6 Causes of Ear Swelling
What is ear swelling?
Ear swelling is caused by a buildup of fluid in the tissues in or around your ear. The skin around your outer ear is very thin, so even a small amount of swelling is obvious. Swollen ears may be red, painful to the touch, or feel itchy.
Ear swelling can be caused by trauma, like from getting hit in the ear by a ball or even getting your ears pierced.
Some medical conditions, like an ear infection, can cause your ears to swell.
If the swelling is uncomfortable, using ice or heat, on and off, can reduce swelling and lessen pain. Over-the-counter pain medications like acetaminophen (Tylenol) or ibuprofen (Advil) may help, too.
While a swollen ear isn’t usually serious, it can be a sign of an infection that needs to be treated right away. It’s important to monitor your symptoms and see a doctor if they get worse.
Even a small trauma can cause the ear to swell. The ear has a rich blood supply and can have a robust healing response. Swelling usually peaks in 6 to 8 hours after an injury, and then will start to decrease. If the swelling does not change after this time frame, seek medical attention. —Dr. David Lee
A bruise can develop from a small amount of trauma (bumping your ear on a hard object) or with a forceful trauma (getting hit in the ear during a fight or a wrestling match).
Try placing an ice pack on the ear, alternating 20 minutes on and 20 minutes off to reduce swelling. You can also alternate with a warm compress. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help with the pain.
It’s important to monitor your symptoms because a bruise could be caused by a more serious problem, such as an infection or hematoma (a collection of blood outside the blood vessels). See your doctor if you’re experiencing serious swelling or pain.
2. Swimmer’s ear
- Swelling around the ear canal
- Redness around the ear canal
- Ear pain
- Drainage or discharge from the ear canal
- Jaw discomfort
- Muffled hearing
Swimmer’s ear (or otitis externa) is an infection of the ear canal. It occurs when bacteria or a virus enters the ear canal, often from swimming. But you can also get it from inserting cotton swabs or other objects into your ear canal.
People with swimmer’s ear sometimes develop ear swelling. This is caused by inflammation from the infection.
Your doctor will likely prescribe ear drops for the infection and pain. These drops may contain an antibiotic. If your infection is severe or you have a lot of swelling around your ear canal, you may be prescribed an oral antibiotic too.
Sometimes your doctor needs to clean your ear because the ear canal may fill with debris and wet discharge. Removing it can speed your recovery and lessen pain.
- Swollen ear
- Red and warm skin over the ear
- Tenderness to the touch
- Occasional fever
Cellulitis is a bacterial skin infection that can develop anywhere on your body, including your external ear. It can start from swimmer’s ear or from any skin irritation or damage (such as a bug bite or scratch on the ear). Cellulitis develops when bacteria enters your skin. As it gets worse, you may have fever and chills. The redness and swelling may also change (become darker) or spread.
If you think you have cellulitis, see your doctor right away. You’ll likely be prescribed antibiotics.
- Swollen ear (your ear may actually stick out and feel painful when you touch it)
- Redness behind and around the ear
- Pus-like white or yellow ear discharge that may have a foul smell
- Throbbing, persistent pain in and around the ear
- Hearing loss
Mastoiditis is a dangerous bone infection in the mastoid bone—the bone behind and around the ear. It’s often caused by an untreated ear infection.
One of the telltale symptoms of mastoiditis is a swollen ear that’s actually sticking out at an unusual angle. The swelling is generally more obvious behind the ear rather than on the external ear and cartilage.
If you’re concerned you may have mastoiditis, go to the ER. Immediate treatment is necessary. Mastoiditis is typically treated with intravenous (IV) antibiotics. In some cases, the infection may create an abscess (inflammatory mass) in the bone that requires surgery.
5. Auricular hematoma
It is important for a doctor to distinguish between an auricular hematoma and a bruise. In a bruise, the ear may have swelling but generally retains the “architecture” of the ear—you can still see the definition of the ear. In contrast, with an auricular hematoma, the skin actually lifts off of the cartilage and the ear will lose definition. —Dr. Lee
- Significant external ear swelling
- Ear pain
- History of very forceful ear trauma
An auricular hematoma is a collection of blood trapped between the skin and cartilage of the outer ear. It is caused by very forceful trauma or impact. People who do contact sports, such as wrestling or boxing, may develop this.
Auricular hematomas should be treated immediately to prevent long-term complications. If a hematoma is not treated (or it recurs), the cartilage of your external ear loses its blood supply. This causes scar tissue to form, leading to “cauliflower ear.” It gets its name from the scar tissue, which has a textured, cauliflower-like appearance. Cauliflower ear is very hard to treat.
To treat an auricular hematoma, your doctor will likely drain the blood from the area and then apply a very tight dressing to prevent the blood from collecting there again. They may also prescribe antibiotics to reduce your risk of developing an infection.
It can sometimes be hard to know if you have a bruise or a hematoma. If you’re at all concerned that you have a hematoma, go to the ER.
6. Relapsing polychondritis
- Recurring ear swelling (but not the ear lobe)
Relapsing polychondritis is a very rare condition that causes repeated bouts of ear swelling. One or both ears may be affected.
It is more likely to occur in people who have an autoimmune disease. These people sometimes have similar problems with cartilage located in other parts of their body, such as the nose or airway.
Relapsing polychondritis usually only affects parts of the ear that have cartilage. The earlobe doesn’t have cartilage, so it doesn’t swell.
The goal of treatment is to reduce inflammation with NSAIDs. Occasionally steroids (like prednisone) are prescribed to reduce swelling. You may also be referred to a rheumatologist, who may prescribe more powerful medications that act on your immune system and can reduce how often you get ear swelling.
When to call the doctor
In diagnosing ear swelling, it is very important to know the timeline of the swelling progressing, and anything that may have happened around that time. Did the patient have insect bites after an outdoor hike before their ear started to swell? Was the teenager wearing ear protection while wrestling prior to ear swelling? Have there been fevers and is the ear very warm to the touch? —Dr. Lee
Consider calling your doctor or go to urgent care if:
- The swelling lasts for more than 24 hours
- Your ear is sticking out at an unusual angle
- You’re having trouble hearing
- You feel dizzy
- You have a bump or rash on the ear that doesn’t go away
- There’s bloody or foul-smelling discharge coming from the ear
Should I go to the ER for swollen ears?
You should go to the ER if you have any of these signs of a more serious problem:
- You have an impact injury on your head (such as from a car accident).
- You’ve had a significant forceful trauma to your ear with a large amount of swelling.
- Severe pain
- High fever
- Redness or a rash on swollen areas
- Swelling around the ear that’s getting worse and spreading
- Applying ice packs (20 minutes on the ear followed by 20 minutes off)
- A heating compress on the ear can soothe pain
- Over-the-counter pain medication (NSAIDs like ibuprofen or acetaminophen)
Other treatment options
- Ear drops (may or may not contain antibiotics)
- Oral antibiotics
- Receiving IV antibiotics at a hospital (if the infection is very serious)
- Treatments such as draining the debris and discharge from the ear
Dr. Lee is a board-eligible otolaryngologist and medical consultant for Buoy Health. He completed his undergraduate degree in Biochemistry and Spanish at the University of Arkansas (2011) and went on to complete medical school from the University of Arkansas for Medical Sciences (2015). He completed his residency training in Otolaryngology - Head and Neck Surgery at the University of Cincinnati (2020). He is currently a fellow in Pediatric Otolaryngology - Head and Neck Surgery at the Children's Hospital of Philadelphia.