Hearing Health

In this series

What Causes a Ruptured Eardrum and How to Treat It

This hole may clear up on its own, but you might need to see your doctor if your hearing loss doesn't improve

Kim Painter,

AARP

Reviewed by

Bria Collins, Au.D.

En español

Published September 03, 2025

Liam Eisenberg

Key takeaways

Adults often rupture eardrums by sticking cotton swabs in their ears.
Symptoms can include ear pain, leaking fluid and ringing in the ears.
Most ruptured eardrums heal on their own.
While you heal, keep water out of your ears and be cautious.

You probably don’t think much about your eardrums. But they’re pretty important. These thin layers of tissue, which sit about 1 inch inside your ear canal, help you hear. They also protect your middle ear from water, bacteria and other harmful substances.

So, a ruptured or perforated eardrum — a hole in your eardrum — is a problem. Fortunately, it’s one that usually clears up on its own. But getting a diagnosis is important, and some people do need medical treatment to close the hole, says Dr. Gavin Le Nobel, an otolaryngologist at Houston Methodist.

Here’s what you need to know.

What causes a ruptured eardrum?

Dr. Jeffrey LaCour, an otolaryngologist at North Oaks Health System in Hammond, Louisiana, says he has one patient in his 60s who ruptures his eardrum repeatedly by slamming into waves while surfing. “He loves the surfing, so he keeps doing it,” making his eardrum more fragile each time, LaCour says.

That’s not the way most people perforate their eardrums, of course. Here are the usual causes:

Infection. When you have an infection in the middle ear, fluid can build up, creating enough pressure to rupture an eardrum. While this is a common problem in children, it’s much rarer in adults, LaCour says.

Sticking objects in your ear. This is the most common cause in adults and is linked to one particular object, LaCour says: cotton swabs. People use them in a misguided attempt to clean impacted earwax from their ears, he and Le Nobel say. “All that generally does is push things in,” Le Nobel says. LaCour says he also frequently sees bobby pin injuries, because people use them to scratch their ears (also a bad idea).

Sudden pressure changes (barotrauma). Air travel, scuba diving or a direct blow to the ear, like from a car airbag, can lead to significant pressure changes in the ear and cause a rupture to the eardrum. “I actually perforated my own eardrum scuba diving,” Le Nobel says.

Head blows. Getting a hard hit to your head, from a fall or even a slap, can rupture your eardrum. It’s sometimes seen in cases of domestic abuse, LaCour says.

Extremely loud noises. The sound waves from an explosion or gunshot, for example, might be strong enough to rupture an eardrum.

Ruptured eardrum symptoms

While you might think that an eardrum rupture is a dramatic event you’d notice right away, that’s not always true, Le Nobel says. Some people can be “totally unaware,” at least at first, he says.

When signs of a ruptured eardrum show up, they can include:

Hearing loss. This happens because your eardrum plays a crucial role in hearing — vibrating in response to sound waves. Those vibrations are transferred to the bones of the middle ear, starting a chain of events that get sounds to your brain.

Some people with an eardrum perforation will say, “I can’t hear at all, compared with my other ear,” while others notice more subtle changes, Le Nobel says. People might say their hearing is “muffled,” LaCour says.

Ear pain. Many people notice an immediate “ouch” when they rupture their eardrum, LaCour says. By the time they see a doctor, he says, there’s often no pain. Ear pain can become chronic, though, if the perforated eardrum is infected, Le Nobel says.

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Leaking fluid. Depending on the cause, the ruptured eardrum might bleed or leak clear, whitish or yellow fluid. If blood coming from your ear is your only symptom, though, “more likely than not, it’s not a hole,” LaCour says. Usually, he says, it’s from scratching the skin in the ear canal.

Ringing or buzzing in the ears. Tinnitus, a condition that causes phantom ringing or buzzing in the ears, may worsen if you have a hole in your eardrum, Le Nobel says.

Spinning sensations (vertigo). The vertigo might also cause nausea. These symptoms can happen because damage to the eardrum affects the inner ear’s vestibular system, which controls balance.

Le Nobel describes what his own ruptured eardrum felt and looked like: “At first, I didn't know what was going on. Then I realized it hurt, and I had difficulty hearing. And later that day, I had some blood coming out of the ear.” He says he also could “feel air in a part of the ear where it shouldn't be.… It just didn't feel right.”

You might wonder if you can see your own ruptured eardrum. With the naked eye, you can’t, Le Nobel and LaCour say. But both say they’ve seen patients who bought ear scoping devices online that allowed them to see deeper into their ear canal and take pictures.

Even then, LaCour says, the untrained eye might not be able to tell if the eardrum is ruptured or not. A spot of blood, he says, might look like a hole.

It's also not a great idea, he says, to stick anything into your own ear.

Diagnosing a ruptured eardrum

If you think you might have a perforated eardrum, see a doctor, both LaCour and Le Nobel urge.

The doctor will ask about your symptoms and then look in your ear with a lighted scope. Ideally, LaCour says, the doctor will also use a tool called a tympanometer. This device can measure the volume of the ear canal and how the eardrum responds to changes in air pressure. If the eardrum doesn’t move and the canal is larger than usual, that confirms a hole, he says.

Your doctor may also refer you to an audiologist for a full exam of your outer, middle and inner ear to see if you have any hearing loss.

Ruptured eardrum treatment

You may need no treatment at all, because most eardrum holes close within a few weeks. One small study found that about half closed within four weeks, 81 percent closed within three months and 97 percent closed at some point, without medical intervention.

Smaller holes tend to heal fastest, LaCour says. Infection can slow healing, Le Nobel says.

If your doctor sees signs of infection in the ear, you’ll probably get antibiotic ear drops, both doctors say. Le Nobel says he often prescribes oral antibiotics as well.

While you’re waiting to see if the hole heals, you should: ·

Keep the ear dry. Your audiologist can make a set of silicone earplugs that are custom molded to you. They’ll keep your ears dry and can help prevent more eardrum ruptures.
Resist cleaning your ear. That could slow healing.
Avoid blowing your nose. The pressure could further damage your eardrum.

Whether any other treatment is considered can depend not only on how long the tear lasts but also on how bad any hearing loss is and whether water restrictions are a problem for you — for example, if you play water sports, Le Nobel says.

In general, he says, he suggests waiting about a year to see if the hole closes. LaCour says he might recommend a procedure within a few months if it looks like the hole isn’t making progress toward healing.

If you decide on treatment, it might include: ·

A temporary patch, often made of paper, that can act as “scaffolding” for the healing tissue, LaCour says. You can get that procedure in a doctor’s office.
A surgery called a tympanoplasty, to use tissue from your own body or, sometimes, a pig, to close the hole. That requires a visit to an operating room, but you usually go home the same day.

If you have hearing loss from a perforation and don’t want surgery, or aren’t a candidate for anesthesia, hearing aids might be a reasonable option, Le Nobel says.

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Kim Painter is a contributing writer who specializes in health and psychology. She frequently writes for AARP's Staying Sharp and previously worked as a health reporter and columnist at USA Today.

Bria R. Collins is an associate director of audiology practices at the American Speech-Language-Hearing Association. She has more than 10 years of clinical experience as an audiologist, including at the Veterans Affairs Medical Center in Washington, D.C., where she evaluated military service members with hearing and balance concerns.