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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can assess a suspected perforated eardrum by video and treat pain and infection; confirming the hole, hearing tests and repair are in person.
- What it is: a hole or tear in the eardrum, the thin layer of tissue between the ear canal and the middle ear.
- Healing: most heal by themselves within a few weeks, usually within 2 months, and hearing returns to normal once the eardrum has healed.
- Keep it dry: no swimming, and no water, cotton buds or ear drops in the ear unless a doctor recommends them, until it has healed.
- Emergency: call 112 for bleeding or clear fluid from the ear after a head injury, or ear symptoms with facial drooping, confusion or a stiff neck.
Do not book a video appointment if the ear started bleeding or leaking clear fluid after a head injury, or if ear symptoms come with facial drooping, weakness, confusion, a stiff neck or severe spinning dizziness: call 112 or go to an emergency department. Sudden hearing loss, or an object stuck in the ear, needs to be seen in person: get medical advice the same day.
Can an online doctor treat a perforated eardrum?
Partly. A perforated eardrum is suspected from the story: sudden pain that may ease quickly, fluid or blood from the ear, and muffled hearing after an ear infection, a blow, a loud bang or a flight. Most heal by themselves within 2 months. A doctor can assess this by video, ease the pain, decide whether you need antibiotics, and plan how to keep the ear dry. Only an examination with an otoscope can confirm the hole, so the doctor tells you when the ear needs to be seen, and hearing tests and repair surgery are in person.
How an online consultation helps with a perforated eardrum
- Perforation, or something else?: An ear infection, swimmer’s ear or ear barotrauma can feel similar, and the story tells them apart.
- Infection treated or prevented: Antibiotics when they are needed, and only drops that are suitable for an ear with a hole in the eardrum.
- A keep-dry plan: How to shower and wash your hair, when you can swim, and what to do about flying.
- Follow-up that checks it healed: When the ear needs examining, and when a hole that has not closed needs a specialist.
What the doctor checks in an online perforated eardrum consultation
The doctor asks about the warning signs first, then about how it happened. The doctor asks about:
- Warning signs: a head injury, facial weakness, severe dizziness, confusion, a stiff neck, a high temperature or severe pain.
- How it happened: an ear infection, a slap or a blow, a loud bang or explosion, a flight or a dive, or a cotton bud or hairpin.
- Your ear now: pain, fluid, pus or blood from the ear, muffled hearing, ringing, and dizziness.
- Your ear history: earlier perforations, grommets, ear surgery, and repeated ear infections.
- Your health: diabetes, a weakened immune system, pregnancy, allergies to antibiotics, and your medicines.
Before the call, note when it started, what happened just before, and whether any fluid has come out and what colour it was.
What is a perforated eardrum, and what causes it?
The eardrum is a thin layer of tissue that separates the ear canal from the middle ear. A perforated, burst or ruptured eardrum is a hole or tear in it. The symptoms usually start suddenly, after one of these:
Swipe sideways to compare →
| Cause | How it happens | Good to know |
|---|---|---|
| Middle ear infection | Pus or fluid builds up behind the eardrum until the pressure breaks it | A common cause; the pain often eases when it bursts |
| Pressure changes (barotrauma) | The pressure in the middle ear cannot keep up with the pressure outside | Most often air travel; also diving, driving in the mountains, or an airbag |
| A blow to the ear | A slap, a fall or an explosion | A powerful slap can be enough |
| Very loud noise | A blast, such as an explosion or a gunshot, close to the ear | A rare cause |
| Objects in the ear | Cotton buds, hairpins or other objects pushed too far | Never clean inside the ear canal |
| Severe head injury | A skull fracture can damage the eardrum and the middle and inner ear | An emergency: call 112 |
What does a perforated eardrum feel like?
The symptoms usually affect one ear and start suddenly. They include:
- hearing loss in the affected ear, which may be partial
- earache or ear pain, which may fade quickly
- clear fluid, pus or blood leaking from the ear
- ringing or buzzing in the ear (tinnitus)
- itching in the ear
- dizziness or a spinning feeling, sometimes with feeling or being sick
- a high temperature, if there is an infection
Is a ruptured eardrum painful?
Often, but the pain may fade quickly. A blow or a sudden pressure change can hurt at the moment it happens. When an ear infection bursts the eardrum, the pain often eases suddenly as the pressure is released, and fluid or pus comes out.
Does a perforated eardrum feel like a blocked ear?
It can: muffled hearing in one ear is one of the most common symptoms. Other causes of a blocked ear, such as earwax or a blocked Eustachian tube, are covered on the blocked ear page.
How can you tell if you have perforated your eardrum?
The story is the main clue: sudden pain, fluid or blood, or muffled hearing after an ear infection, a blow, a bang or a flight. Only an examination can confirm it. A doctor looks into the ear with an otoscope, sometimes with a microscope, and the hole shows as an opening in the eardrum. Pus can block the view, so the ear may need cleaning first, and a hearing test measures how much hearing is affected.
How long does a perforated eardrum take to heal?
Most perforated eardrums heal by themselves within a few weeks, and usually within 2 months. Hearing usually returns to normal once the eardrum has healed completely.
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| When | What usually happens | What to do |
|---|---|---|
| The first days | Pain eases; there may be some fluid or blood | Painkillers, a warm compress, keep the ear dry |
| The first few weeks | The hole closes and hearing improves | See a doctor if symptoms have not started to improve after a few weeks |
| Within 2 months | Most eardrums have healed | Keep the ear dry until it has |
| After 2 months | A hole that has not closed | An ear examination and a hearing test; surgery may be offered |
| After 3 to 6 months | Complications are more likely if it has not healed | A specialist opinion |
How long will a perforated eardrum leak?
Fluid from an infection usually settles as the infection clears and the eardrum heals. Discharge that does not go away after antibiotics, or keeps coming back, needs the ear examined, because a hole that does not close can lead to repeated infections.
Which side should I sleep on?
There is no recommended side. Sleep however is comfortable, keep the ear dry, and do not plug the ear canal with anything. If fluid is leaking, a clean pad or towel on the pillow keeps things clean, and you can wipe the outer ear gently.
Is a perforated eardrum serious?
Usually not. Most heal without treatment, and complications are uncommon. They are more likely when the eardrum has not healed after 3 to 6 months:
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| Complication | What it means |
|---|---|
| Hearing loss | Usually temporary until the eardrum heals; the size and place of the hole affect how much hearing is lost |
| Repeated or long-term ear infections | A hole that does not close can let infections back in, with ongoing discharge and hearing loss |
| Cholesteatoma | A rare growth of skin cells in the middle ear that can damage the small bones of hearing |
| Mastoiditis | A rare infection that spreads to the bone behind the ear |
| Long-term dizziness | Rare |
The cholesteatoma and mastoiditis pages explain the warning signs of both.
Which perforated eardrum treatment might the doctor recommend?
Treatment depends on the cause, whether there is an infection, and how the healing is going. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Sudden relief of earache, then fluid, during an ear infection | Painkillers, keep the ear dry, antibiotics if needed | Yes | If symptoms have not started to improve after a few weeks |
| Muffled hearing after a flight, a dive or a slap, little pain | Keep the ear dry, painkillers, and an examination to confirm | Partly | For an examination and a hearing test |
| Discharge that does not settle after antibiotics | An ear examination | Partly | For otoscopy, cleaning of the ear canal and specialist review |
| A hole that has not healed after 2 months | Hearing test and ENT referral | Partly | For repair surgery |
| Severe pain, severe dizziness, loud ringing or a high temperature | Urgent assessment | Only to assess | Urgently: get medical advice the same day |
| Bleeding or clear fluid after a head injury | Emergency care | No | Call 112 now |
Think your eardrum may have burst? A doctor can tell you in one consultation what to do now.
See available times →Treatment options for a perforated eardrum
What you can do yourself
- Take paracetamol or ibuprofen for the pain, and hold a warm compress against the ear.
- Keep the ear dry: when you shower or wash your hair, put a large piece of cotton wool coated in petroleum jelly in the outer ear.
- Do not swim, or put your head under water, until the eardrum has healed.
- Do not put anything in the ear, such as cotton buds or ear drops, unless a doctor recommends them.
- Do not blow your nose too hard, which can damage the healing eardrum.
- Wipe away any fluid from the outer ear gently.
Prescription treatment
A prescription is never issued without a consultation. If there is an ear infection, or a risk of one while the eardrum heals, the doctor may prescribe antibiotics, as tablets or as ear drops that are suitable for an ear with a hole in the eardrum. Most perforations need no other medicine. If the doctor prescribes, use the prescription at a pharmacy near you.
Repair surgery
If the eardrum does not heal by itself, or the hole is large, it can be repaired, in a clinic or under anaesthetic. A myringoplasty closes a smaller hole with a gel or paper patch and usually takes 10 to 30 minutes; a tympanoplasty patches the eardrum with your own tissue and usually takes 30 minutes to 2 hours.
What does not help
Cotton buds, which can make a hole bigger. Ear drops that a doctor has not recommended, as some are not suitable when the eardrum has a hole. Swimming before it has healed. Blowing your nose hard.
Special situations
Flying
It is safe to fly with a perforated eardrum. After surgery to repair one, do not fly until you are told it is safe. To protect your ears on future flights, avoid flying with a cold or a blocked nose, and swallow, yawn or equalise on the way down; the ear barotrauma page has the details.
Swimming and diving
Do not swim or dive until a doctor has confirmed that the eardrum has healed. Water getting into the middle ear through the hole can cause an infection.
Work and noise
You can usually keep working if you feel well and can keep the ear dry. If your work is noisy, wear earplugs or earmuffs: very loud noise can damage the eardrum and your hearing.
Diabetes or a weakened immune system
Ear infection symptoms with diabetes or a weakened immune system need prompt assessment, so the doctor has a lower threshold for antibiotics and for an examination in person.
Perforated eardrum while travelling in Europe
Pack cotton wool and petroleum jelly to keep the ear dry in the shower, skip the pool and the sea until it has healed, and keep any discharge letter or examination report.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When a perforated eardrum is treated online, and when you need in-person care
Treated online: a suspected perforation after an ear infection, a flight or a minor injury, pain relief, antibiotics when they are needed, keep-dry care, and advice on flying, swimming and work.
In-person care: confirming the hole with an otoscope, hearing tests, discharge that does not settle, a hole that has not healed after 2 months, repair surgery, objects in the ear, and any head injury.
When to get in-person care
Call 112 or go to an emergency department now for:
- bleeding or clear fluid from the ear after a head injury
- ear symptoms with facial drooping or weakness, or slurred speech
- ear pain with a stiff neck, a high temperature and confusion
- severe spinning dizziness with vomiting, or being unable to stand
Get medical advice the same day for:
- sudden hearing loss in one or both ears, or hearing loss with earache or discharge
- severe ear pain, loud ringing, or severe dizziness
- a high temperature, or feeling generally unwell
- swelling, redness or tenderness behind the ear
- an object stuck in the ear
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your ear: say what happened just before it started, whether any fluid or blood came out, and how your hearing is now.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s a perforated eardrum? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Ear infection can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about a perforated eardrum
How can you tell if you have perforated your eardrum?
Typical signs of a perforated eardrum are sudden pain that may ease quickly, clear fluid, pus or blood from the ear, and muffled hearing, often after an ear infection, a blow, a loud bang or a flight. Only an examination with an otoscope can confirm it.
Is a ruptured eardrum painful?
Often, but the pain may fade quickly. A blow or a pressure change can hurt at the moment it happens, while an ear infection that bursts the eardrum often brings sudden relief as fluid comes out.
Can a perforated eardrum heal on its own?
Yes. Most perforated eardrums heal by themselves within a few weeks, usually within 2 months, and hearing returns to normal once it has healed. A hole that has not healed may need repair surgery.
How long does a perforated eardrum take to heal?
A perforated eardrum usually heals within 2 months. See a doctor if symptoms have not started to improve after a few weeks, and get the ear examined if it has not healed after 2 months.
How serious is a ruptured eardrum?
Usually not serious. Complications such as hearing loss that lasts, repeated ear infections or cholesteatoma are uncommon, and more likely if the eardrum has not healed after 3 to 6 months.
Does a perforated eardrum feel like a blocked ear?
It can. Muffled hearing in one ear is one of the most common symptoms of a perforated eardrum. Earwax and a blocked Eustachian tube are other common causes of a blocked ear.
Can I fly with a perforated eardrum?
Yes, it is safe to fly with a perforated eardrum. After surgery to repair one, do not fly until you are told it is safe.
Can I shower or swim with a perforated eardrum?
You can shower if you keep water out of the ear, for example with cotton wool coated in petroleum jelly in the outer ear. Do not swim until a doctor has confirmed that the eardrum has healed.
How do I look after a perforated eardrum at home?
Keep the ear dry while a perforated eardrum heals: no swimming, keep water out in the shower with a cotton wool ball coated in petroleum jelly, and do not put ear drops or cotton buds into the ear unless a doctor has prescribed them. Take paracetamol or ibuprofen for pain, hold a warm flannel against the ear, do not blow your nose hard, and avoid flying and diving until it has healed. See a doctor for a high temperature, worsening pain or discharge.
Which side should I sleep on with a ruptured eardrum?
There is no recommended side to sleep on with a perforated eardrum. Sleep however is comfortable, keep the ear dry, do not plug the ear canal, and put a clean pad on the pillow if fluid is leaking.
What causes a perforated eardrum?
Most often a middle ear infection, when pressure behind the eardrum bursts it. Pressure changes when flying or diving, a slap or a blow, very loud noise, objects such as cotton buds, and head injuries can also cause one.
How can I prevent a perforated eardrum?
Get middle ear infections treated when they are severe or not settling, because pressure from pus is a common cause of a perforated eardrum; never put cotton buds, hairgrips or other objects into the ear; and equalise on flights and dives by swallowing, yawning or gently breathing out against a pinched nose, avoiding flying with a heavy cold if you can. Wear ear protection around loud bangs, and avoid blows to the ear, including slaps, which can burst the eardrum by sudden pressure.
Do I need antibiotics for a perforated eardrum?
Only if there is an ear infection or a risk of one while it heals. The doctor may prescribe tablets, or ear drops that are suitable for an ear with a hole in the eardrum.
Is it a perforated eardrum or an ear infection?
An ear infection, swimmer’s ear and ear barotrauma can all feel like a perforated eardrum, and the story tells them apart: sudden pain, fluid or blood from the ear, or muffled hearing straight after an ear infection, a blow, a bang or a flight points to a perforated eardrum. Only an examination with an otoscope can confirm the hole, so the doctor tells you when the ear needs to be seen; earwax and other causes of a blocked ear are on the blocked ear page.
Can an online doctor treat a perforated eardrum?
Partly. A doctor can assess a suspected perforation by video, treat pain and infection, and plan keep-dry care. Confirming the hole, hearing tests and repair surgery are in person.
- Perforated eardrum, NHS, National Health Service (UK), reviewed 19 April 2023.
- Ruptured eardrum (perforated eardrum): symptoms and causes, Mayo Clinic (US), 2025.
- Ruptured eardrum, MedlinePlus, US National Library of Medicine, reviewed 29 April 2026.
- Ear infections, NHS, National Health Service (UK), reviewed 16 January 2025.
- Ear barotrauma, MedlinePlus, US National Library of Medicine, reviewed 29 April 2026.
- Cholesteatoma, NHS, National Health Service (UK), reviewed 20 February 2025.
- Hearing loss, NHS, National Health Service (UK), reviewed 30 May 2025.
- Earwax (cerumen impaction), ENT Health, American Academy of Otolaryngology–Head and Neck Surgery, reviewed August 2018.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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