Perforated eardrum

Although the terms are often used interchangeably, there is a subtle difference between a perforated eardrum and a ruptured eardrum. A perforated eardrum refers to any small hole or tear in the tympanic membrane, which may occur gradually due to infection or minor trauma. A ruptured eardrum, on the other hand, usually describes a sudden, complete tear of the eardrum caused by acute trauma, loud noise, or severe pressure changes.

A perforated eardrum can present with various symptoms, and while pain is common, it can vary depending on the cause and size of the perforation. Typical signs include:

• Ear pain or discomfort – often sudden and sharp; some people may feel only mild irritation. Pain may subside quickly once the eardrum tears.
• Loss of hearing – sounds may seem muffled or quieter in the affected ear.
• Drainage from the ear – a perforated eardrum may cause discharge, such as fluid or pus, and sometimes bleeding from the middle ear.
• Tinnitus – ringing, buzzing, or humming sounds in the ear.
• Vertigo or dizziness – occasional imbalance or spinning sensations.
• Fullness or pressure in the ear – a clogged or blocked feeling.

Most people wonder: “Does a perforated eardrum hurt?” The answer is yes, there is usually pain at the time of injury or infection, but it often decreases once the eardrum has torn, even though other symptoms like hearing loss may persist.

• Middle ear infections (otitis media) – infection can build pressure behind the eardrum, causing it to rupture.
• Barotrauma – sudden changes in air or water pressure, such as during flying, scuba diving, or rapid altitude changes, can tear the eardrum.
• Loud noises or acoustic trauma – explosions, concerts, or other very loud sounds can cause a rupture.
• Physical injury or trauma – inserting objects like cotton swabs, hairpins, or accidental hits to the ear.
• Head trauma or skull fractures – severe injuries can damage the eardrum directly or indirectly.
• Sudden changes from sneezing or blowing the nose – rare but possible if pressure in the ear increases rapidly.

Many people wonder if a perforated eardrum can heal on its own. Small perforations often do, especially when caused by minor infections or mild trauma, and may close naturally within a few weeks while the ear is kept clean and protected. However, larger or persistent perforations may not heal without intervention. In these cases, a perforated eardrum can be repaired using medical procedures such as eardrum patching or surgical repair (tympanoplasty) to restore the membrane and improve hearing.

Whether you need to take time off work with a perforated eardrum depends on the severity of your symptoms and the nature of your job. Mild cases with minimal pain and no active infection may allow you to continue working, especially if your work does not involve heavy lifting, sudden pressure changes, or exposure to water. However, if you experience significant pain, dizziness, drainage, or hearing difficulties, taking time off can help you rest and prevent complications. Jobs that involve air travel, swimming, or high-risk environments may require temporary leave until the eardrum heals.

Although many perforated eardrums heal naturally, complications can occur if left untreated or exposed to repeated infections:

• Chronic ear infections – recurring infections can damage the middle ear.
• Persistent drainage – fluid, pus, or blood may continue leaking from the ear.
• Hearing loss – temporary or, in severe cases, permanent hearing impairment.
• Middle ear damage or mastoiditis – rare but serious infection spreading to surrounding structures.
• Balance problems or dizziness – due to disruption of the inner ear.
• Weakened eardrum – repeated perforations may increase the risk of future tears, sometimes requiring surgical repair.