Ear drainage – why it happens and what it means

It’s normal for ear wax to drain from your ears on occasion, but if you’re experiencing excessive drainage of fluid accompanied by pain, fever, swelling, redness, or reduced hearing, it’s time to seek medical treatment. You may have an infection.

What does it mean when your ear is draining?

It might mean your ear is cleaning itself, or it could mean you have an active infection.

People often confuse earwax with a draining ear, says Dr. David F. Smith, an Associate Professor and Clinical Director for the Center for Circadian Medicine at Cincinnati Children’s Medical Center. Dr. Smith is board certified in ear, nose and throat medicine.

Earwax, or cerumen, is normal and serves as a cleaning mechanism for the ear canal and the ear drum, he says. This soft, yellow substance may fall out of your ear canal from time to time.

When the ear is draining excessive amounts of fluid, on the other hand, it typically means there is an active infection in either the middle ear or outer ear.

Middle ear infections occur in the area behind or very near the ear drum and indicate a hole in the ear drum from which the fluid is draining.

Outer ear infections occur in the ear canal, which may occur from excess moisture in the ear canal. For example, Dr. Smith said swimmer’s ear occurs frequently among children in the summer if they spend a lot of time in the water. Proper swim ear plugs can reduce the chance of developing swimmer's ear.

What causes ear infections?

Dr. Smith said the most common type of drainage from the ear is pus, a collection of dead, white blood cells that form when your body is trying to fight an infection. This type of drainage is usually a sign that germs are growing in these areas from a virus, yeast, or bacteria.

Young children are more prone to middle ear infections and eustachian tube dysfunction. That's because their eustachian tubes—which help fluid drain away from the ear—are small and positioned horizontally, which makes it difficult for fluid to exit the ear. Additionally, children have more immature immune systems than adults and are often exposed to frequent bacterial and viral infections at daycare and primary school.

How do you know when you have an ear infection?

Just because your ear is draining doesn’t mean you have an ear infection.

A small amount of fluid is secreted throughout the day by the lining of the middle ear space and normally drains into the back of the nose and throat by a narrow area called the eustachian tube. If there is a hole in the ear drum (known as a perforated eardrum), this clear or brownish colored fluid can drain through the ear drum and out of the ear canal.

Pus is yellow, green, or white in color. If it is excessive and accompanied by ear pain, swelling, or redness within or around the ear canal, reduced hearing, or dizziness and ringing in the ear, it is most likely an infection.  

Yellow or white drainage, especially copious drainage, is concerning. Although rare, these infections can lead to very serious complications, such as infections spreading to the brain.

How are ear infections treated?

In the case of excessive drainage, your hearing healthcare provider will first remove the fluid that is in the ear canal with a special instrument which is designed to not cause injury to the canal wall or ear drum. Treatment primarily involves taking an oral antibiotic and/or antibiotic ear drops.

Never try to clean or remove the drainage with a cotton swab or other object, which can cause serious injury.

In the case of kids or people who experience repeated infections, your provider may take a culture, or sample, of the fluid to determine what germ is growing to prescribe the treatment that is most effective for that particular type of infection.

Dr. Smith said it’s important to seek medical attention promptly if you suspect you have an ear infection.

“Yellow or white drainage, especially copious drainage, is concerning,” he said. “Although rare, these infections can lead to very serious complications, such as infections spreading to the brain.”