5 most common causes
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What causes clear, odorless ear discharge?
The only thing that’s supposed to come out of your ears is earwax, which is your body’s natural way to protect your ear from invaders like bacteria, viruses, and even foreign bodies, while also providing lubrication.
A clear discharge may be a sign of infection or even trauma.
But you may mistake discharge for a thinner earwax, which can produce odor-free, clear to yellowish or brownish discharge as the earwax dissolves. People naturally make different amounts of earwax. Some make excessive amounts that can cause blockages, triggering ear pain and even hearing problems.
Treatments for ear discharge can range from safely cleaning out the wax at home to prescription medications to treat infections.
Does clear ear discharge always need to be treated?
“A lot of ear infections are actually caused by viruses like the common cold. These infections often get better on their own and antibiotics would not help and could even make matters worse! Whether or not you need antibiotics depends on many factors. See your doctor to best figure out the cause of your earache.” —Dr. Petrina Craine
Top 5 causes
1. Swimmer’s ear (otitis externa)
Symptoms
- Ear itching or pain
- Redness
- Clear discharge
- Swelling
- Ear and jaw discomfort
Swimmer’s ear is an inflammation of the outer ear canal. It doesn’t mean you had to be in a pool to get it. You can get it from bacteria, fungus, or a virus getting into the ear canal. This is more likely to happen when the ear’s delicate skin is injured, such as from cleaning with cotton swabs or scratching.
Moisture from swimming, showering, or bathing can get trapped near the injured skin, making it easier for organisms like bacteria to grow. Children may be more susceptible to swimmer’s ear because they have narrow ear canals, according to the CDC. Your doctor can diagnose swimmer’s ear by doing an exam, and will prescribe antibiotic ear drops to clear up the infection.
2. Eczema (atopic dermatitis)
Symptoms
- Itchy ears
- Red, cracked, dry, patchy, or scaly skin
- Clear discharge
Eczema can affect many areas of the body, including the ears. The constant breakdown in the skin barrier can cause clear discharge. It is more common in people with allergies, asthma, and other skin diseases.
Your treatment depends on the underlying cause. It can be helpful to avoid triggers like earbuds and irritating substances like soaps or shampoos. Sometimes you’ll need to use medications, such as steroids to decrease inflammation or antibiotics to treat infections.
It’s also helpful to use skin products that promote a healthy skin barrier, such as gentle soaps and moisturizing lotions.
3. Foreign object in the ear
Symptoms
- Feeling of fullness or pressure
- Feeling that something is “stuck” in your ear
- Pain in one ear
- Fluid or bloody discharge from one ear
Sometimes ear discharge is caused by a foreign object in the ear. This is especially common in children, who may put food, a bead, or a toy inside their ears. It is the reason for many emergency room visits in children, according to a study in the International Archives of Otorhinolaryngology.
In adults, it can happen when a cotton swab or even an insect gets stuck inside.
Over time, the object itself can cause an infection, or sometimes attempts to remove the object can cause an injury or infection in the ear canal. In these cases, discharge can be clear or bloody, pus-filled, or foul-smelling.
If something is stuck in your ear, don’t try to get the object out yourself. You can unintentionally worsen the situation by pushing it deeper inside or damaging the canal.
Most objects can be removed by a pediatrician or primary care doctor, but you should go to the ER for a button battery or sharp object, or if the discomfort is unbearable. Your doctor will have special instruments to remove foreign objects. You may also get a prescription for antibiotics if the ear is infected.
What are the best ways to protect the ears?
“A key part to keeping ears healthy is based on prevention. Think about how you can protect your overall health and how that can benefit your ears. For example, wear earplugs, especially if you are around a lot of noise, like drilling from a construction, to prevent eardrum rupture. Quitting smoking and avoiding secondhand smoke can also help reduce ear infection risk.” —Dr. Craine
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4. Ruptured (perforated) eardrum
Symptoms
- Ear pain (often going from intense to sudden relief)
- Ringing or buzzing in the ears
- Dizziness
- Decreased hearing or hearing loss (often sudden)
- Clear discharge
Your eardrum is a thin membrane that separates your ear canal (outer ear) from your middle ear. Sound enters your ear and causes the membrane to vibrate with sound frequency.
Ear discharge can be caused by a ruptured eardrum. This can be from force, such as trauma from slapping an ear or a head injury, a loud noise like an exploding firecracker close to the ear, changes in pressure when flying or scuba diving, or a buildup of pressure from an infection.
Your doctor will perform an ear exam to see if there is a hole or tear. The ruptured eardrum usually heals on its own in a few weeks, but you may need antibiotics to avoid or treat an underlying infection. Tears that don’t heal on their own may need to be repaired with surgery.
5. Glue ear (otitis media with effusion)
Symptoms
- Feeling of fullness in an ear
- Clear discharge
- Difficulty hearing
- Ear canal pain
- Clicking, crackling, or popping sounds
The middle ear is located behind the eardrum and is normally filled with air. It is also connected to a part of the nose by a thin channel called the eustachian tube. This tube is normally closed, but opens when you’re swallowing or yawning to let more air into the middle ear and to drain any fluid out.
Sometimes fluid, such as from a middle ear infection or a cold, builds up in the middle ear and the tubes. This creates a clear, mucus-like discharge that resembles clear glue. Problems with opening and closing of the eustachian tube allow pressure to build up in this space and worsen symptoms. The condition usually develops during or after an infection, but sometimes non-infected fluid can build up after an injury.
"Glue ear" is more common in children than adults, because kids get frequent colds and have smaller eustachian tubes than adults. Children with cleft palate and Down’s syndrome are at higher risk of developing glue ear because they often have smaller eustachian tubes that don’t function properly.
Adults can also get glue ear after having a respiratory infection like a sinus infection or cold. Gastric reflux and allergies can also contribute to fluid buildup.
Although glue ear often gets better on its own, it can cause temporary or permanent hearing loss, which can affect a child’s speech and language skills.
You should see a doctor to treat glue ear. They'll prescribe antibiotics if you have an infection. Steroids, antihistamines, and decongestants can also be used to relieve symptoms.
“Autoinflation” can help open the eustachian tube to allow fluid drainage; to do this, breathe out forcefully while keeping the mouth and nose closed. You can buy a nose balloon to accomplish this in a child. Surgery may be necessary to open up the tubes.
Other possible causes
Other conditions that may cause clear, odorless ear discharge and ear pain include:
- Acute otitis media
- Cholesteatoma
- Leakage from surgically placed ear tubes
- Malignant otitis externa
- Skull fracture to the temporal bone
- Tumors or cancers of the ear
When to call the doctor
You should contact doctor if:
- You have pain that doesn’t get better with acetaminophen or ibuprofen
- Symptoms don’t go away, especially after 3 to 5 days
- You have a fever
- You have pain or swelling behind the ear (called the mastoid area)
- You experience hearing loss
How do you treat clear ear discharge?
“I often ask, ‘When did your symptoms start? Are you having pain and/or dizziness? What activities have you been up to (like swimming, flying, or going to concerts)? Have you had ear infections or procedures before? How do you clean your ears? Have you hurt your head recently? Have you had a fever? Do you have any medical problems like diabetes mellitus?’ ” —Dr. Craine
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Should I go to the ER?
You should go to the emergency department if you have the following signs and symptoms of a more serious problem:
- A head injury
- Excruciating pain
- Bloody, cloudy, or foul-smelling discharge
- Face numbness or droopy face
- Pain or swelling behind the ear
- Vision problems
- Headache
- Dizziness
- Foreign body placed in ear (particularly if the object placed could be a button battery)
Treatment
At-home care and prevention
- For ear pain, take medications like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). Applying a warm compress to the ear may also give you some relief.
- To keep the ear canal dry while swimming or showering, try using soft waterproof earplugs or cotton balls lubricated with petroleum jelly (Vaseline). It’s important to keep your ear dry, especially when it’s healing from a ruptured eardrum or an infection. Ideally you should avoid activities that could allow water to get inside your ears.
- Do not use foreign objects like cotton swabs to clean your ears. The ears are self-cleaning. If you have a buildup of wax that’s affecting your hearing, you can try to dissolve the wax with mineral oil, diluted household-grade hydrogen peroxide, or saline. (Check with your doctor about how to do it safely.) Do not irrigate or place drops in your ear if you have a ruptured eardrum.
- When you have an infection, try to avoid activities that drastically change the pressure in your ear, such as flying, forcefully blowing your nose, or scuba diving. If you can’t avoid an activity like flying, try to decrease pressure changes by yawning or opening your mouth wide, chewing gum, or sucking on hard candy.
- Avoid wearing a hearing aid in an infected ear until the infection has cleared up. It can help the bacteria to grow.
Other treatment options
Your doctor may recommend:
- Medications like antibiotics to treat infections or steroids to decrease inflammation.
- Surgical procedures, such as placing ear tubes (tympanostomy) in children with frequent ear infections, removing foreign bodies, ear irrigation, or repairing ruptured eardrums (tympanoplasty).
- Hearing tests (audiometry) and tests measuring pressure in the ear (tympanometry).
- Imaging tests. Although they aren’t always beneficial, a CT scan may help your doctor figure out the cause of your ear symptoms (e.g., a skull fracture or bone infection).
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