Diseases and Symtoms articole page
Diseases and Symtoms articole page
Other hearing diseases

Understanding the causes & treatments of auricular hematoma

Auricular hematoma, also known as cauliflower ear, is a condition caused by an injury to the outer ear. Learn more about how it happens and why preventing it is important.

Key takeaways

  • Auricular hematoma is a buildup of blood underneath the skin of the outer ear.
  • Cauliflower earis a common name for the condition, since it causes a puffy, puckered appearance in the ear.
  • It is mostly caused by trauma to the ear, often from contact sports, but also from accidents, falls or piercings. It can also be caused by infection or even overuse of mobile phones.
  • Symptoms can include swelling, pain, bruising and tinnitus.
  • Treatment involves draining the wound and then keeping pressure on it afterward to prevent blood from re-accumulating.
  • Auricular hematoma is prone to re-occurring, so fast and proper treatment is important. It’s ideal to see a doctor for treatment within 48 hours of the injury.
  • Scarring of the outer ear caused by auricular hematoma can contribute to conductive hearing loss.

Our experts will help you with any questions you may have

Book an appointment

Definition of auricular hematoma

What is auricular hematoma? The definition of this medical term is a buildup of blood underneath the skin of the outer ear. It is also sometimes called apinna hematoma” because it develops on the pinna (the outer part of the ear), but you might know it by its more common name, “cauliflower ear.” 

Causes of auricular hematoma

Individual auricular hematoma causes vary, but ultimately, it’s due to an injury that tears apart layers of ear tissue or damages the cartilage (the stiff material that gives your ears their shape). Blood then collects where the injury occurred. If left untreated, scarring causes the puffy and puckered look that led to the name “cauliflower ear.” Injuries that lead to auricular hematoma are associated with:

  • Contact sports (e.g. wrestling, boxing, rugby)
  • Vehicle accidents
  • Falls
  • Piercings

But, besides trauma, what could cause auricular hematoma? There are a few possibilities:

  • Infection
  • Medical conditions (e.g. leprosy)
  • Congenital issues
  • Cell phone use

It’s true: there are some auricular hematoma cases caused by mobile phones. The pressure of the phone up against the ear can cause tissue and blood vessel irritation — but this is only likely with excessive use. Studies of cell-phone-related auricular hematoma showed that people who developed them were using their phones for three to four hours per day over an extended period.1
Woman touching her ear

Experiencing changes in your ear?

Our hearing care professionals will conduct a thorough, in-person evaluation, review your results with you, and create a personalized plan to find the best treatment for you.

Symptoms of auricular hematoma

If you’ve had an ear injury, pay attention to auricular hematoma symptoms such as:

Conditions similar to auricular hematoma

As doctors work to identify your condition, they have to consider other causes that may have similar looks or characteristics, in order to rule them out. This is calleddifferential diagnosis”.2 For auricular hematoma, differential diagnosis conditions might include:

  • Abscess (a collection of puss caused by infection)
  • Cellulitis (a bacterial infection)
  • Hemangioma (a non-cancerous tumor caused by irregular blood vessel growth)
  • Keloid (a type of scar with a puffy appearance) 
  • Otitis externa (outer ear infection)
  • Perichondritis (an infection that inflames the ear tissue)
  • Skin cancer
  • Sunburn

Auricular hematoma: common occurrence areas in ear

external anatomy of the ear

Each section of the ear has a specialized medical name, so let’s look at the spots where auricular hematomas form most often:

  • Helix: The “rim” at the top of your ear
  • Antihelix: The inner “ridge” of the ear, just inside of the rim
  • Tragus: The bump that’s on the outside of your ear canal opening, nearest to your cheek
  • Antitragus: The bump on the opposite side of the ear canal opening

Howeverhematomas can form in other places around and in the ear as well.

 

 

It’s possible to develop an auricular hematoma behind the ear as well. The same kind of tissue damage — separation of the skin from the cartilage — that causes a pocket of blood to form on the front of the ear can also happen on the back side

When it occurs behind the eardrum, hematoma is known as hemotympanum. This buildup of blood in the middle ear can be caused by trauma, ear infection, bleeding disorders or nasal packing (the insertion of gauze or cotton in the nose to stop bleeding). It’s a different condition than auricular hematoma and requires other kinds of treatment.

Perichondrial hematoma is a medical term that doctors might use to add specificity about where a hematoma occurs. There’s a layer of tissue under the skin the perichondriumwhich covers the cartilage. When blood collects between the perichondrium and the cartilage, as opposed to within the cartilage or between the skin and the perichondrium, it’s called a perichondrial hematoma. 

Find your nearest Miracle-Ear store

Find a store

Treatments of auricular hematoma

There are a few kinds of auricular hematoma treatments, but it’s always advised that if you have an ear injury, you should see a doctor as soon as you can. 

For auricular hematoma aspiration, your doctor will use a needle and syringe to draw blood from the injury. With the blood removed, the tissue layers can be brought back into contact to prevent scar tissue from forming. This treatment typically works better on small, new injuries (less than 48 hours old). 

In auricular hematoma incision and drainage, an incision is made in the ear so that blood clot can be drained out. The goal is the same as needle aspiration — removing the blood so that the layers of tissue can heal together — but this method is more often used on hematomas that are larger and more than 48 hours old

Auricular hematomas have a high tendency to reoccurand the hole-punch technique was developed to prevent that from happening.

In this procedure, doctors make an incision in the ear and then use a tool to punch tiny holes in the cartilage. These holes allow the tissue layers under the cartilage and on top of the cartilage to come into contact. When they heal together, it tightens the tissue and there is less room for a hematoma to reform.

Auricular hematoma surgery, or otoplasty, can be done to help improve the appearance of cauliflower ear. In the procedure, doctors remove scar tissue and then work to rebuild the ear; they may use a prosthesis or cartilage taken from the ribs.3

Care and management of the ear after auricular hematoma

Post-auricular hematoma treatment is important and needs to be monitored carefully to prevent the tissue from separating again and allowing another clot to form. The key to this is constant pressure on the ear, which can be done in a few ways. Before attempting the treatment options below, consult with your doctor to ensure it is safe and appropriate for your condition. 

Auricular hematoma pressure dressing is a non-invasive method. Petrolatum gauze (gauze soaked in Vaseline) is molded to the shape of the ear and then a bandage is wrapped around the head. The bandage should be tight enough to put pressure on the ear, and the molded gauze places more direct pressure on the hematoma site. 

In auricular hematoma bolster dressing, either petrolatum gauze (see pressure dressing, above) or dental rolls (small cylinders of compressed cotton), are placed on the front and back of the hematoma site and held in place with stitches. These “bolsters” apply pressure that can prevent another clot from forming. 

For auricular hematoma, mattress sutures are another way of applying post-treatment pressure. In this method, stitches are made directly in the ear at the hematoma site, putting pressure on the tissue to prevent more blood clotting.
Woman taking a hearing test with an audiologist

Care for your ears

One of the best ways to care for your ears and prevent hearing loss is to get them properly examined by a hearing professional. Find your nearest Miracle-Ear store to get started on your journey to better hearing.

Complications of an auricular hematoma

Auricular hematoma complications can be simply cosmetic — or more serious.

  • Re-occurring hematoma: If the ear tissues don’t reattach properly, they can re-tear and lead to another hematoma.
  • Chondritis: The ear cartilage can become inflamed, causing swelling and discomfort.
  • Conductive hearing loss: Changes to the structure of the outer ear can partially block sound from entering the ear, or they can make it harder for the ears to naturally drain earwax. Either case can lead to what is known as conductive hearing loss, in which when a physical blockage reduces your ability to hear.
  • Infection: Wounds that are not properly cared for can become infected.

FAQs about auricular hematoma

No. An inner ear infection cannot cause auricular hematoma. However, infections like perichondritis (which affects the perichondrium tissue of the outer ear) can lead to auricular hematoma.

Ideally, auricular hematoma should be drained within 48 hours of the injury occurring. Early treatment can help reduce the development of scar tissue and the risk of recurring hematomas.

Sources

1 Halil E. Özel, Selahattin Genç, Erkan Esen, Fatih Özdoğan, Adin Selçuk, Auricular hematoma cases caused by mobile phones, Oral and Maxillofacial Surgery Cases, Volume 1, Issue 4, 2015, ISSN 2214-5419. https://doi.org/10.1016/j.omsc.2015.10.002.

2 Hohman MH, Jamal Z, Krogmann RJ, et al. Auricular Hematoma. [Updated 2024 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531499/.

3 Putri IL, Bogari M, Khoirunnisa A, Dhafin FR, Kuswanto D. Surgery of Severe Cauliflower Ear Deformity. Plast Reconstr Surg Glob Open. 2023 Apr 19;11(4):e4953. doi: 10.1097/GOX.0000000000004953. PMID: 37091928; PMCID: PMC10115543. https://pmc.ncbi.nlm.nih.gov/articles/PMC10115543/.

Dr. Tom Tedeschi

Our experts

Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

Our experts will help you with any questions you may have

Book an appointment

Get support and advice

Book an appointment online

Book now

Take a free online hearing test

Start test

Find a hearing aid center near you

Search now