Bloody earwax, appearing red or mixed with typical yellowish, tan, brown, or black earwax, indicates the presence of blood. While often a minor issue, it can sometimes signal a more serious underlying condition. Understanding the potential causes helps determine if medical attention is necessary.
Common Reasons for Bloody Earwax
Minor injury to the ear canal is a frequent cause of bloody earwax. This often occurs when cleaning ears with cotton swabs, fingers, or other objects, leading to scratches or cuts on the delicate skin. These abrasions, even if small, can cause blood to mix with earwax.
Improper ear cleaning habits can irritate the ear canal’s sensitive lining, which is rich in small blood vessels. The thin skin is vulnerable to damage from excessive force or repeated contact, resulting in superficial injuries that bleed.
Dry skin conditions, such as eczema or psoriasis, can also contribute. These conditions cause the skin inside the ear to become dry, flaky, and cracked. Such cracks can bleed, especially if scratched or irritated, and this blood then combines with earwax. Over-cleaning can worsen dryness by removing protective skin oils, making the ear canal more susceptible to cracking and bleeding.
Underlying Medical Causes of Bloody Earwax
Beyond minor irritations, several medical conditions can lead to bloody earwax. Ear infections, such as otitis externa (swimmer’s ear) or otitis media (middle ear infection), are common culprits. Otitis externa can cause bleeding due to inflammation and irritation of the outer ear canal. Severe middle ear infections can lead to fluid buildup behind the eardrum, potentially causing it to rupture and release blood.
A ruptured eardrum (tympanic membrane perforation) is a more serious cause. This tear can result from severe ear infections, sudden changes in air pressure (barotrauma from flying or diving), loud noises, or direct injury from an object inserted too deeply. When the eardrum ruptures, it causes bleeding that mixes with earwax as it drains.
Other, less common, but serious conditions include cholesteatoma, an abnormal, noncancerous skin growth in the middle ear that can cause persistent discharge and bleeding. Ear cancer, though rare, may also present with bleeding, numbness, and hearing loss. Additionally, a foreign object lodged in the ear canal can injure delicate tissues, causing bleeding and discomfort.
When to Seek Medical Attention
While minor bloody earwax may resolve spontaneously, certain symptoms warrant immediate medical evaluation. Contact a healthcare provider if bleeding is persistent, significant, or doesn’t stop. Accompanying symptoms like severe ear pain, fever, or non-earwax discharge (e.g., white, yellow, or clear fluid) also indicate a need for professional assessment.
Prompt medical attention is necessary for hearing loss, dizziness, or vertigo occurring alongside bloody earwax. If bloody earwax appears after a head injury or trauma, such as a fall or car accident, seek emergency care immediately, as this could indicate a skull fracture. Any signs of infection, such as swelling, increased redness around the ear, or facial weakness, also require a doctor’s visit.
Self-Care and Prevention
For minor cases of bloody earwax, gentle self-care can help manage the issue and prevent recurrence. Avoid inserting anything into the ear canal, including cotton swabs or other objects, as these are common causes of injury. Instead, clean the outer ear gently with a soft, damp cloth.
For those prone to dry skin in the ear, moisturizing the outer ear and avoiding over-cleaning can help maintain skin integrity. If earwax buildup becomes problematic, consider using over-the-counter ear drops to soften earwax, or consult a healthcare professional for safe removal. If concerns about bloody earwax persist or serious symptoms arise, seek professional medical advice for accurate diagnosis and treatment.