear, and accidents are all common ways the ear can be hurt.

Whether mild or severe, this damage can lead to watery, bloody, or cloudy ear discharge.

Foreign Object 

Inserting foreign objects into your ear can easily cause damage to the ear canal and deeper structures, which makes it more prone to infections. 

Malignant Otitis Externa 

Malignant otitis externa happens when there is infection and damage to the bones in the ear canal and the base of the skull.

It is a rare condition and a complication of swimmer’s ear that occurs in people with an impaired immune system, like those with diabetes. 

Some of the symptoms include yellow or green discharge with a foul odor, ear pain that may worsen from head movement, itching of the ear, fever, trouble swallowing, and weakness in the facial muscles.

Risk Factors

Some of the risk factors for ear discharge include:

• Swimming
• Leaving the inner ear wet for prolonged periods
• Playing contact sports like wrestling and rugby
• Activities involving pressure change such as flying and scuba diving
• Skin conditions such as eczema or psoriasis affecting the ear
• Use of cotton swabs or any object to clean ear

Diagnosis

A medical professional may use an otoscope, a cone-shaped instrument with a light, to carry out a visual examination of the ear canal and middle ear.

They will check for signs of an infection, tears or holes on the eardrum, and the presence of foreign objects. 

An ENT may also perform a test called tympanometry, where an earbud-shaped probe pushes air into the ear, to check for problems with the middle ear.

Tympanometry can reveal the presence of fluid in the middle ear and if there is perforation and scarring of the middle ear. 

Your provider may also conduct a hearing test to check for hearing loss if need be. 

Treatment 

Treatment depends on the cause of the discharge.

For mild middle ear infections in children, providers will typically recommend watchful waiting or delayed prescribing for two to three days to see if the child needs the antibiotics.

This is because the immune system may be able to fight off the infection on its own over 85% of the time.

If a middle ear infection has caused a hole in the eardrum, the ear infection can typically be treated with antibiotic drops.

In addition, the provider may prescribe pain relief medicines for the ear pain, which also helps to lower fever, and will recommend a warm compress to provide relief.

A ruptured eardrum usually heals on its own within two months.

However, keeping it dry can help speed up the process, and a provider may prescribe antibiotics, either oral or ear drops, to help prevent infections.

Outer ear infections or swimmer’s ear are typically treated with antibiotic and anti-inflammatory ear drops.

Ear wax buildup can be treated with ear drops and a procedure to flush out wax.

Prevention 

Some of the ways to prevent abnormal ear discharge include: 

• Drying ears after being in water
• Avoiding loud noises
• Using water resistant ear plugs when going into water
• Avoiding any foreign objects in the ear, including cotton swabs
• Protecting the ear adequately while playing contact sports
• Keeping earbuds clean and sanitized and avoiding prolonged use

When to See a Medical Provider   

Although most cases of ear drainage are not emergencies, you should see a provider if you notice these symptoms:

• Bloody, cloudy, or watery ear discharge accompanied by pain
• Persistent high fever 
• Ringing in the ear
• Hearing loss
• Severe ear pain
• Inflamed ear
• Ruptured eardrum 
• Discharge that has lasted more than five days

If the discharge happens after a head injury, seek immediate medical attention.

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