What is cauliflower ear?

If you’ve ever attended a wrestling match, you may have noticed something different about some of the athletes’ ears. Cauliflower ear, also known as perichondrial hematoma or wrestler’s ear, is a deformity of the ear caused by trauma.

Cauliflower ear occurs when blood pools in your pinna after it’s been hit or struck. The pinna is your outer ear. This pooling of blood, known as a hematoma, needs to be treated right away.

While there’s no treatment for cauliflower ear, it can be prevented even after the trauma has occurred. So it’s crucial to know the warning signs and take action right away.

If you’ve experienced an ear injury or hit to the side of your head, check your outer ear in a mirror for swelling or bruising. You may also notice a change to the shape of your ear. As blood begins to pool around the injured area, fresh blood supply to your ear cartilage is cut off.

Left untreated, cauliflower ear can lead to:

  • ringing in your ear
  • hearing loss
  • headache
  • blurred vision

A study in the Asian Journal of Sports Medicine found that wrestlers with cauliflower ear were significantly more likely to experience hearing loss than wrestlers without the condition. Cauliflower ear may also be associated with increased risk for ear infections. Catching the beginning signs of cauliflower ear will protect you from other complications down the road, as well as help prevent deformity of your ear.

What does cauliflower ear look like?

Cauliflower ear is the result of a direct trauma to your ear. Your outer ear is made up of cartilage, not bone. If your ear is injured, the blood vessels that supple blood to the ear cartilage can tear, causing blood to pool up between the cartilage and the perichondrium. The perichondrium is the connective tissue that surrounds the cartilage, and is important for transportation of blood and nutrients to the cartilage.

Once that fresh blood supply is cut off, your ear cartilage can’t get the fresh nutrients that it needs. This leads to infection and death of the tissue. Once that happens, new fibrous tissue can form around the area, creating a cauliflower texture on your ear.

Anyone who is at risk for trauma to their head and ears is at risk for cauliflower ear. According to board-certified plastic surgeon Manish H. Shah, MD, FACS, “Risk factors include blunt trauma especially when playing certain sports such as boxing, MMA, water polo, and wrestling, as well as the use of blood thinners.”

Initial treatment

Ice the injury as quickly as possible. You can do this by applying ice for 15-minute intervals. That will help reduce the swelling and may prevent cauliflower ear. You should also seek medical treatment right away.

Drainage and compression

Your doctor may be able to treat the condition by draining the excess blood from your ear. They do this by making an incision at the site of the injury so that the blood can drain out of the injury.

After draining your ear, your doctor will prescribe antibiotics to help prevent infection. Your doctor will also place a compression dressing on your ear to ensure that it heals in the correct shape.

You’ll need to avoid activities that may cause additional trauma to your ear until your ear is completely healed. Ask your doctor when you can resume normal activities. It’s important to follow their advice to improve your outcome.

Cauliflower ear can reoccur, so it’s important to monitor your ear for swelling even after it’s been drained.

If the swelling isn’t treated quickly enough, or if initial treatment is unsuccessful, “the cartilage will then become thickened and scarred and start to look like the cauliflower vegetable, hence the term ‘cauliflower ear,’” says Dr. Nguyen Pham, pediatric otolaryngologist at Children’s Hospital of Orange County.


Cauliflower ear is permanent, but in some cases, you may be able to reverse the appearance using corrective surgery, known as otoplasty.

During the surgery, your doctor makes a cut behind your ear to expose the cartilage. Your doctor then either removes some of the cartilage or uses stitches to reshape your ear. You may need general anesthetic for the surgery, but in some cases, a local anesthetic can be used.

You should be able to resume physical activities within six weeks, though your doctor may recommend waiting longer.

The best prevention for cauliflower ear is to prevent the trauma in the first place. If you participate in high-risk sports, such as wrestling, wear a helmet to protect yourself.

Protection is especially important for children. Look for protective head gear that includes ear guards, and make sure your child always wears this protective gear when participating in contact sports.

Make sure your child and their coach understand the early signs of cauliflower ear and the importance of seeking immediate medical attention.

You should also talk to your doctor about the use of blood thinners while participating in contact sports. Blood thinners can increase your risk for cauliflower ear, so avoiding the use of them before participating in a contact sport may help prevent this condition.

Never stop taking medications your doctor has prescribed without first speaking to them.

Early treatment can help prevent cauliflower ear. It’s also important to protect your ears during contact sports. Once cauliflower ear develops, it’s not reversible.