Ear wax accounts for most ear discharges. However, discharges may also be caused by minor irritation or infection. Ear wax serves as a protective lining for the ear canal. It is almost never a problem unless attempts are made to "clean" the ear canals; if cleaning is done improperly, the ear canal can become blocked. Taking warm showers or washing the outside of the ears with a warm, moist washcloth usually helps prevent the build-up of wax.

A ruptured eardrum in a child who has been complaining of ear pain is often demonstrated by a white, slightly bloody or yellow discharge from the ear. Dry crusted material on the child's pillow is often a sign of a ruptured eardrum.

Don't get alarmed over a ruptured eardrum. Eardrum rupturing is the first sign of the healing process. Antibiotics, as prescribed by the doctor, can help prevent further infection during the healing process. Children will usually heal completely within a few weeks.

• Swimmer's ear -- usually accompanied by itching, scaling, a red or moist ear canal and pain increased by moving the ear lobe
• Inflammation or infection:
  • otitis externa
  • otitis externa - chronic
  • otitis externa - malignant
  • otitis media
  • otitis media - chronic
  • mastoiditis
• Injury from a blow to the head, foreign object, very loud noises, or sudden pressure changes (such as in airplanes), resulting in a ruptured or perforated eardrum
• Eczema and other skin irritations in the ear canal can cause some bleeding

To be safe, never put anything in the ear smaller than the tip of your little finger.

EAR INFECTIONS

Treat inflammation or infection as advised by your health care provider. Often, local treatment with ear drops is recommended.

EAR WAX

A gentle, warm water flush using a syringe (available at the drug store) can be helpful to remove packed-down ear wax. Do not attempt to remove impacted ear wax in very young children. If black and impacted ear wax can be easily seen and retrieved in older children, do so carefully. NEVER use sharp objects to attempt to remove wax.

INJURY

Seek medical help for injury from a foreign object, noises or pressure changes, head injury, or a suspected clotting or bleeding problem.

SWIMMER'S EAR

For swimmer's ear (unless the eardrum is perforated):

• tilt the head sideways, with the water-filled ear up.
• pull the ear upward and backward.
• carefully squeeze into the ear a medicine-dropper full of rubbing alcohol, or a mix of half rubbing alcohol and half white vinegar. This mixture will dry out the ear, and kill any bacteria or fungus.
• wiggle the ear to move the solution all the way down.
• then, retilt the head so that the affected ear is now down, and let the fluids drain out.

Putting a little mineral oil or baby oil in each ear before swimming may help prevent the problem.

• The discharge is white, yellow, or bloody.
• The discharge is the result of an injury.
• The discharge has lasted more than 5 days.
• There is severe pain.
• The discharge is associated with other symptoms, such as fever or headache.
• There is loss of hearing.

• Time pattern
  • When did it begin?
  • How long has the ear been draining?
  • Does it drain all the time or off-and-on?
• Quality
  • Is the drainage clear?
  • Is the drainage bloody?
  • Does the drainage look like pus?
• Other
  • What other symptoms are also present?
  • Is there a fever?
  • Is there an earache?
  • Is there a headache?

The physical examination will include a detailed examination of the ears. Diagnostic tests that may be performed include a culture (and cytology or cell studies) testing of drainage.

TREATMENT

Corticosteroid and antibiotic preparations that are placed in the ear canal may be prescribed. Oral antibiotics will usually be given if a ruptured eardrum is causing the discharge.

If a diagnosis was made by your health care provider related to ear drainage, you may want to note that diagnosis in your personal medical record.