Cauliflower Ear: Causes, Symptoms, and Treatment

Medically Reviewed by Poonam Sachdev on November 17, 2023
Written by Alexandra Benisek
6 min read

Cauliflower ear is a deformity of the ear caused by blunt trauma or other injury, as you might get during a boxing or wrestling match. It's also called subperichondrial hematoma, wrestler’s ear, and boxer’s ear. 

Left untreated, this type of injury can lead to a blockage that prevents blood flow and damages tissue. As a result, part of your ear looks bumpy or lumpy, similar to a cauliflower. Early treatment can help prevent permanent deformity.

Fortunately, you can often prevent the types of injuries that cause cauliflower ear by wearing the right type of protective head gear.

 

 

The most common cause of cauliflower ear is a hit – or repeated hits – to the ear. This leads to small pools of blood (hematomas) that clot and block the flow of blood and nutrients. These pockets of blood can also develop when the skin of your ear gets pulled away from the cartilage, the semi-rigid tissue that gives the ear its shape. 

When blood flow is blocked, the affected cartilage may die. Without that supportive tissue, your ear folds in on itself. Scar tissue can form, adding to a swollen and deformed look. Over time, the effects may become more obvious, and they may be permanent. 

But treatment can usually prevent cauliflower ear, even after such an injury.

How do you get cauliflower ear?

Cauliflower ear is usually related to sports injuries, but not always. Any trauma to the ear can cause it. It can even result from an infection in the earlobe.

 

Cauliflower ear most often affects people who take part in close-contact sports, such as wrestling or boxing. In wrestling, for instance, ear trauma can happen when opponents' heads rub or hit one another during matches or from contact with the wrestling mat. Cauliflower ear is also common among rugby players and people who practice martial arts. Protective headgear has long been commonplace in these sports.

But these injuries can also happen in non-athletes. They may be the result of accidents or fights. They also can be a complication of "high" piercings in the upper part of the ear, if the piercing becomes infected.

The first symptoms of the types of injuries that lead to cauliflower ear are similar to those you'd have from blunt trauma elsewhere on your body. You may have swelling, and the area may be red or bruised.

Don't shrug off such symptoms if you've had a blow, or several blows, to your ear. Prompt treatment can keep cauliflower ear from developing. But it must be done before your ear tissue is compromised by lack of blood flow.

Other cauliflower ear symptoms include:

  • A change in the shape of your ear
  • Tinnitus (ringing in your ears)
  • Hearing loss
  • Swelling in your face
  • Blurry vision
  • Bleeding from your ear
  • Headaches

If your ear gets infected, you might have these symptoms:

  • Pus drainage
  • Further swelling
  • More pain
  • Fever

To diagnose cauliflower ear, your doctor will examine your head and neck. They might also:

  • Do a neurological evaluation
  • Do an exam of your cranial nerves
  • Check you for a ruptured eardrum
  • Take a CT scan of your head

After a blow to the ear, ice it as soon as you can to ease pain and reduce the swelling. Do this in 15-minute cycles. It's also important to see a doctor within 6 hours after the injury.

Treatment may be able to stop you from developing cauliflower ear. The goal of treatment is to ease the blockage to let blood flow to the affected tissues.

Incision, draining, and compression

To reduce your risk of permanent damage, your doctor can do an incision and draining procedure. They can use a syringe or make a small cut to drain pooled blood and remove any clotting you have. You might need stitches. If you have larger pools of blood, the doctor can put a temporary drain, or catheter, in your ear.

After the procedure, they'll apply a bandage to put pressure on the area. Some doctors use silicone molds or splints in place of a bandage. When you've had cauliflower ear, compression is important to keep the blood from pooling. The pressure dressing needs to stay in place for several days to a week.

Your doctor will monitor the injury for signs of infection or signs you need further treatment. They'll likely prescribe antibiotics to prevent infection. You'll need to avoid contact sports until your ear is healed, which can take 1-3 weeks.

Never try draining cauliflower ear at home with a needle. This can cause permanent deformity (changes in the shape of your ear) or infection. If you don't have a doctor apply pressure in the proper way, the hematomas in your ear can fill up again and again

Surgery for cauliflower ear

If you have permanent damage from cauliflower ear, you can get cosmetic surgery to fix the issue. This surgery, called an otoplasty, usually takes 3 hours at most to finish. 

During this procedure, your doctor will make a cut behind your ear, move the skin back from the front of your ear, and take out the deformed scar tissue. Then, they'll reshape your cartilage and replace the skin over the front of your ear. Finally, they'll stitch up the cut.

Your doctor will continue to watch your ear to make sure that the cauliflower ear doesn't come back.

It takes about 4 weeks to heal from cosmetic surgery. But everyone's situation is different, so ask your doctor about your healing time.

The most important thing you can do to prevent cauliflower ear is to wear the right headgear when you do activities that increase your risk of ear injury, such as wrestling, boxing, rugby, and martial arts.

It's crucial to get headgear that fits well. A helmet that's too loose can slip out of place, leaving you vulnerable to injury. And one that's too tight may damage your ears, especially if you repeatedly rub it against your ears while putting it on and taking it off.

Athletes should remember to use protective gear during practices. And those thinking about high ear piercings may want to talk with a doctor first.

You can buy silicone ear molds to wear under sports headgear during sports that are supposed to help protect against cauliflower ear. But there's little research on how well they work.

To guard against permanent damage, be aware of the risk of cauliflower ear. Have a doctor promptly check out any injury to your ears, even if it seems mild. 

Living with cauliflower ear

Even if it's not treated, cauliflower ear doesn't tend to cause major issues other than cosmetic ones. But it won't go away on its own. If you don't get treatment, your misshapen ear can become permanent within 10 days. 

Cauliflower ear can also return, with or without treatment.

One study found that people with cauliflower ear may have a slightly higher risk of hearing loss than others. This may be because the risk of infection is higher when you have cauliflower ear. It's also possible that swelling could partially block your ears and make it harder to hear.

An injury to your ear can lead to cauliflower ear. You should get treatment quickly to avoid deformities. Even if you don't treat it, you usually won't have any serious side effects. But you may need surgery to help your ear look normal again. To prevent cauliflower ear, always wear protective headgear while doing high-impact activities. 

Can cauliflower ear go away?

Cauliflower ear won't go away on its own. But with quick treatment or surgery, your ear can look normal again. Still, it can sometimes come back – even if you get treatment. 

Is cauliflower ear repairable?

The only way to repair deformities from cauliflower ear is to have cosmetic surgery to correct the shape of your ear.