Ruptured Eardrum: Symptoms and Treatments

Medically Reviewed by Jabeen Begum, MD on April 04, 2024
Written by Lori M. King, PhD
9 min read

Your eardrum (tympanic membrane) is the thin, circular piece of tissue that separates your outer and middle ear. It protects your middle ear from dirt, debris, and bacteria and also plays a vital role in your ability to hear.  

A ruptured eardrum is when you get a hole or tear in your eardrum. The most common cause of a ruptured eardrum is a middle ear infection, but you can also get it from pressure changes, head and ear injuries, and something stuck in your ear.

A ruptured eardrum can lead to complications such as repeated middle ear infections and hearing loss. You may need surgery to repair the damage to your eardrum. But typically, a ruptured eardrum will heal on its own without treatment within a couple of months, especially if you protect your ear from further damage.

Is a ruptured eardrum serious?

Not usually, but it can become serious if it doesn't heal on its own. You may get complications, such as long-term hearing loss, vertigo, dizziness, or an infection that spreads.

Can you swim with a ruptured eardrum?

No, you can't swim with a ruptured eardrum. Your doctor will likely recommend you avoid getting water in your ear at all when you have a ruptured eardrum because you could get a serious middle ear infection. In fact, your doctor may recommend you coat a cotton ball in petroleum jelly and put it in your ear while you shower or bathe to keep any water out until your eardrum heals.

A number of things can cause your eardrum to rupture, such as: 

Ear infections. One of the most common causes is a middle or outer ear infection. When the middle ear is infected, pressure builds up and pushes against the eardrum. When the pressure gets too great, it can cause the eardrum to perforate. When that happens, you may suddenly notice that the pain and pressure you've felt from the infection suddenly stops and pus drains from the ear. If you've had ear surgery or a severe ear infection before, you're more likely to have an eardrum rupture when you get another ear infection.

Pressure differences in your ear (barotrauma). This happens when the pressure inside and outside your ears isn't equal. That may be because of a sudden loud noise (also called acoustic trauma), when your airplane changes altitude while flying, or when you're scuba diving and you go up and down in the water.

Putting objects in your ear. Another common cause of a ruptured eardrum is poking the eardrum with a foreign object, such as a cotton-tipped swab or a bobby pin that's being used to clean wax out of the ear canal. Sometimes children can puncture their own eardrum by putting objects such as a stick or a small toy in their ear.

Head injury. A head injury , especially at the base of your skull near your ear, or an open-handed slap across your ear may also cause your eardrum to rupture.

Symptoms usually start after you've:

  • Had an ear infection
  • Had an injury to your ear
  • Heard a sudden, loud noise (like fireworks or gunfire)
  • Experienced a sudden change in pressure

You may not notice any symptoms until your eardrum ruptures, especially if it's caused by a sudden noise or injury. Once your eardrum ruptures, you may have the following, usually in one ear:

  • Sudden, sharp ear pain or, if you've had pain from an ear infection, a sudden decrease in ear pain
  • Fluid draining from your ear that may be bloody, clear, or cloudy
  • Ear ringing or buzzing (tinnitus)
  • Itching in your ear canal
  • Hearing loss that may be partial or complete in the affected ear
  • Dizziness or vertigo
  • Nausea or vomiting from vertigo
  • Fever
  • In severe cases, weakness in your face

What does a ruptured eardrum feel like?

At the time it ruptures, you may feel a sudden, sharp pain in your ear, followed by bleeding, hearing loss, and tinnitus. If an ear infection causes your rupture, your pain may suddenly get intense, followed by a feeling of relief as the pressure in your ear goes down.

Ruptured eardrum bleeding

You may have some bleeding once your eardrum ruptures. This is common, especially in people with an ear infection. The bleeding should stop soon after it starts, but you may have a cloudy fluid that leaks out for a few days.

How long will a ruptured eardrum leak?

Your ear may or may not leak fluid after an eardrum rupture. It's more common for your ear to leak fluid if you've had an ear infection, but it should stop leaking in 2-3 days.

About 90% of kids get at least one ear infection during childhood and about 20% have frequent ear infections. And about 5%-10% of bacterial ear infections will rupture from the pressure of fluid built up behind the eardrum. 

Kids need antibiotics if they have a bacterial ear infection, and they should start to feel better about 2-3 days after they start. If they have a ruptured eardrum from the infection, don't use any eardrops except the antibiotics your pediatrician prescribes. Don't let them go swimming, and keep their ears dry when they bathe. Wipe away any fluid that's leaking out of their ear, but don't plug their ear with a cotton ball since this can cause an outer ear infection. 

Give them acetaminophen or ibuprofen for fevers above 102 F and to help with the pain.

If you have any of the symptoms of a ruptured eardrum, your doctor will look inside your ear with a lighted instrument called an otoscope. In most cases, if there is a hole or tear in the eardrum, your doctor will be able to see it. If the hole is very small and your doctor can't see it with an otoscope, they may need to perform other tests, such as middle ear impedance audiometry. 

Your doctor may also do hearing tests to measure how well you can hear and how well your eardrum works. These tests may include:

  • Audiometry to test how well you can hear soft sounds and different pitches
  • Tympanometry to see how your eardrum moves in response to changes in air pressure

If you have serious hearing loss or vertigo, your doctor may send you to an otolaryngologist (ear, nose, and throat doctor). You may also need to see them if you have a very large hole in your eardrum since you may need surgery to repair the hole.

 

Typically, no specific treatment is needed for a ruptured eardrum because most heal on their own within 2-3 months. 

Your doctor may prescribe an antibiotic -- either oral or in the form of eardrops -- to prevent an ear infection or treat an existing infection. If your ear is causing you pain, your doctor may recommend using an over-the-counter pain medication such as acetaminophen or ibuprofen. You may also try a warm or cool pack on your ear to help relieve discomfort.

Ruptured eardrum surgery

If your eardrum takes longer than 3-4 weeks to heal, you may want to talk to an ear, nose, and throat doctor who may do a procedure to close or patch the hole. These procedures are typically done on an outpatient basis, which means that you can go home the same day.

Myringoplasty. In this procedure, your doctor puts a paper patch over the tear or hole. The patch is usually treated with a medicine to help your eardrum heal, though you may need to have this procedure more than once before it heals completely.

Tympanoplasty. If your doctor doesn't think a patch will give full healing or myringoplasty hasn't worked for you, your doctor may try grafting some of your tissue as a patch over the hole.

Home remedies

To help heal your eardrum and ease your symptoms, try the following:

  • Take over-the-counter painkillers like acetaminophen or ibuprofen.
  • Don't go swimming or let water in your ear until you have healed or your doctor says it's OK.
  • Don't put anything in your ear (including cotton balls or swabs or eardrops) unless your doctor says it's OK.
  • Take care when you blow your nose; blowing too hard can damage your eardrum as it heals.

Ruptured eardrum healing time

It depends a lot on how big the hole in your eardrum is. Small holes generally start to heal over in 1-2 days, but it may take several months to completely heal. If you're still having pain, drainage, or hearing loss after 2-3 days, go talk to your doctor because you may need to start or change your treatment.

Can you fly with a ruptured eardrum?

Generally, yes, you can fly with a ruptured eardrum. However, if you've had surgery to patch your eardrum, ask your doctor to make sure it's OK to fly.

Which side should I sleep on with a ruptured eardrum?

Sleeping on your side can put pressure on your ear, which can cause pain and discomfort or interfere with your healing. It's best to sleep either on your back or on the side that's unaffected. For instance, if your right eardrum is ruptured, sleep on your left side, with your right ear facing away from your pillow. If you sleep on your back, elevate your head slightly with an extra pillow to help reduce the pressure on your ears.

If your eardrum hasn't healed on its own after 3-6 months, you may get complications, including:

Hearing loss. Usually any hearing loss you have is temporary. Your hearing tends to come back once the hole has healed, but sometimes, if the hole is large or it's in an area that's hard to heal, your hearing loss may be long-term.

Middle ear infection. A hole in your eardrum may allow bacteria to get into your middle ear. If your eardrum doesn't heal, you may get ear infections over and over again. If this happens, you may have permanent hearing loss and fluid leaking out of your ear.

Cholesteatoma (cyst in your middle ear). A hole in your eardrum may also allow skin and earwax to get into your middle ear. This can form a cyst, which makes proteins that can damage the bones in your middle ear and cause permanent hearing loss.

Mastoiditis. This is when an infection spreads to the bone behind your ear (mastoid).

Long-term vertigo or dizziness.

The two most important steps you can take to prevent a ruptured eardrum are to avoid putting any object into your ear -- even to clean it -- and to treat any ear infections promptly. Have your doctor remove any foreign objects in your ear. Don't try to remove it yourself because you could make things worse.

A ruptured eardrum is when you get a hole or tear in your eardrum. The most common cause of a ruptured eardrum is a bad middle ear infection. Most of the time, a ruptured eardrum will heal on its own in a couple of months. But if your eardrum doesn't heal on its own, you can get complications such as middle ear infections and hearing loss. An ear, nose, and throat doctor can patch or repair your eardrum in that case.

How long will a ruptured eardrum hurt?

Most of the time, you should be pain free by day 3, especially if you are taking medicine. Generally, your eardrum will start to heal within 1-2 days, at which point you should start to feel better. 

Does a ruptured eardrum feel like it's clogged?

At the time your eardrum ruptures, you will likely feel a sharp pain in your ear that can be intense. Before your eardrum ruptures, you may have a feeling of pressure in your ear that may feel clogged.