A bleeding ear is naturally a cause for concern. The sight of blood is usually associated with severe injury that has caused a break in a blood vessel. The ear is no different. Bleeding from the ear should always be taken seriously and investigated. While it can be due to many serious and sometimes even life-threatening conditions, often a bleeding ear is not very serious if it has not arisen after a major head injury. Nevertheless the underlying cause needs to be investigated and appropriately treated.
Why do the ears bleed?
A hemorrhage (bleeding) arises when there is a break in a blood vessel and the blood can seep out of it. Surface bleeding is visible while deeper bleeding is not but with the ears, blood could be arising from deeper structures and reach the surface via the ear canal. Furthermore, blood can also leak out into the nose or mouth as the eustachian tube from the middle ear connects to the back of the nose. Therefore nasal bleeding or blood in the mouth could arise from the ear.
Bleeding may arise for a number of different reasons – from injury, to severe infections and even cancers. The extent of the tissue damage is such that blood vessels which are normally protected by overlying tissue Generally bleeding is considered to a be serious sign and the presence of blood should always be investigated, irrespective of the quantity. However, this does not always mean that bleeding is due to a serious condition and could resolve shortly without any need for treatment.
Causes of Bleeding Ears
There may be gross bleeding from the ears, blood mixed with wax or blood-tinged ear discharge. With an intact eardrum, bleeding from the ears is usually originates from the outer ear. However, when the eardrum is torn (perforated), bleeding from the middle ear and even inner ear could pass out through the ear canal.
Injury to the ear can arise through a number of different ways. Piercings, trauma by picking at the ear, foreign bodies in the ear or barotrauma caused by high pressure (air or water) are some of the possible causes. It may injure the pinna, ear canal or ear drum. A ruptured ear drum is one of the more common causes of bleeding ears. Smaller tears may heal with little or no discomfort or bleeding. Apart from the causes mentioned, a torn eardrum can also arise with a slap to the ear or even a very loud sound.
Trauma to the head can result in otorrhea which is a discharge of cerebrospinal fluid (CSF) from the ears. This may be tinged with blood or accompanied large volumes of blood to the point that the CSF is not visibly discernible. Traumatic head injury may arise with falls, assaults or motor vehicle collisions. The thin bone that forms the base of the skull is fracture in these cases allowing the brain cavity to communicate with the ear cavity. It may also be accompanied by a CSF discharge from the nose which is referred to as rhinorrhea.
Infections and Infestations
Ear infections can be caused by viruses, bacteria and fungi. Bacterial infections can usually be severe, especially if left untreated and is therefore more likely to lead bleeding. Infections are more common in children, people with allergies and repeated irritation of the outer ear as is seen with swimmer’s ear (otitis externa). Systemic infections like viral hemorrhagic fever can cause bleeding from the orifices including the ears.
Infestations of the ear are uncommon as the ear wax (cerumen) repels insects from residing in the ear canal. Scabies is one mite that may reside by the ear as it forms its own tiny burrows in the skin. Although there may be no bleeding from these burrow tracks, repeated scratching of the area can cause breaks in the skin and result in bleeding.
Polyps are benign (non-cancerous) growths that develops from the surfaces of cavities. Ear polyps, also known as otic polyps or aural polyps, may form from the skin lining the ear and from the ear drum. This is usually linked to repeated irritation and injury of the ear canal or ear drum. Polyps do not usually bleed unless it is injured to the point where a blood vessel is broken.
A malignant growth (cancer) of the ear may not be as frequently heard of as other cancers but can occur in the outer or middle ear and lead to ear bleeding. Skin cancer of the ear is not as uncommon as is thought. Cancers arise when cells become abnormal and grow rapidly, often destroying health cells in the process.
A cholesteatoma is an uncommon growth of skin cells in the middle ear that is more likely to arise with a ruptured eardrum or repeated infections. Over time it can damage the middle ear structures, including bones. Bleeding may occur with more severe cases or secondary infections that arise as a complication.
Remedies for Bleeding Ear
Always seek medical attention for a bleeding ear. Do not try to treat the condition at home. Once the condition causing the bleeding ear is diagnosed and being treated, a few simple measures can reduce the risk of further complications.
- Avoid picking the ear with a cotton bud, hair clip, matchstick or any other object. The ear does not require cleaning as ear wax traps dirt and microbes and pushes it out of the ear canal.
- Do not use ear phones until the underlying condition has been treated. Even once the treatment is successful, ear phone use should be minimal.
- Use ear plugs when swimming and even when taking a shower. There is no need to let water enter the ear in an attempt to clean it as this can cause irritation and infections.
- Do not attempt to flush out the blood with water or oil. These fluids can worsen the condition. Similarly oil to moisturize a dry ear canal should be avoided until the underlying cause is diagnosed and treated.