Open Wound of the Ear: First Aid and Healing

First aid for an ear wound

1. Stop the bleeding: press firmly with clean gauze or cloth for 10 minutes without lifting to check.
2. Clean the wound: rinse with clean running water and mild soap around (not in) the wound. Do not pour anything into the ear canal.
3. Protect it: apply a thin layer of petroleum jelly and a small non-stick dressing or bandage.
4. Do not pack the ear canal or put cotton swabs inside it.
5. Check tetanus: you need a booster if you have not had one in 10 years, or in 5 years for a dirty wound.

Types of ear wounds

Outer ear (pinna) cuts and tears

The outer ear is thin skin over cartilage. Cartilage has a limited blood supply, so it heals slowly and is vulnerable to infection. Deep cuts may need careful stitching by a clinician to restore the ear's shape. Earlobes, which contain no cartilage, often tear from earrings and can be repaired.

Wounds behind the ear

Open wounds or splits behind the ear are common and often not from injury:

• Cracks from eczema or seborrheic dermatitis: the crease behind the ear can split and weep, especially in babies and people with eczema.
• Friction from glasses, masks or hearing aids.
• Scratching.
• Infection: bacterial or fungal infection of the crease.
• Skin cancer: basal cell and squamous cell carcinoma commonly occur on and around the ears.

Moisturizing, treating eczema with prescribed creams, and adjusting glasses usually help.

Wounds in the ear canal

The skin of the external ear canal is thin and easily scraped by cotton swabs, fingernails, hairpins or earbuds. These wounds can bleed, hurt and become infected (otitis externa). Keep the ear dry and avoid putting anything in it. Bleeding with hearing loss or pain after an object entered the ear may mean an eardrum injury and needs examination. See ear canal injury.

Bites

Human and animal bites carry high infection risk. They need cleaning by a clinician, antibiotics in most cases, and assessment for tetanus and, for animal bites, rabies.

Blunt trauma and hematoma

A blow to the ear can cause bleeding between the cartilage and its covering, forming a tense swelling (auricular hematoma). It must be drained promptly to prevent cauliflower ear, a permanent thickened deformity.

Why an ear wound may not heal

• Infection, including perichondritis
• Repeated picking, scratching or friction
• Eczema or psoriasis
• Poor circulation, smoking or diabetes
• Skin cancer: a sore on the rim of the ear or behind it that bleeds, crusts and never fully heals, especially in older adults with sun exposure, should be checked. Basal cell carcinoma and squamous cell carcinoma are common on the ears.
• Chondrodermatitis nodularis helicis: a painful nodule on the ear rim, often from sleeping on that side.

Medical treatment

• Stitches, skin glue or strips for gaping cuts, ideally within 6 to 24 hours.
• Specialist repair for complex lacerations through cartilage or partial amputations.
• Drainage of hematomas, with a pressure dressing.
• Antibiotics: for bites and infected wounds. Perichondritis needs antibiotics that cover Pseudomonas.
• Biopsy of non-healing sores.
• Keloid treatment: steroid injections, pressure earrings or surgery for keloids, which are especially common after earlobe piercings. See keloid scars.

How ear wounds heal

Small scrapes and cuts typically heal in 7 to 14 days. Stitches on the ear are usually removed after 5 to 7 days. Keep the wound clean and moist, avoid sleeping on it, protect it from the sun, and avoid swimming until it has closed. Scars continue to fade over months.

Frequently asked questions

How do I treat an open wound on my ear?

Press firmly to stop bleeding, rinse with clean water, apply petroleum jelly and cover with a non-stick dressing. Do not put anything into the ear canal. See a clinician if the cut is deep, gaping, through cartilage, from a bite, or if the ear becomes swollen, red or painful.

Why is the open wound behind my ear not healing?

Common reasons are eczema or seborrheic dermatitis splitting the skin, friction from glasses or hearing aids, scratching and infection. A sore that does not heal after 3 to 4 weeks, bleeds or keeps crusting should be checked by a doctor, as skin cancers often appear around the ears.

Does a cut on the ear need stitches?

Cuts that gape open, are longer than about 1 cm, go through cartilage, or involve a torn earlobe usually need stitches, ideally within 6 to 24 hours. Small, shallow cuts with edges that stay together can heal with simple dressings.

How can I tell if an ear wound is infected?

Signs of infection include increasing pain, redness spreading around the wound, warmth, swelling, pus and fever. If the whole outer ear becomes red, hot and swollen, especially after a cartilage piercing, it may be perichondritis, which needs prompt antibiotics.