Better Me

Do I Have a Ruptured Eardrum? Here’s How to Tell

We’ve all heard the old phrase: Never put anything smaller than your elbow in your ear. Yet it doesn’t stop many of us from grabbing a Q-tip or cotton swab — and even foreign objects like keys and pens — to clear out earwax. 

While it may feel good in the moment, you may do more harm than good. 

Our ears are pretty much self-cleaning organs. When you shove a cotton swab in there, you can’t actually remove the wax. In fact, you may just push the wax deeper in your ear canal and potentially scratch or burst your eardrum. 

Called a perforated or ruptured eardrum, a burst eardrum can result in a loss of hearing in the affected ear, a risk of infection and a great deal of pain. 

Read on to learn more about your eardrum, signs and symptoms you’ve ruptured it and how to properly treat a perforated eardrum.

What is a perforated or ruptured eardrum?

A ruptured eardrum is a tear or hole in the delicate tissue that makes up your eardrum known as the tympanic membrane. The tympanic membrane separates the ear canal from the middle ear (the space behind the eardrum) and plays an important role in sound transmission.

“When sound enters the ear canal as a wave of pressure, this pressure makes the eardrum vibrate,” said Christopher Adams, PA, an ear, nose and throat specialist at Banner Health in Tucson, AZ. “This vibration is then sent along the three bones of hearing (the ossicles) to the hearing organ (cochlea) where it is turned into an electrical signal that is sent to the brain.”

The tympanic membrane is tough and flexible, but it’s not immune to damage. 

“A perforated eardrum disrupts normal sound amplification and sound transmission, which can lead to hearing loss,” Adams said. “If the hole in the eardrum is large enough, there is also a higher risk of getting an infection of the middle ear, especially if water gets into that area.”

How do I know if my eardrum has ruptured?

Sudden hearing loss, either full or partial, is a tell-tale sign, but there are a number of other symptoms of a perforated eardrum to watch out for:

What causes a ruptured eardrum?

Cotton swabs are a major culprit for tympanic membrane perforations, but there are many factors that can cause an eardrum to rupture as well. 

These include:

  • Middle ear infection: Also known as otitis media, a middle ear infection occurs when viruses or bacteria cause fluid build-up behind the eardrum, causing pressure. This may cause the eardrum to tear as a result. Middle ear infections are very common in children.
  • Sudden changes in air pressure: When the pressure outside the ear is different from the pressure inside your ear, this can cause a perforation. Air travel and scuba diving can impact your ears.
  • Head injuries or acoustic trauma: Any sort of blow to the head or very loud noises can cause a ruptured eardrum. Anything over 85 decibels for extended periods of time can cause permanent hearing loss. Things like loud music, fireworks or gunshots at close range can cause perforation.

What is the treatment for a perforated eardrum?

In most cases, a ruptured eardrum isn’t serious, but it’s important to see your health care provider or an ear, nose and throat specialist so they can assess and treat accordingly. If there is an infection that caused the perforation, they’ll most likely want to prescribe antibiotics to treat it first.

With a perforated eardrum, it’s very important to keep your ear dry until it heals. A wet ear will affect healing and may result in a serious infection. 

“We usually recommend placing a cotton ball covered in Vaseline in the ear when showering and avoiding putting your head under water,” Adams said. 

With proper care, a small, punctured eardrum may recover in a few weeks or few months. If it doesn’t heal, there are a few surgical techniques such as tympanoplasty or paper patch myringolplasty. These can help either patch the hole or rebuild a new eardrum depending on how big the perforation is.

Ways you can prevent a ruptured eardrum

There are several things you can do to avoid having a perforated eardrum. 

  • Numero uno? Avoid sticking cotton swabs in the ear canal.
  • Treat middle ear infections quickly to avoid potential damage to the eardrums. Signs of a middle ear infection include reduced hearing, nasal congestion, earaches and fevers. In young children, they may rub or pull at their ears as well.
  • Guard against loud noises. Wear protective earmuffs or earplugs if you’ll be around loud noises nearby.
  • Avoid flying if you have a cold or an allergy that causes ear congestion. If you have to fly, make sure you keep your ears clear during take-off and landing. You can yawn, chew gum or pinch your nose and gently blow (known as the Valsalva maneuver). 


A ruptured or perforated eardrum can be painful but most often isn’t serious. 

However, it can put you at risk of infection and possible long term hearing loss if not treated properly. Most often perforated eardrums can heal on their own — usually within three months — but may require antibiotics or surgery.

Visit your health care provider or an ear, nose and throat specialist if you’re experiencing persistent ear pain, drainage, loss of hearing, vertigo or ringing in the ears. They can guide you on how to take care of your eardrums.

To find a Banner Health ENT specialist near you, visit 

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