Cauliflower Ear

What is cauliflower ear?

Cauliflower ear — also called subperichondrial hematoma — is a condition that can happen after blunt force trauma to your ear. It causes your ear to look lumpy and deformed.

How do you get cauliflower ear?

The skin covering your ear carries blood to the cartilage underneath. When you sustain an ear injury, your skin can separate from the cartilage that gives your ear its shape. When this happens, it disrupts the blood supply, resulting in a hematoma (pocket of blood). As the injury heals, your ear folds in on itself, giving it a shriveled, cauliflower-like appearance.

Who does cauliflower ear affect?

Cauliflower ear commonly affects boxers, wrestlers and martial artists. (For this reason, cauliflower ear is sometimes called boxer’s ear or wrestler’s ear.) But, anyone who sustains an injury to their ear can develop the condition.

What happens if you have cauliflower ear?

If you have cauliflower ear, the best thing you can do is seek medical care immediately. Prompt treatment greatly reduces your risk for permanent deformity.

In the meantime, ice your ear as quickly as possible. Apply the compress for 15 minutes, wait 15 minutes, then ice it again. Continue this until you see your healthcare provider.

What are the symptoms of cauliflower ear?

People with cauliflower ear may experience a range of symptoms, including:

• Redness, swelling or bruising of their outer ear.
• A change in the shape of their ear.
• Ear pain.
• Ear bleeding.
• Tinnitus (ringing in their ears).
• Headaches.
• Facial swelling.
• Blurry vision.
• Hearing loss.

If your ear becomes infected, you may develop these additional symptoms:

• Fever.
• Increased ear pain.
• Increased swelling.
• Pus drainage.

How painful is cauliflower ear?

The initial impact or blow to your ear can be quite painful. Many people find that discomfort and swelling subside over the next few days. However, pain may continue, especially if your ear becomes infected.

What causes cauliflower ear?

The main cause of cauliflower ear is blunt force trauma. When an ear injury occurs, the blood vessels that supply nutrients to your cartilage can tear. This causes blood to accumulate between your cartilage and your perichondrium. (The perichondrium surrounds your cartilage, and it’s made of connective tissue.)

When the blood supply to your ear is cut off, your cartilage no longer receives the nutrients it needs. As a result, tissue death (necrosis) occurs. At this point, new cartilage begins to grow. And for reasons that aren’t fully understood, this new cartilage is usually lumpy, deformed and asymmetrical — resulting in a cauliflower-like appearance.

How is cauliflower ear diagnosed?

Your healthcare provider can diagnose cauliflower ear during a physical examination of your head and neck. During this exam, they’ll:

• Check for a ruptured eardrum.
• Perform an examination of your cranial nerves.
• Perform a neurological evaluation.

In some cases, your healthcare provider may ask to take a CT scan of your head.

How is cauliflower ear treated?

If you undergo treatment quickly, you may not even develop cauliflower ear. For best results, it’s important that you seek treatment within six hours of your injury. In the meantime, ice your ear to minimize pain and swelling.

Your healthcare provider will likely perform a procedure called incision and draining. When done promptly, it greatly reduces your risk of permanent deformity.

It’s important to note, though, that recurrence (return) is common among people who get cauliflower ear. If the issue continues, or if your ear becomes permanently deformed, a surgeon may be able to improve the appearance with cosmetic surgery.

Incision and drainage for cauliflower ear

During this procedure, your healthcare provider will:

• Numb your ear with local anesthesia.
• Make an incision in your ear.
• Drain the blood from the hematoma.
• Reconnect the tissues using special stitches or bandages.
• Place a dressing to help keep your ear’s natural shape.

They’ll prescribe antibiotics to prevent post-surgical infection. Your healthcare provider will monitor you during recovery to ensure you’re healing properly.

Cosmetic surgery for cauliflower ear

If you have permanent damage or deformity as a result of cauliflower ear, your surgeon can often improve the issue with an otoplasty. They may perform this procedure under local or general anesthesia. During otoplasty, your surgeon will:

• Create an incision behind your ear.
• Temporarily move the skin back from the front of your ear.
• Remove the fibrous, deformed scar tissue.
• Reshape your cartilage.
• Reposition the skin over the front of your ear.
• Close the incision using stitches (sutures).

Typically, an otoplasty takes three hours or less to complete. Your surgeon will monitor your healing to make sure your cauliflower ear doesn’t return.

How long does it take to recover from cauliflower ear treatment?

Your recovery timeline depends on several factors, including the severity of your condition, how much time passed between the injury and your treatment, and what type of treatment you received.

For incision and draining, most people recover in about two weeks. If you’ve undergone cosmetic surgery, healing time usually takes about four weeks. Your healthcare provider can tell you what to expect in your specific situation.

Can I drain cauliflower ear on my own?

Some people attempt to drain their own cauliflower ear using a syringe. There are a couple of problems with this. First, your ear may become infected. This can lead to even more issues. Second, simply draining the fluid from your ear does nothing to keep your ear compressed. As a result, the pocket created by the hematoma just keeps filling up again and again. This is why so many people have recurring issues with cauliflower ear.

If you sustain an injury that leads to cauliflower ear, you should seek professional medical care immediately. For best results, treatment should be completed within the first six hours.

Can I prevent cauliflower ear?

Yes. You can prevent cauliflower ear by wearing appropriate headgear while playing contact sports. Be sure you purchase headgear that fits properly.

What can I expect if I have cauliflower ear?

If you undergo treatment within the first six hours of your injury, you’ll likely recover without complications. However, recurrence (return) is common with cauliflower ear. This happens when the pocket between your skin and cartilage fills up with fluid.

Does cauliflower ear go away?

Cauliflower ear won’t go away on its own. It requires prompt medical attention.

Left untreated, the deformity becomes permanent in about seven to 10 days. The edge of your ear may even flop over as a result of dying cartilage.

If you have an injury that resulted in cauliflower ear, it’s important to see your healthcare provider immediately to avoid permanent issues.

When should I see my healthcare provider?

If you sustained an injury to your ear, you should see your healthcare provider immediately. To avoid permanent disfigurement or deformity, cauliflower ear should be treated within six hours of the initial injury. Call your primary care physician or head to your nearest emergency room.

Even if your ear injury doesn’t seem serious, you should seek care right away.

A note from Cleveland Clinic

Cauliflower ear is a common injury among athletes, but it can happen to anyone who sustains an injury to their ear. Even if your injury seems harmless, it’s important to seek treatment within six hours to prevent permanent damage. Additionally, you should never try to drain the fluid from your ear by yourself. This can lead to infection, recurrence and other issues.