Cauliflower Ear: What It Is, How It Happens, and How To Drain It

Philip Scolaro, MD

cauliflower ear

Boxing and wrestling fans know the unusual look of a perichondrial hematoma, more commonly referred to as “wrestler’s ear” or “cauliflower ear.”

Cauliflower ear has become less common in organizations like the UFC in recent years because of participants wearing more protective equipment.

Fighters like Phil Vickery and Randy Couture wear their cauliflower ears as badges of honor. But for the rest of us, cauliflower ear is something we’d probably rather steer clear of.

Unfortunately, avoiding a career in full-contact sports like wrestling, boxing, and martial arts isn’t quite enough to ensure we avoid this condition.

What Causes Cauliflower Ear?

Most people associate cauliflower ear with trauma to the ear, and that is a very common cause.

But cauliflower ear can also occur any time the skin of the ear separates from the cartilage. Blood (a hematoma) or clear yellow fluid (a seroma) can accumulate in this space under the skin.

This separation can be spontaneous, or it can result from an infection from an ear piercing. While piercing the cartilage in the upper part of the ear is fairly common, it can unfortunately result in quite a bit of (sometimes irreversible) damage.

What Happens in the Body When Cauliflower Ear Occurs?

Cartilage gets its blood supply from the skin. But when the skin separates from the cartilage, that blood can’t reach its usual destination. Instead, it accumulates in the open space and clots underneath the skin.

This disruption in blood flow, if left untreated, will cause the cartilage to die. Scar tissue then builds up, thickening the area. The ear loses its “crisp” shape, resulting in the “cauliflower” look.

This process can happen quickly, sometimes in just a few weeks, so timely treatment is important.

cauliflower ear

Is the Look of Cauliflower Ear Reversible?

Unfortunately, the unique look of cauliflower ear is not readily reversible. Your best bet is to prevent it from happening in the first place.

Always use a helmet or protective headgear when participating in full-contact sports. (You’ll also protect your brain in the process!) If you notice an injury, infection, or fluid accumulation around the cartilage of your ear, see a doctor right away.

A physician can extract the fluid from under the skin with a needle. But because the skin will continue to provide blood flow to the area, that fluid often reaccumulates even after it drains.

The doctor can also install a tiny, portable drain in the ear, along with pressure dressings, to keep the fluid from building up until the issue resolves. This may require the patient to change their dressings at home. (Your medical provider will show you how to do this if it’s needed.)

How Can an ENT Doctor Help?

If a patient comes to the office with this issue, we perform a thorough assessment and examination of the entire ear. From that point, we can prescribe antibiotics to deal with any infection, drain any fluid accumulation, or both. In more severe cases, we can install the drain mentioned above.

Our physicians will look several steps ahead. Even if your ear is the only complaint you come in with, we also make sure nothing more serious could be causing your condition.

This is particularly important if the damage to your ear seems random and isn’t associated with an injury. Even though it’s uncommon, some autoimmune conditions target cartilage and could cause a separation between the cartilage and skin.

When Should I See an ENT Doctor for Cauliflower Ear?

Because a traumatic insult to the ear can progress quickly and isn’t easily reversible, it’s important to seek medical care as soon as you notice symptoms. Even if you only suspect an injury caused damage, but aren’t sure, it’s better to seek care sooner rather than later.

An infection or fluid accumulation between the skin and cartilage may cause pain, or it may only feel thick and heavy. Either way, it needs to be drained promptly. Doing so will help you avoid the thickened, cauliflower-like appearance that can result from a delay in care.

ENT Associates of Lubbock Treats Cauliflower Ear

Even though contact sports-related cauliflower ear is on the decline, we see a fair amount of ear injuries in our practice. From an accidental injury from siblings wrestling to an autoimmune disease that impacts your cartilage, we’ve got you covered.

Our physicians are experts at treating the ear, nose, and throat complaints of your entire family. Call us today to schedule a consultation with our team. We look forward to serving you!

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Ear