Earwax, medically termed cerumen, is a naturally occurring substance produced by glands in the ear canal to protect the inner ear structures. It functions as a protective barrier, trapping dust and small foreign particles, and moisturizing the skin lining the ear canal. While cerumen is typically yellow or light brown, a shift to a reddish-brown color can be unsettling. This common color change is usually explained by either a normal biological process or the presence of blood from a minor injury.
Why Does Earwax Darken?
The most frequent reason for earwax to appear dark brown or reddish-brown is time and exposure to air. Cerumen is a complex mixture primarily composed of keratin from shed skin cells, along with fatty acids, squalene, and cholesterol secreted by specialized glands. When newly produced wax is exposed to oxygen, oxidation occurs.
This chemical reaction causes the lighter-colored lipids and fatty compounds in the wax to darken, resulting in a deeper brown hue. As the wax naturally migrates toward the outer ear opening, it dries out and collects dirt and debris, which further concentrates the color. The longer the wax remains in the ear canal, the darker it becomes, often presenting as a dark, dense, reddish-brown lump.
Is It Blood? Causes of Reddish Discharge
While darkening due to oxidation is normal, a true reddish tint or streaks of red within the wax signals the presence of blood, indicating a potential injury inside the ear canal. The ear canal is lined with thin, sensitive skin containing many tiny blood vessels, making it prone to minor trauma. A common cause of minor bleeding is mechanical irritation from cleaning the ear, such as using cotton swabs or other foreign objects.
Inserting any object into the ear canal can easily cause a superficial scratch or abrasion, resulting in fresh blood mixing with the cerumen. Other minor causes include vigorous scratching or placing foreign objects. A reddish discharge may also point to more significant issues, such as otitis externa, commonly known as swimmer’s ear. This infection of the outer ear canal causes inflammation, swelling, and bleeding from the irritated skin, which then mixes with the earwax.
A more serious cause of blood mixing with earwax is a perforated eardrum, which can occur due to severe infection, sudden pressure changes, or trauma. If a reddish discharge is watery or accompanied by a foul smell, it may indicate a ruptured eardrum. Differentiating between oxidized wax and blood can be difficult, but a dark brown wax tinged with red should be considered a potential signal of a bleeding injury.
Accompanying Symptoms That Require Medical Attention
If the reddish earwax results from a minor scratch, it often clears up on its own. However, the presence of certain accompanying symptoms suggests the need for a professional medical evaluation. Persistent ear pain indicates inflammation or infection, such as an ear infection or a ruptured eardrum.
A fever, especially if it is 102.2°F (39°C) or higher, signals a systemic infection that requires prompt treatment. Other concerning signs include sudden or worsening hearing loss, which can be caused by severe inflammation or a blockage. You should also seek medical care if you experience dizziness, ringing in the ears, or a persistent discharge that is thick, yellow, or foul-smelling.