Observing blood in or from the ear can be concerning. Medically termed otorrhagia, its presence warrants attention. While sometimes indicating a minor issue, it can also signal a more serious underlying health condition requiring prompt medical evaluation.
Common Causes
Minor injuries frequently cause blood in the ear. Scratching the ear canal with a fingernail or inserting cotton swabs too deeply can cause small cuts or abrasions. These superficial skin injuries typically heal quickly. An irritated or infected ear piercing may also result in bleeding from the outer ear.
Ear infections are another common reason for ear bleeding. Both external ear infections (otitis externa) and middle ear infections (otitis media) cause inflammation and fluid accumulation. This pressure or irritation can lead to discharge that includes blood, especially if the eardrum ruptures. Ear pain, discharge, and fever often accompany these infections.
Foreign objects lodged within the ear canal, common among children, can also cause bleeding. Small items like beads, toys, or insects can irritate or puncture delicate ear structures. Such objects can lead to pain, pressure, and hearing changes. Attempting to remove these objects at home can push them deeper or cause further injury.
Certain skin conditions affecting the ear canal or outer ear can result in bleeding. Dermatological issues like eczema or psoriasis can cause the skin to become dry, cracked, or inflamed. When disturbed, this affected skin can bleed. Pimples or scabs within the ear canal, if picked or irritated, can also lead to minor bleeding.
Serious Underlying Conditions
A perforated eardrum, or tympanic membrane perforation, is a more significant cause of ear bleeding. This tear in the membrane separating the outer and middle ear can occur due to severe ear infections, sudden air pressure changes (barotrauma), loud noises, or direct trauma. A small amount of blood may accompany the rupture, alongside symptoms such as pain that might suddenly subside, hearing loss, ringing in the ears, or a spinning sensation.
Head trauma can lead to ear bleeding, which requires immediate medical attention. Injuries to the head, particularly those affecting the temporal bone, can cause internal bleeding. Bleeding from the ear after a head injury may indicate a skull fracture or other serious internal injury, including bleeding around the brain. This can also be accompanied by dizziness, nausea, vision issues, confusion, or loss of consciousness.
Severe ear infections, particularly those extending beyond the middle ear, can also result in bleeding. Mastoiditis, an infection of the mastoid bone behind the ear, can erode tissue and lead to complications. These deep-seated infections are more serious than typical ear infections and require specific treatment to prevent further tissue damage.
While less common, tumors or abnormal growths in the ear canal or middle ear can cause bleeding. These growths, which can be benign or malignant, may irritate surrounding tissues or have fragile blood vessels. Ear cancer, though rare, can cause bleeding, numbness, and hearing loss.
Conditions affecting blood vessels in or around the ear, though rare, can also contribute to ear bleeding. Issues such as vascular malformations or fragile capillaries could lead to spontaneous bleeding or bleeding from minor trauma. These conditions often require specialized diagnostic imaging to identify.
When to Seek Medical Attention
Any bleeding from the ear should be evaluated by a healthcare professional to determine its cause. This ensures proper diagnosis and treatment. Medical consultation is particularly important if ear bleeding occurs with other symptoms. These include:
Pain that is severe or worsening.
Hearing loss.
Dizziness or a spinning sensation (vertigo).
Ringing in the ears (tinnitus).
Any discharge that is not blood, such as pus or clear fluid.
Fever, severe headache, or facial weakness.
Following any head injury, blood from the ear is a serious symptom requiring immediate emergency care. This could indicate a skull fracture or bleeding around the brain. If a foreign object is suspected in the ear, especially if it causes pain, bleeding, or hearing issues, a medical professional should remove it. Sudden or heavy bleeding from the ear, without a clear minor cause, should also prompt immediate medical attention. When a child has blood from the ear, especially if accompanied by crankiness or crying, medical advice should be sought.
Diagnostic Approaches and Treatment
Diagnostic Approaches
A medical professional will typically begin diagnosing the cause of ear bleeding by taking a detailed medical history. They will inquire about recent injuries, symptoms, and past health conditions. A physical examination, using an otoscope to visually inspect the ear canal and eardrum, is a standard initial step. For more complex cases, imaging tests like X-rays, CT scans, or MRI scans may be ordered to detect skull fractures, deep-seated infections, or tumors. Laboratory tests, such as blood tests or cultures of ear discharge, might be performed if an infection is suspected.
Treatment
Treatment for ear bleeding depends on the underlying cause. For minor cuts or abrasions, cleaning the ear and sometimes applying topical antibiotics may be sufficient. If an ear infection is diagnosed, treatment typically involves oral antibiotics or antibiotic ear drops.
A perforated eardrum often heals on its own within a few weeks or months. If it does not heal naturally, surgery (tympanoplasty) may be recommended. Trauma-related bleeding requires management ranging from observation to surgical intervention. If a foreign object is present, a medical professional will use specialized instruments to safely remove it. For rare cases of tumors, treatment may involve surgical removal, radiation, or chemotherapy.