Seeing blood on a cotton swab after cleaning your ears can be unsettling. While often due to minor irritation, it may sometimes signal a more significant underlying concern. Understanding the common reasons this occurs and knowing the appropriate actions is important for maintaining ear health and preventing complications.
Common Causes of Bleeding
The delicate skin lining the ear canal is susceptible to injury. Inserting a cotton swab too far or aggressively can scratch or irritate this skin, which contains superficial blood vessels. This minor trauma can lead to a small amount of blood appearing on the swab.
Impacted earwax is another common reason for bleeding. When earwax hardens or becomes impacted, it adheres firmly to the ear canal lining. Using a Q-tip to dislodge this wax can cause friction or minor tears in the sensitive skin, resulting in bleeding.
Ear infections, such as otitis externa (also known as swimmer’s ear), can also make the ear canal prone to bleeding. These infections cause inflammation, tenderness, and increased fragility of the ear canal skin, which can bleed with even slight contact. The skin may become red, swollen, or scaly, and discharge might be present.
Dryness or eczema can also contribute to bleeding. Eczema causes the skin to become dry, flaky, itchy, and sometimes inflamed, making it brittle and prone to cracking or bleeding upon contact. Small foreign objects lodged in the ear canal can cause irritation, and a Q-tip might inadvertently push against or rub them, leading to bleeding.
Immediate Steps to Take
If you discover blood on a cotton swab, immediately stop any ear cleaning activity. Continuing to probe the ear could worsen an existing injury or introduce new trauma to the sensitive ear canal.
Gently wipe away any visible blood from the outer ear using a clean, soft cloth or tissue. Avoid inserting anything into the ear canal, including fingers or additional cotton swabs, to prevent further irritation or injury.
Observe the ear closely for any continued bleeding, pain, or changes in hearing. Avoid introducing anything else into the ear canal, such as ear drops, unless advised by a healthcare professional. Keep the ear dry by avoiding swimming or getting water in the ear, as moisture can introduce bacteria and increase the risk of infection.
When to Seek Medical Care
While minor bleeding often resolves on its own, certain symptoms warrant prompt medical evaluation. Seek professional medical attention if bleeding is persistent, heavy, or does not stop quickly, as it could indicate a more serious underlying issue.
Consult a healthcare provider if bleeding is accompanied by severe pain, dizziness, a spinning sensation (vertigo), sudden hearing loss, or ringing in the ears (tinnitus). Also seek care for any unusual discharge such as pus or a foul odor.
Signs of an infection, such as fever, increased redness, swelling, or tenderness around the ear, also necessitate a doctor’s visit. If there is suspicion of a ruptured eardrum, indicated by sudden, sharp pain followed by relief, or a noticeable change in hearing, immediate medical attention is important. A ruptured eardrum is a tear in the thin membrane separating the outer and middle ear, which can be caused by inserting objects too far into the ear canal.
Consult a healthcare professional if bleeding is suspected to be caused by a foreign object, or if it occurs without clear reason or obvious trauma. Early diagnosis and treatment are important to prevent complications.
Preventing Future Occurrences
To avoid future bleeding, reconsider using cotton swabs for inner ear cleaning. Healthcare professionals advise against inserting cotton swabs or any other objects into the ear canal. This practice can push earwax deeper, causing impaction, or injure the delicate ear canal lining or eardrum.
The ear is naturally self-cleaning, with earwax typically migrating out of the ear canal on its own. For routine hygiene, cleaning should be limited to the external ear and earlobe, which can be gently wiped with a soft, damp cloth after showering.
For individuals experiencing significant earwax buildup, over-the-counter earwax softening drops can be a safe option. Products containing ingredients like mineral oil, hydrogen peroxide, or carbamide peroxide can help soften hardened wax, allowing it to drain more easily. However, it is important to use these products as directed and consult a doctor if there are concerns, especially if a ruptured eardrum is suspected.
If earwax becomes impacted or causes symptoms like hearing loss or fullness, seeking professional ear cleaning is advisable. Healthcare providers can safely remove excess wax using specialized instruments, irrigation, or microsuction, avoiding the risks associated with at-home methods. For underlying conditions such as eczema or chronic dryness, working with a doctor to manage these issues can also reduce the likelihood of future bleeding.