Cauliflower Ear

What is cauliflower ear?

Cauliflower ear (wrestler’s ear, auricular hematoma) is a condition that can happen after blunt force trauma to your ear. It causes your ear to look lumpy and deformed.

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. In addition to ear deformity, you could also end up with infections or hearing loss.

Despite the health complications that can arise from cauliflower ear, many combat athletes consider it a badge of honor in their chosen sport. Only you can make decisions for your body. But if you’re thinking about getting a cauliflower ear on purpose, it’s important to know the risks.

Even though cauliflower ear is most common among athletes, anyone can get it. The best rule of thumb is to seek immediate treatment any time you have an ear injury.

How common is cauliflower ear?

Experts aren’t sure how common cauliflower ear is among the general population. But they know it’s extremely common among combat athletes like boxers, wrestlers, martial artists and anyone who participates in contact sports. One Finnish study reported that 96% of national-champion-level martial artists experienced at least one symptom of cauliflower ear.

What are the symptoms of cauliflower ear?

If you have cauliflower ear, you might experience a range of symptoms like:

• A change in the shape of your ear.
• Blurred vision.
• Discoloration, swelling or bruising of your outer ear.
• Ear pain.
• Ear bleeding.
• Headaches.
• Tinnitus (ringing in your ears).

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 is made of connective tissue.)

If your ear loses its blood supply, your cartilage no longer receives the nutrients it needs. As a result, tissue death (necrosis) occurs. At this point, new cartilage and scar tissue forms. But it’s typically lumpy, deformed and asymmetrical, resulting in a cauliflower-like appearance. Experts aren’t exactly sure why the new cartilage grows back lumpy and deformed.

What are complications of this condition?

The main complications of cauliflower ear are:

• Ear deformity.
• Hearing loss.
• Infections.

If your ear becomes infected, you may develop additional complications like:

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

How is cauliflower ear diagnosed?

Your healthcare provider can diagnose cauliflower ear during a physical examination of your head and neck. They’ll also need to find out if you have other health issues related to blunt force trauma to your ear. To do this, they’ll:

• Check for a ruptured eardrum.
• Do a neurological evaluation to check for disorders affecting your brain, spinal cord and nerves.
• Evaluate your cranial nerves, which help you hear taste, smell and feel.

Your healthcare provider may also take a CT scan to check for head trauma.

How is cauliflower ear treated?

Cauliflower ear treatments may include:

• Incision and draining. When done promptly, this procedure can greatly reduce your risk of permanent ear deformity.
• Otoplasty (ear reshaping). This cosmetic surgery procedure can improve the appearance of your ear. You might need otoplasty if you have permanent ear damage or deformity.

If you undergo treatment quickly, you may not even develop cauliflower ear. That’s why it’s best to see a healthcare provider right away. In the meantime, ice your ear to minimize pain and swelling.

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 repeatedly. This is why so many people have recurring issues with cauliflower ear.

If you get an injury that leads to cauliflower ear, you should seek medical care immediately. For best results, healthcare providers prefer to complete treatment within the first six hours.

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

Your recovery timeline can vary, depending on:

• The severity of your condition.
• How much time passed between your ear injury and your treatment.
• What type of treatment you received.

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

Can cauliflower ear be prevented?

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?

Cauliflower ear won’t go away on its own. If you undergo treatment quickly, 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.

Unless you treat it, the deformity usually becomes permanent in about seven to 10 days. The edge of your ear may even flop over due to dying cartilage.

How do I take care of myself?

Prompt treatment 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 a healthcare provider.

When should I see my healthcare provider?

If you sustained an injury to your ear, you should see a healthcare provider as soon as possible. This may help you avoid permanent disfigurement or deformity. Call your primary care physician or head to your nearest emergency room.

Even if your ear injury doesn’t seem serious, you should visit a healthcare provider.

What questions should I ask my doctor?

If you have cauliflower ear, here are some questions you might want to ask your healthcare provider:

• What type of treatment do I need?
• How soon do I need treatment?
• Will I have permanent ear damage or deformity?

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. But pain may continue, especially if your ear becomes infected.