Causes and Treatment for Ear Drainage

Ear drainage may be a sign of several health conditions, depending on what type of fluid is coming from the ear. It's common to have fluid discharge from the ear while sleeping, so you find the evidence on your pillow. It's most often ear wax. But if it's white, yellow, or bloody, it could be from a ruptured eardrum.

Ear wax is yellow to orange-brown in color and is generally not a medical problem. Other types of drainage, though, may be a sign that you need medical attention.

This article presents several types of ear fluid you may see. It will help you to know what some of the suspected causes are, and whether you may need to call your healthcare provider.

Symptoms

The type of fluid you see may help you to understand what exactly is going on in the affected ear. Here are some of the more common types of ear fluid you may encounter.

Clear Ear Drainage

Ear drainage that is clear or slightly blood-tinged can be caused by skin problems. These problems, such as eczema or swimmer's ear, affect the skin inside the ear. In most cases, the ear fluid is due to a weeping wound. It should get better by itself within a few days.

In rare cases, clear ear drainage can be the result of a cerebospinal fluid (CSF) leak. This is the fluid that surrounds the brain and spinal cord. CSF leaks usually happen after a traumatic injury. Large amounts of clear CSF can mean damage to the skull, brain, or spine.

Another reason you may see clear fluid draining from the ear is after a surgery. This also may happen as a result of chronic (long-term) ear disease, including chronic middle ear infections or cancer.

Bleeding

It's likely that bright red fluid draining from the ear is a sign of a serious condition. It should be seen by a healthcare provider. Bloody ear drainage may be caused by a foreign object in the ear, which is fairly common in children. It also may be the sign of a head injury.

Some medical conditions, such as cancer, may cause bloody fluid to drain from the ear. People who are on blood-thinning drugs, such as aspirin or Coumadin (warfarin), may be more likely to have bloody ear drainage.

Causes

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

• Ruptured eardrum
• Swimmer's ear
• Foreign objects in the ear
• Ear wax
• Dermatitis
• Trauma (blood or cerebral spinal fluid)

Less common causes of ear drainage include:

• Malignant otitis externa, a complication of swimmer's ear infection
• Cancer
• Psoriasis
• Polyps
• Fungal infection

Because these reasons for ear fluid are more rare, they are less likely to be a cause for your concern. A healthcare provider can decide if your ear discharge is related to one of these issues.

Excess Ear Wax

Ear wax is the most common discharge seen in the ear. It is normal for a small amount of ear wax to be seen in the outer ear canal. Some ear specialists say to use a washcloth or tissue over your little finger to clean the outer ear canal only.

Using cotton swabs, like Q-tips, is not the best solution for the removal of ear wax. That's because using a Q-tip may push the ear wax in farther. It also may cause trauma to the eardrum.

Sometimes, there may be large amounts of ear wax. This may be a sign of a blockage. It also may mean there is a reason why the ear is making too much wax. If this is the case, the ear wax may need to be removed by a healthcare provider.

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 a healthcare provider.

Ruptured Eardrum

In most cases, a ruptured (or perforated) eardrum is not a medical emergency. It should, however, be checked out by a healthcare provider. The ear fluid in this case is usually clear but may also be bloody and whitish-yellow. Typically, there is only a small amount of fluid.

Signs that you might have a ruptured eardrum include:

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

The most common causes of a ruptured eardrum include:

• Barotrauma, caused by rapid pressure changes
• Cholesteatoma, a noncancerous growth behind the eardrum
• Middle ear infections
• Loud noises
• A trauma emergency, such as a sharp pencil or head injury

You may need to be checked for infection and treated with an antibiotic. If there is no active infection, antibiotic ear drops may be prescribed to help prevent any infection from occurring.

If your eardrum has not healed after a few weeks, you will need to talk about other ways to repair your eardrum. Preferably, you would discuss this with an ear, nose, and throat specialist (ENT).

A tympanoplasty may be needed. This is a procedure to repair the eardrum in a healthcare provider's office. They may also want to try a 1% sodium hyaluronate solution, which has been shown to help in the healing of ruptured eardrums.

Infection

Aside from ear wax, blood, and clear ear drainage, you may also see a white, yellow, or foul-smelling fluid. These types of ear drainage may indicate infection and need to be assessed by a healthcare provider. If the fluid is because of a bacterial infection, antibiotics will be needed.

Treatment

Over-the-counter acetaminophen can be used to control pain and fever. If you think that the ear fluid is not because of an emergency, you may want to solve the problem on your own. Here are a few things you should know:

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

When to See Your Healthcare Provider

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

• Severe pain that won't go away
• A persistent high fever
• A large amount of bright red blood coming from the ear
• Fluid draining after a serious blow to the head
• Sudden hearing loss
• A sharp object that has caused bloody drainage

Summary

There are several reasons for why you may see fluid drain from your ear. You're likely familiar with ear wax, the most common type of drainage. This causes no real problems unless there is a buildup or the ear is making too much wax.

In other cases, though, fluid leaking from the ear may be a sign of a serious medical issue. Any trauma-related fluid should be viewed as a medical emergency.

A Word From Verywell

It can be frightening to see fluid draining from your ear. Most cases will not be an emergency. In many cases, you should see a healthcare provider to ensure proper treatment. Fortunately, aside from traumatic injury, any side effects like tinnitus or hearing loss will be temporary and improve with time and proper care.