What Causes Pus Drainage from the Ear?

• Causes
• Outlook

Pus draining from your ear is often a sign of an infection, but it can also signal a skin cyst, ruptured ear drum, or other concerns. Depending on the cause, you may need antibiotics or surgical treatment.

Ear pain and infections are common and can cause serious discomfort. While pain is sometimes the only symptom, an ear infection or a more serious condition may be accompanied by pus or other drainage.

Pus is usually associated with bacterial buildup. If you notice pus or other drainage coming from your ears, consult your doctor to prevent the symptoms from getting worse.

What causes pus discharge from the ear?

Ear drainage shouldn’t be ignored. If you notice fluid, blood, or pus accumulating in your ear or drainage from your ear, this may be an indication of a serious condition. Following are some of the potential causes of drainage or pus from your ear.

Ear infection

Middle ear infections — also known as acute otitis media — are common, particularly in children. They’re often caused by a bacterial or viral infection affecting the middle portion of the ear. Common symptoms of an ear infection include:

• pain
• pus or drainage
• difficulty hearing
• loss of balance
• fever

If too much pressure builds up from an infection in the middle ear, the ear drum can tear open, causing bleeding and drainage to occur.

Minor ear infections can clear up on their own, but more severe cases require antibiotics and pain medication. If the condition becomes recurrent, your doctor may recommend tympanostomy tubes (ear tubes).

This requires a surgical procedure that drains the fluid from the middle ear and inserts tiny tubes into the ear drum. These help prevent the buildup of fluid and bacteria in the middle ear.

Swimmer’s ear

Swimmer’s ear is a type of infection that affects the outer ear canal (otitis externa). It can happen when water becomes trapped in your ear, after swimming, for example, allowing bacteria or fungus to grow.

You can also develop outer ear infections if you damage the lining of your ear canal by using cotton swabs or other materials to clean your ear. Certain medical conditions, such as diabetes, can make you more prone to these infections.

Symptoms are typically mild but can become severe if the infection goes untreated. If you have swimmer’s ear or another type of outer ear infection, you may experience symptoms including:

• itching in your ear
• scaling and peeling of the outer ear
• redness
• swelling of the ear canal
• pus or drainage
• ear pain
• muffled hearing
• fever
• swollen lymph nodes

Treating a swimmer’s ear infection and other outer ear infections requires medicated ear drops. Antibiotics or antifungal medication may also be needed depending on the cause of your infection.

Your doctor may also recommend pain medication for temporary relief. While treating this infection, it’s recommended that you do not soak your ear, swim, or use ear plugs or earbud headphones.

Skin cyst

A cholesteatoma is an abnormal, noncancerous growth that can develop in the middle portion of your ear behind your eardrum. They often develop as cysts that may increase in size over time.

If a cholesteatoma increases in size, it can destroy bones in your middle ear and result in hearing loss, facial muscle paralysis, and dizziness. Other symptoms you may experience with this abnormal skin growth include:

• pain or aching
• foul-smelling drainage or pus
• pressure in the ear

Cholesteatomas don’t heal or go away on their own. Surgery is needed to remove them, and antibiotics are required to treat the infection and reduce inflammation.

Foreign object

Anything foreign to the body that can get stuck in your ear can cause pain, drainage, and damage. This is particularly a problem for younger children. Common objects that can get trapped in the ear canal include:

• small toy pieces
• beads
• food
• insects
• buttons
• cotton swabs

In some cases, these objects can be removed at home once they’re noticed — but only if they’re easily seen near the outer opening of the ear.

If they’re trapped further along in the ear canal, seek immediate medical attention.

Trying to pry these foreign objects out on your own may cause more damage.

Ruptured eardrum

A ruptured eardrum can be the result of pressure caused by fluid buildup in the middle ear, often from an infection. It can also result from ear injury or trauma from a foreign body. As a result, you may notice fluid or pus draining from the ear.

Other common symptoms associated with this condition include:

• sharp, sudden ear pain
• ear ache
• bleeding
• ear buzzing
• dizziness
• hearing changes
• eye or sinus infections

A ruptured eardrum usually heals without medical treatment. However, your doctor may recommend surgery to repair the rupture if it doesn’t heal on its own.

Your doctor may also prescribe antibiotics to treat an ear infection along with medication for pain relief.

Outlook

Ear drainage or discharge shouldn’t be ignored. The appearance of pus may be a sign of an ear infection or an underlying condition that should be discussed with your doctor.

If this symptom is paired with intense pain, a head injury, or hearing loss, seek immediate medical attention.

Minor infections may clear on their own, but treatment by your doctor is often necessary to prevent or manage recurring conditions.

Last medically reviewed on August 27, 2018

How we reviewed this article:

Medically reviewed by Judith Marcin, M.D. — Written by Kiara Anthony — Updated on August 28, 2018

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What Causes Ear Discharge and How Do I Treat It?

Ear discharge can be caused by several types of infections and injuries. A doctor can help determine the cause and best course of treatment.

Overview

Ear discharge, also known as otorrhea, is any fluid that comes from the ear.

Most of the time, your ears discharge earwax. This is an oil that your body naturally produces. The job of earwax is to make sure that dust, bacteria, and other foreign bodies don’t get into your ear.

However, other conditions, such as a ruptured eardrum, can cause blood or other fluids to drain from your ear. This kind of discharge is a sign that your ear has been injured or infected and requires medical attention.

What causes ear discharge?

In most cases, discharge from your ear is simply ear wax making its way out of your body. This is natural. Other conditions that can cause discharge include infection or injury.

Middle ear infection

Middle ear infection (otitis media) is a common cause of discharge from the ear. Otitis media occurs when bacteria or viruses make their way into the middle ear. The middle ear is behind the eardrum. It contains three bones called ossicles. These are vital to hearing.

Ear infections in the middle ear can cause fluid to build up behind the eardrum. If there is too much fluid, there is a risk of perforation of the eardrum, which can lead to ear discharge.

Trauma

Trauma to the ear canal can also cause discharge. Such trauma can occur while cleaning your ear with a cotton swab if you push it in too deep.

An increase in pressure, such as when you’re flying in an airplane or scuba diving, can also result in trauma to your ear. These situations may also cause your eardrum to rupture or tear.

Acoustic trauma is damage to the ear due to extremely loud noises. Acoustic trauma can cause your eardrum to rupture as well. However, these cases aren’t as common as the others described.

Swimmer’s ear

Otitis externa, commonly known as swimmer’s ear, occurs when bacteria or fungus infects your ear canal. It usually occurs when you spend long periods of time in water.

Too much moisture inside your ear can break down the skin on the walls of your ear canal. This allows bacteria or fungus to enter and cause an infection.

However, swimmer’s ear isn’t exclusive to swimmers. It can result whenever there’s a break in the skin of the ear canal. This might occur if you have irritated skin as a result of eczema.

It can also occur if you insert a foreign object into the ear. Any damage to your ear canal makes it more susceptible to infection.

Less common causes

A less common cause for ear discharge ismalignant otitis externa, a complication of swimmer’s ear that causes damage to the cartilage and bones in the base of the skull.

Other rare causes include a skull fracture, which is a break in any of the bones in the skull, or mastoiditis, which is an infection of the mastoid bone behind your ear.

When should I seek medical attention?

You should call your doctor if the discharge from your ear is white, yellow, or bloody or if you’ve had discharge for more than five days. Sometimes ear discharge may occur with other symptoms, such as a fever. Tell your doctor if you have any accompanying symptoms.

If you experience serious pain, your ear is swollen or red, or you have a loss of hearing, you should see your doctor.

If you have an injury to the ear that causes discharge, that’s another good reason to consult a doctor.

You can connect with an ENT in your area using the Healthline FindCare tool.

What are the treatment options for ear discharge?

Treatment of your ear discharge depends on its cause. In some cases, your condition won’t need medical treatment.

For example, the American Academy of Pediatrics describes a 48-hour “wait-and-see” approach, accompanied by close follow-up, as one option for treating mild ear pain in children.

Signs of an ear infection usually start to clear up within the first week or two, without any treatment. Pain medications might be needed to deal with any pain or discomfort.

If your child is under six months old or has a fever over 102.2°F, your doctor might prescribe antibiotic ear drops.

Most cases of ear trauma also heal without treatment. If you have a tear in your eardrum that doesn’t heal naturally, your doctor might apply a special paper patch to the tear. This patch keeps the hole closed while your eardrum heals.

If a patch doesn’t work, your doctor might surgically repair your ear using a patch of your own skin.

A doctor should treat swimmer’s ear to prevent the infection from spreading. Typically, your doctor will give you antibiotic ear drops to use for about a week. In severe cases, oral antibiotics will also be necessary.

How can I prevent ear discharge?

To avoid ear infections, try to stay away from people who are sick.

According to the Mayo Clinic, breastfeeding may provide infants with protection from ear infections, since they receive their mother’s antibodies in their milk.

They advise that, if you bottle-feed your baby, you should try holding your infant in an upright position rather than letting them drink lying down.

Keep foreign objects out of your ears to avoid rupturing your eardrum. If you know you’ll be in an area with excessive noise, bring ear plugs or muffs to protect your eardrums.

You can prevent swimmer’s ear by making sure to dry your ears after being in the water. Also, try to drain any water by turning your head to one side and then the other. You can also use over-the-counter medicated ear drops after you swim to control and alleviate swimmer’s ear.

Shop for over-the-counter ear drops online.

Shop for ear plugs or muffs online.

There are many different causes of ear drainage. The most common type of draining from the ear is earwax, which keeps the ear clean and healthy.

Other types of drainage and discharge include blood, clear fluid, and pus. These may signal a ruptured eardrum or ear infection.

Anyone who notices ear discharge after an injury to the head should seek medical attention straight away.

In this article, we look at the possible causes of ear drainage as well as treatment options and when to see a doctor.

Types and causes

Discharge from the ear can be a symptom of an infection.

Types and causes of ear drainage include:

Earwax

Earwax is normal drainage from the ear, and it can be white, yellow, or brown. The ears produce earwax to keep the ear clean and healthy and to protect it from infection.

If earwax mixes with water, for example, when someone bathes or swims, it can look like runny discharge.

Clear fluid

Clear fluid draining from the ear may be water, which can collect in the ear after swimming or bathing.

People can gently dry their ears after getting wet by holding a hair dryer on low heat away from their ear or by using a towel. Taking time to dry the ears can help prevent an infection called swimmer’s ear, in which water becomes trapped in the ear.

Doctors sometimes place an ear tube in the ears of people who get frequent ear infections. The ear tube provides an opening into the middle ear, which may allow a small amount of clear fluid to drain from the ear.

People should contact their doctor if any clear fluid drainage continues for more than 24 hours.

If a person notices clear fluid from their ears after an injury to the head, they should seek immediate medical attention.

Blood

A minor injury or scratch in the ear canal can sometimes cause a small amount of blood to exit the ear.

If a person has a ruptured eardrum, they may notice blood, pus, or clear fluid draining from the ear. The eardrum sits between the ear canal and the middle ear, and it can rupture if something creates a small hole in it.

The eardrum can rupture if:

• an ear infection puts pressure on the ear
• a loud noise happens very close to the ear
• a person inserts something too far into the ear
• someone experiences a sudden change in air pressure
• an injury occurs, such as a hit to the ear

A ruptured eardrum can cause the following symptoms:

• ear pain, then sudden relief
• ringing in the ear
• loss of hearing in the affected ear

If people notice any bleeding from the ear due to a head injury, they should seek immediate medical help.

Pus or cloudy fluid

Pus or cloudy fluid coming from the ear can be a sign of an ear infection in the ear canal or middle ear. The ear canal is the tube that joins the outer ear to the middle ear.

An infection of the middle ear, which doctors may refer to as otitis media, can cause fluid discharge from the ear. Ear infections can cause the eardrum to rupture in roughly 10 percent of cases. A ruptured eardrum can also cause drainage from the ear.

Ear infections can happen due to a cold, flu, or injury to the ear. Some people are more prone than others to frequent ear infections. If people have an ear infection, they may also have the following symptoms:

• an earache
• fever
• nausea

Diagnosis

A doctor will use an otoscope during an ear examination.

A doctor will use an otoscope, which is a lighted microscope, to examine the ear and try to identify the underlying cause of the drainage.

They may also use a pneumatic otoscope that produces a puff of air to show how the eardrum moves in response to pressure. Doing this can show whether there is a buildup of fluid behind the eardrum.

A test called tympanometry can help doctors examine the health of the middle ear. To do this test, a doctor will insert a probe into the ear and evaluate how the middle ear responds to different pressure levels.

During an ear examination, doctors may also carry out a hearing test or use a tuning fork to test hearing levels.

Treatment

Doctors will often prescribe antibiotics for some types of infection, which people can take either by mouth or as ear drops depending on the location of the infection in the ear.

To help ease earache, people can use a warm compress on their ear or take over-the-counter pain relievers, such as ibuprofen.

A ruptured eardrum will often heal without treatment within a few weeks to 2 months. People can help the healing process and prevent infections by keeping their ear dry and protecting it from loud noises and physical knocks.

If an eardrum does not heal by itself, surgery may be necessary to patch new skin over the hole.

A doctor may prescribe antibiotics to treat ear fluid. The combination of a decongestant and an antihistamine can help reduce congestion.

If this treatment is not effective, the doctor can place an ear tube through the middle ear to allow fluids to drain as usual.

Prevention

People can help prevent conditions that cause ear drainage by taking steps to care for their ears, such as:

• using earplugs in the ear when swimming to help keep water out and prevent infection
• blowing the nose gently, not forcefully
• carefully drying the outside of the ears after getting them wet
• avoiding inserting any objects into the ear

When to see a doctor
If a person has a fever along with ear drainage, they may wish to consult their doctor.

People should see their doctor if they experience any of the following:

• blood, clear fluid, or pus leaking from the ear
• ringing or loss of hearing in the ear
• symptoms of a ruptured eardrum that persist for longer than 2 months
• severe pain in the ear
• a high fever
• swelling and inflammation behind the ear

If people notice any drainage from the ear after a head injury, they should seek medical help immediately.

Summary

Ear drainage can include:

Viruses cause most ear infections, although sometimes bacteria are the culprit. There are three main typesTrusted Source of ear infections that affect the middle ear:

• Acute otitis media (AOM) is the most common type of ear infection. Fluid builds up behind the eardrum, causing a painful earache.
• Otitis media with effusion (OME) usually occurs in children. It develops after an original ear infection has resolved, but fluid remains trapped in the middle ear. A child may not have any symptoms, but a doctor can see signs of fluid behind their eardrum.
• Chronic otitis media with effusion (COME) is when fluid stays in the ear for an extended period or keeps coming back. Someone with COME often finds it harder to fight off new ear infections and may have some trouble hearing. A doctor will diagnose COME after a person has had OME for 3 or more monthsTrusted Source.

Another form of chronic ear infection is called chronic suppurative otitis media (CSOM). People with CSOM have recurring and persistent ear discharge. The condition usually developsTrusted Source as a complication of AOM with perforation of the eardrum in childhood.

People with untreated or chronic ear infections can develop several complications. Repeated ear inflammation can cause the following conditions:

• Mastoiditis, which is an uncommon condition that causes AOM symptoms as well as redness or swelling behind the ear.
• Cholesteatoma, which is a growth of skin cells in the middle ear, often due to recurrent ear infections.

Symptoms

A person’s symptoms will differ depending on the type of ear infection they have. The symptoms may be present in one or both ears and may come and go.

A chronic ear infection usually develops when a person has:

• an acute ear infection (AOM) that does not completely heal
• repeated ear infections

Symptoms of an acute ear infection

The symptoms of an acute ear infection include:

• ear pain
• hearing problems
• fever of 100.4°F or higher
• nausea or vomiting
• ear discharge

Children may also show signs of irritability. They may also cry more frequently and tug at the affected ear.

Symptoms of chronic ear infections

Someone with a chronic ear infection does not usually have any visible symptoms. However, long-term OME can cause hearing problems and other difficulties, particularly in children. These include:

• delayed responses, or taking a long time to understand speech
• difficulties speaking or reading
• poor balance
• limited attention
• less ability to work independently

Doctors consider OME to be chronic if it lasts for 3 monthsTrusted Source or more.

According to a 2016 guideline, OME usually disappears by itself within 3 months.

They also report that 30–40 percent of children experience OME more than once, and 5–10 percent of episodes last for 1 year or longer.

When someone has CSOM, they have a hole in their eardrum. When the eardrum bursts, it releases tension, so not everyone with CSOM will feel painTrusted Source. However, people with AOM or recurrent AOM will likely experience pain.

The symptoms of CSOM include:

• hearing loss
• leaking fluid from the ear
• a hole in the eardrum

People with CSOM are unlikely to have a fever.

Causes and risk factors

Chronic ear infections develop from a long-lasting or recurrent acute ear infection. Preventing acute ear infections can help prevent chronic ear infection.

Acute ear infections happen when the eustachian tube, a tube that runs from the middle ear to the back of the throat, becomes clogged.

Children are more likely to be affected by ear infections because these tubes are shorter and narrower, so they become clogged more easily.

Fluid build-up in the middle ear can become infected, which will cause pain and other symptoms.

Causes of ear infections includeTrusted Source:

• bacterial infection
• the common cold
• the flu

Risk factors for chronic ear infections include:

• a recent upper respiratory tract infection
• Down syndrome
• having a cleft palate
• a family history of ear infections

Busy day-care centers can also increase the risk of children developing ear infections, as they come into more contact with viruses and bacteria.

Treatment

Some ear infections resolve on their own, while others may need further treatment. Anyone who still has an ear infection after several days should seek medical attention to find out the type of ear infection they have.

Generally, OME goes away on its ownTrusted Source. The American Academy of Otolaryngology recommend against using antibiotics, antihistamines, and decongestants for treatment of OME. However, antibiotics may benefit people with acute ear infections.

Treatments for chronic ear infections include the following:

Dry mopping

Dry mopping, also called an aural toilet, is when a doctor flushes and cleans the ear of wax and discharge.

Doctors think this speeds up recovery from some types of chronic ear infections, such as CSOM, as it keeps the ear canal free of debris and discharge.

Medication

People who have an ear infection may find relief in taking over-the-counter pain and fever reduction medication, such as acetaminophen or non-steroidal anti-inflammatories (NSAIDs). Children should not take aspirin.

Antibiotics

Antibiotics only work if bacteria are the cause of the infection, and may not be helpful for people with chronic ear infections.

Many professionals recommendTrusted Source “watchful waiting” to allow the infection to clear up by itself. Some doctors may prescribe antibiotics for a bacterial infectionTrusted Source if there is drainage from the ear, or if the infection is in both ears of a child under 2 years old.

People with infections that have resulted in a punctured eardrum or a hole in the middle ear, such as CSOM, may benefit from prescribed antibiotic ear drops, such as ciprofloxacin.

However, antibiotics can have side effects, so taking them unnecessarily can make a person feel worse, rather than better. Also, over time, the bacteria that cause some ear infections can become more resistant to antibiotics.

Antifungal treatments

Doctors may recommend antifungal ear drops or ointments if a fungal infection causes a person’s symptoms.

An ear tap

Also known as tympanocentesis, an ear tap involves removing fluid from behind the eardrum and testing the fluid to identify what is causing the ear infections.

In situations where a person has a recurring ear infection or one that does not respond to treatment, a doctor might perform a surgical procedure to insert a pressure equalization (PE) tube into the eardrum.

This allows fluid to move out of the middle ear and relieves pressure in the eardrum. Sometimes, these tubes fall out on their own, other times a doctor will need to remove them.

Adenoidectomy

An adenoidectomy is a procedure to remove the adenoids. The adenoids are glands at the back of the nose that help fight infections.

However, if they become enlarged due to an infection, they can cause an earache and a build-up of fluid.

If this happens regularly, a doctor may perform an adenoidectomy to help reduce chronic ear infections.

According to a 2014 studyTrusted Source, children under the age of 2 with recurrent AOM and those who are over the age of 4 with persistent OME are most likely to benefit from adenoidectomy.