What Causes the Eardrum to Appear Red?

The eardrum, which is also called the tympanic membrane is a thin piece of tissue which separates the middle and inner ear from the external auditory canal. The eardrum receives sound vibrations and carries them to the tiny bones (called ossicles) inside the ear. The eardrum also functions to protect the delicate structures of the middle and inner ear from the external environment.

The eardrum can be examined by a physician using an instrument called an otoscope. A healthy eardrum is usually a pearl-gray color. Changes in the appearance of the eardrum including color are often an indication of illness or infection. In addition to color, the mobility of the eardrum is also assessed. A healthy eardrum remains flexible while a rigid, stiff eardrum may indicate an abnormal condition such as fluid in the ears. Diseases of the ears can also cause the eardrum to appear bulging or retracted.

In medicine, redness is often an indication of irritation or inflammation. While many ear conditions can result in a red eardrum it should be noted that in the absence of other signs or symptoms a red eardrum alone may not indicate any kind of illness. However, the following conditions can be associated with redness of the eardrum.

Middle ear infections, also called acute otitis media, are a common condition which affects people of all ages but is much more common in small children than adults. A common finding is a red eardrum which may also appear bulging or immobile. A red eardrum is almost always accompanied by other symptoms such as a fever, earache, or ear discharge. Middle ear infections are often caused by a bacterial infection and usually treated with antibiotics.

Swimmer's ear, also called otitis externa, is an infection of the external ear canal. Swimmer's ear is caused by contaminated water entering the ear. The infection generally causes redness and irritation of the external ear canal but it is possible that redness could spread to the eardrum as well. Swimmer's ear is commonly treated with antibiotic ear drops.

Trauma to the eardrum which often occurs as the result of barotrauma can also cause redness in the ear which may be accompanied by ear pain, drainage or other visible signs of trauma. Barotrauma of the ear occurs when the auditory tube does not function properly and excessive pressure builds up behind the eardrum, sometimes resulting in rupture of the tympanic membrane. This usually occurs when you are participating in activities that involve sudden or extreme changes in atmospheric air pressure, such as scuba diving or flying in an airplane. It can also be the result of being exposed to an extremely loud noise such as an explosion.

Bullous myringitis is a condition in which painful vesicles form on the eardrum.  These vesicles are sometimes filled with blood. Bullous myringitis is often the result of a viral infection such as influenza.

Fungal myringitis is an infection of the tympanic membrane that is caused by a fungus.

Allergic skin conditions such as eczema can also affect the inside of the ear and the epidermis of the eardrum. In addition to redness, severe itching and flaking of the skin inside of the ear may also be symptoms. These conditions are sometimes treated with ear drops which contain a steroid.