This article was co-authored by Monica Kieu, DO, FACS. Dr. Monica Kieu is a board certified Otolaryngologist and Specialist in Facial Plastic and Reconstructive Surgery in Los Angeles, California. Dr. Kieu received a BS in Anthropology from the University of California, Riverside and earned her medical degree (DO), with honors, from Western University of Health Sciences in Pomona. She then completed her residency in Otolaryngology-Head and Neck Surgery at Michigan State University/Detroit Medical Center, where she served as chief resident. Dr. Kieu also completed a prestigious fellowship in Facial Plastic and Reconstructive Surgery at the University of Toronto. She is a member of the American Academy of Otolaryngology-Head and Neck Surgery, American Osteopathic Colleges of Ophthalmology and Otolaryngology-Head and Neck Surgery, American Academy of Cosmetic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, and the American Rhinologic Society. Dr. Kieu was recently named one of LA’s Top Docs by Los Angeles Magazine.
There are 11 references cited in this article, which can be found at the bottom of the page.
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The eardrum is fairly fragile, and trauma to the ear can cause the eardrum to tear, which is known as a ruptured or perforated eardrum. They're more common in children who develop middle ear infections, though they have multiple causes and can happen at any age.[1] Most ruptured eardrums heal on their own without medical intervention, but it's important to see your doctor to make sure there's not a possibility of hearing loss or infection. In the meantime, focus on protecting your eardrum from further damage, and treating any potential infection that might occur alongside it.
Steps
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Recognize the signs of a ruptured eardrum. Perforated eardrums can share symptoms with middle ear infections or other ear damage, so it can be hard to tell them apart. If your eardrum ruptures, you may experience:
- Ear pain (that may stop suddenly)[2]
- Discharge or bleeding from the ear[3]
- Hearing loss[4]
- Ringing or buzzing in the ear[5]
- Nausea or vomiting[6]
- Dizziness, wobbliness, or vertigo[7]
- Seek emergency care if you experience excessive bleeding or total hearing loss, are in extreme pain, are abnormally dizzy, or have something stuck in your ear[8]
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Know when a ruptured eardrum is more likely. Injury or damage to the eardrum is typically caused by a sudden change in pressure, which can result from several different circumstances. The eardrum is more likely to be damaged or torn due to:[9]
- Fluid from a middle ear infection breaking the eardrum (this is more common in children, but can happen at any age)
- Small and/or blunt objects being inserted into the ear
- Rapid shifts in air pressure (for example, being on a plane)
- Exposure to extremely loud sounds, like explosions or concerts
- Injury to the ear, head, or neck
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See your doctor as soon as you can. Because a ruptured eardrum can cause permanent hearing loss in serious cases, it's vital to see your doctor if you suspect any kind of injury or damage to your ear. Tell your doctor:[10] [11]
- The symptoms you're experiencing
- What happened leading up to the symptoms
- If you've had problems with your ears in the past, like recurring ear infections
- Whether you were sick
- If anything has been in your ear
- Anything you did to treat it
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Allow your doctor to examine your ear. Your doctor might check your ear themselves, or they may refer you to a specialist. They will look for any damage in the ear using an otoscope, and likely test your hearing to see if it's intact. If necessary, they may also check how your ear reacts to shifts in air pressure, and check any drainage for signs of infection.[12]
- Your doctor might have to clear out your ears to examine them, depending on whether there's drainage.[13]
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Recognize that most times, no intervention is needed. The majority of eardrum ruptures will heal on their own with minimal or no treatment. You may be prescribed antibiotics if there are signs of infection, but you likely won't need any interventions beyond protecting your ear as it heals.[14]
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Get surgical intervention in serious cases. Some ruptures can be serious or slow to heal and require medical intervention to heal properly. If your doctor determines your eardrum is severely damaged or is recovering too slowly, they may literally patch up your ear, or have you undergo surgery.[15]
- Your doctor might apply a patch to the eardrum to close the hole. This can sometimes be done in the doctor's office and doesn't require anesthesia, though it might take several patches to fully repair the damage.
- If surgery is required, it will be performed while you're under anesthesia. Most people can leave the hospital the same day.[16]
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Stay home if needed. A ruptured eardrum alone typically won't prevent you from going to school or work, but if you have a fever, are in excessive pain, work in a high-intensity field, or are regularly exposed to loud noise, your doctor will likely recommend you stay home until you've recovered. Ask them whether or not it's best to stay home.
- If you had to have surgery on your ear, ask your doctor when it's safe to return to school or work.[17]
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Take any medication your doctor has prescribed. Perforated eardrums don't usually need medicinal treatment. However, if your ear shows any signs of infection, your doctor might prescribe you antibiotics to treat it. You'll likely be given either oral medication or antibiotic eardrops, though in some cases you might take both.[18]
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Use heat to reduce pain. Warmth can help relieve the earache that can come with a ruptured eardrum. You can try holding a warm, dry piece of flannel or cloth against your ear.[21]
- Make sure the packs or compress is warm, not hot. You don't want to burn yourself.
- Avoid sleeping with your ear or face up against an electric heating pad, as this can result in burns.
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Take over-the-counter pain relievers. If heat isn't enough to soothe your ear, try taking NSAIDs like ibuprofen or acetaminophen (like Tylenol) to reduce the pain. If you're unable to take NSAIDs, ask your doctor for recommendations.[22]
- Only take one type of pain reliever at once. Don't combine them if your doctor hasn't recommended it.[23]
- Don't take more than the maximum recommended amount. If you have taken the maximum amount and are still in pain, see your doctor.
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Avoid putting pressure on an infected ear. An infection in your ear can hurt and cause pressure when you lay down, which isn't good for a ruptured eardrum. When you go to sleep, lay in a way that doesn't put your infected ear directly against the pillow. (For example, if your right ear is infected, sleep on your left side.)[24]
- Some back sleepers recommend using extra pillows to raise the height of your infected ear. While there isn't clear evidence to back this up, it doesn't hurt to try it.[25]
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Protect your ears from water. If water gets through the tear in the eardrum, you can develop an ear infection and slow the healing process. Take precautions to keep your ears dry and free of water.[26]
- Before you bathe, apply petroleum jelly to a cotton ball and put it in your ear to block water.
- If possible, take baths rather than showers—the water is less likely to accidentally trickle into your ears.
- Be gentle when washing your hair so nothing enters your ear.
- Don't go swimming or scuba diving until your doctor says it's okay.
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Keep things out of your ears. Anything placed in your ears—like earplugs, earbuds, cotton swabs, fingers, and so on—can introduce bacteria into the wound or worsen the tear. Avoid inserting anything into your ears, and try not to poke or prod at your ear, even if it's itchy or painful.[27]
- Over-the-ear headphones are technically safe. However, exposing your ears to loud noise can cause pain and permanent hearing damage. Skip the headphones where possible, and if they're truly necessary, keep the volume low.
- Do not attempt to clean your ears. If they feel plugged or are draining excessively, contact your doctor.
Michael D. Seidman, OtolaryngologistLet a ruptured eardrum mend gently. Keep the ear dry and untouched to prevent aggravating the injury. In many cases, the body alone can heal if given proper time and conditions. However, some ruptures need medical care to avoid complications. Above all, be proactive in safeguarding your ears from hazardous noise and pressure shifts—an ounce of prevention outweighs the cure. Protect your hearing, and it will protect you.
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Try to steer clear of blowing your nose. Blowing your nose puts pressure on your ears and can further injure the internal workings of your ear. While gently blowing your nose is less dangerous than using excessive strength, it's best avoided when possible.[28]
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Call your doctor if there's no improvement or the problem worsens. Perforated eardrums generally take up to 2 months to heal.[29] However, if your eardrum is healing extremely slowly or is showing signs of worsening, medical care is needed. Contact your doctor if:
Expert Q&A
Video
Tips
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There's no way to guarantee that a middle ear infection won't break the eardrum. However, treating an infection early can reduce the risk of severe infections and perforation.[34]Thanks
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If your sinuses or ears are congested for any reason, try to avoid anything that requires changes in altitude, like flying or driving up into the mountains. The change in air pressure can put your ears at risk.[35]Thanks
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If you are regularly around loud noises, wear protective ear coverings to lessen the chance of hearing damage and eardrum ruptures.[36]Thanks
References
- ↑ https://my.clevelandclinic.org/health/diseases/15581-ruptured-eardrum-acutely-perforated-tympanic-membrane
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.uchealth.com/en/conditions/ruptered-eardrum
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ Monica Kieu, DO, FACS. Board Certified Otolaryngologist. Expert Interview. 20 October 2020.
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/diagnosis-treatment/drc-20351884
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/diagnosis-treatment/drc-20351884
- ↑ https://medlineplus.gov/ency/article/001038.htm
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/diagnosis-treatment/drc-20351884
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/diagnosis-treatment/drc-20351884
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/surgery/
- ↑ https://my.clevelandclinic.org/health/diseases/15581-ruptured-eardrum-acutely-perforated-tympanic-membrane
- ↑ https://www.who.int/news-room/q-a-detail/antimicrobial-resistance-does-stopping-a-course-of-antibiotics-early-lead-to-antibiotic-resistance
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh5075
- ↑ https://health.clevelandclinic.org/3-home-remedies-for-an-ear-infection/
- ↑ https://health.clevelandclinic.org/3-home-remedies-for-an-ear-infection/
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/diagnosis-treatment/drc-20351884
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
- ↑ https://medlineplus.gov/ency/article/001038.htm
- ↑ https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh5075
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/surgery/
- ↑ https://medlineplus.gov/ency/article/001038.htm
- ↑ https://medlineplus.gov/ency/article/001038.htm
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
- ↑ https://www.nhs.uk/conditions/perforated-eardrum/
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