I know the feeling.

You run your hand over your ear and it feels a little bit…puffy.

Or you wake up in the middle of night and wonder, why is my ear throbbing?

Maybe you just felt a little rip at jiu jitsu training and now your ear is slowly filling up like a water balloon.

Yep. Cauliflower ear.

The thing about cauliflower ear is, while it’s not difficult to treat, it is very cumbersome and annoying to do. It also takes a great deal of personal time and care, as the way you need to treat it is unique for each situation, depending exactly where on the ear it is, how severe, and the options available to you.

In this article I’ll share the different treatments I’ve used for cauliflower ear, and the pros and cons of using each.

What is cauliflower ear?

Cauliflower ear occurs when you suffer trauma to the ear. This most common in contact sports, such as wrestling, rugby, jiu jitsu and MMA.

The reason this occurs on the ear is because of how our ears are made. Our ears do not have any bones in them, just skin and cartilage. This allows the ear to better receive sound waves so we can hear. However, the trade-off is this makes the ear soft and vulnerable.

When the ear gets stuck in a tight space, such as a choke hold, or the bottom of a ruck, and is suddenly pulled, scraped or squashed, it is not uncommon for some skin to tear away from the cartilage. When this happens, the ear swells up and fills with fluid as a defense mechanism.

This is why you’ll notice upon draining the ear, it is not actually blood inside the ear, but a clear, water-like fluid.

While the body is good at rushing this fluid to the ear upon damage, it is not so good at draining it. The ear is in many ways detached from the body, and therefore the draining of this fluid does not occur naturally like it does when we have a swollen knee or ankle.

Because the fluid is unable to drain, it simply remains in the ear until it hardens. These little hardened pockets of fluid start give the appearance of little bulbs in the ear, which we know as cauliflower ear.

So how do we treat cauliflower ear?

Ice and treat as soon as possible

The first thing you want to do, as soon as you feel like your ear might be swelling up, is hold some ice against it. This will hopefully reduce any swelling you will have and make treatment much easier.

It’s also important to note that time is of the essence here. The longer you leave cauliflower ear, the harder it is going to be to treat. Make sure you treat it when the fluid is fresh, because once it hardens, you’ve got it for life.

The only way to remove hardened cauliflower ear is to get a very expensive surgery, where they cut your ear open, scrape out the hardened fluid and sew it back up again. Even then, the success of this surgery is mixed.

Once your ear fills with fluid, you have around 4-6 days before it hardens, so don’t mess around. Treat immediately.

Surgical drainage and ear bolster

This is easily the most effective treatment for cauliflower ear and is almost a “set-and-forget” type approach that will appeal to most people. However, it highly depends on the expertise available to you at the time.

How this works is a doctor will make a small incision in the swollen part of the ear, and drain the liquid out. Then, he will allow this incision to remain open to prevent the ear from filling up again.

He will apply an antiseptic over the year, most likely betadine, and then stitch a piece of gauze or cotton wall onto the area to soak up and blood/fluid, and prevent any further infection.

After that, it’s simply a waiting game. After about a week, your stitches should be ready to be removed, and your ear should be looking like an ear again.

The great thing about a bolster is once it’s done, you simply leave it and get on with your life. You can even continue to train if you have a solid pair of ear guards, although any hard training is definitely not recommended.

Self drainage and clamping

One very popular method of treating cauliflower ear is to drain the ear yourself at home.

While this is not generally recommended due to risk of infection (and also because it’s never a good idea to be sticking needles into your body!), most martial artists and rugby players find it rather amusing to perform this “surgery” on themselves or their training partners.

The things you will need to do this are

• A sterile needle attached to a syringe.
• Some antiseptic wipes or tea tree oil as a disinfectant.
• Something to compress the ear after drainage (explained below).

First, ensure the needle is sterile. If it’s not sealed in packaging marked sterile, do not use it. I can’t stress this enough. Your best bet is to purchase these directly from a pharmacy, rather than online.

Next, clean the ear. Use antiseptic wipes to clean the ear thoroughly. I few drops of tea tree oil is also a good option.

Once you’ve done that, it’s time to drain the ear. Find the center of the pocket of fluid. Slowly insert the needle until you reach the center. You can test if you’ve hit the fluid by slowly drawing on the syringe. If no fluid comes out, you need to go a little deeper. Remember to move slowly here, there is no rush.

Once you’ve hit the center of the swelling, you should be able to draw fluid into the syringe rather easily. Continue doing so until the ear is empty.

Withdraw the needle and dispose of it. Using an antiseptic wipe, press on the ear gently to push any excess fluid out. You will probably notice a few dribbles come out that the syringe was unable to reach.

Compress the ear!

This next step is extremely important. You must clamp the swollen portion of the ear down and compress it, otherwise it will simply fill up with fluid again. Think of it like putting a curled up piece of paper between two heavy books to straighten it out again. That’s essentially what you need to do with your ear to avoid it from swelling up again.

Many people learn this the hard way.

If you do not put pressure on the ear, when you wake up the next morning you will just have a new bout of swelling, probably worse than before.

There are many methods to compressing the ear:

Rare earth magnets

Rare earth magnets are strong, disc shaped magnets that are ideal for compressing the ear. Simply put one on each side of the affected part of the ear, and they should help keep your ear flat until the swelling goes down and the ear heals.

You can even put them in the fridge first to further combat the swelling.

Rare earth magnets can be found at a hardware store, or you can buy them here on Amazon.

Use a clothes peg and two coins

This is a DIY strategy that is ugly but it still works.

Simply get two dime pieces and hold them on either side of your ear with a strong clothing peg.

Be sure to sterilize all items first, both by boiling them in water and then giving them a good wipe with antiseptic. Coins are some of the most filthy things in our society, handled by millions of dirty fingers and covered in bacteria, so be thorough!

Prevention is better than cure

Of course, the best treatment for cauliflower ear is to never get it in the first place.

The absolute best thing you can do for the health of your ears is to purchase a quality pair of ear guards. If you’re worried your training partners will make fun of you, harden up. You’ll have plenty of time to make fun of their screwed up ears when they’re eighty years old.

I personally use the Cliff Keen Tornado and it’s excellent for jiu jitsu. However, there are many different ear guards to suit your style. It doesn’t really matter which one you wear, as long as you wear something! Once cauliflower ear experience will be enough to teach you that.

Best of luck and keep those ears safe!

Photo credit: MartialArtsNomad.com

References:
https://www.youtube.com/watch?v=mwjzOml7AcA
https://www.webmd.com/skin-problems-and-treatments/cauliflower-ear-symptoms-causes-treatments#1
https://www.healthline.com/health/cauliflower-ear
https://en.wikipedia.org/wiki/Cauliflower_ear