Noticing a reddish tint mixed with normal earwax can be alarming. Earwax, medically known as cerumen, is a natural secretion produced by specialized glands in the ear canal. This substance lubricates the skin, prevents dryness, and acts as a barrier, trapping dust, small particles, and microorganisms before they reach the eardrum. The appearance of blood (hemorrhagic otorrhea) indicates an injury or condition affecting the ear canal or middle ear, warranting investigation. While the cause is often minor, it signals that the protective barrier has been breached.
Self-Inflicted Trauma and Hygiene Practices
The most frequent reason for bloody earwax involves mechanical injury caused by the individual’s own actions. The skin lining the external ear canal is thin and sensitive, making it susceptible to damage from foreign objects. Introducing items like cotton swabs, hairpins, or keys can easily create micro-abrasions or small cuts that bleed. This minor bleeding mixes with the cerumen as it exits the canal, resulting in reddish or pink-tinged wax. Vigorous cleaning or the use of cotton swabs can irritate the skin, cause superficial tears, or push earwax deeper, increasing the risk of trauma and impaction.
Underlying Infections and Skin Irritations
If the cause is not a simple scratch, bloody earwax can signal deeper issues within the ear structure. One common infectious cause is Otitis Externa, or “Swimmer’s Ear,” which is an inflammation and infection of the outer ear canal. This infection leads to swelling, redness, and discharge that may include blood due to the inflammation of the canal skin.
A more serious cause is Otitis Media, an infection behind the eardrum. Fluid buildup creates intense pressure on the tympanic membrane. If the pressure becomes too great, the eardrum can rupture or perforate, releasing fluid mixed with blood. The sudden discharge of bloody fluid following severe ear pain that suddenly stops often indicates this type of rupture.
Dermatological conditions can also contribute to bleeding within the ear canal. Conditions such as eczema, psoriasis, or seborrheic dermatitis can affect the skin of the ear canal, causing it to become dry, cracked, and fragile. Scratching or rubbing an itchy, inflamed area can break the skin, leading to minor bleeding that blends with the cerumen.
Identifying When to Seek Professional Care
While many instances of bloody earwax are minor and resolve quickly, certain warning signs require evaluation by a medical professional. Seek care promptly if the bleeding is persistent, continuing for more than 24 hours, or if the ear begins to bleed heavily.
Accompanying symptoms should be taken seriously as they may indicate a significant problem like a ruptured eardrum or severe infection. These symptoms include severe or worsening ear pain, sudden hearing loss, fever, or dizziness and vertigo. While waiting for an appointment, avoid inserting anything into the ear canal, including cotton swabs or water, which could worsen an injury or introduce infection.