Perforated eardrum: Symptoms, causes, and treatment options

A perforated eardrum—sometimes called a ruptured eardrum—can sound alarming, but it’s more common than many people realize. This thin, delicate membrane plays an important role in hearing and protecting the middle ear, so when it’s damaged, symptoms like pain or temporary hearing changes can occur. 

The good news is that many perforated eardrums heal on their own with the right care. Understanding the signs, causes, and treatment options can help you know when to seek medical attention and how to support proper healing. 

• What is a perforated eardrum?
• What are the symptoms of a perforated eardrum?
• What causes a perforated eardrum?
• How is a perforated eardrum treated?
• How long does a perforated eardrum take to heal?
• Protecting your ears while they heal

Note: Our Hearing Care Providers (HCPs) are here to support your hearing health and provide personalized guidance. However, if you're concerned about medical issues affecting your hearing, always consult your healthcare provider first. 

What is a perforated eardrum? 

The eardrum, also known as the tympanic membrane, is a thin, oval-shaped layer of tissue located deep inside the ear canal. Its job is twofold: it helps transmit sound vibrations to the middle ear and acts as a protective barrier against bacteria, water, and debris. 

A perforated eardrum occurs when this membrane develops a tear or hole. When that barrier is compromised, the ear becomes more vulnerable to infection and sound may not be transmitted as efficiently, leading to hearing changes. While the injury can be uncomfortable, many perforations are temporary and heal naturally over time. 

Because the eardrum is delicate, even small changes in pressure or direct irritation can cause damage. Prompt evaluation by a healthcare provider helps ensure proper healing and reduces the risk of complications. 

What are the symptoms of a perforated eardrum? 

Symptoms can vary widely depending on the size of the perforation and whether an infection is present. Some people notice symptoms immediately, while others may have very mild symptoms—or none at all. Common signs of a perforated eardrum include: 

• Ear pain or a feeling of pressure or fullness
• Sudden or noticeable hearing loss
• Ringing or buzzing in the ear (tinnitus)
• Itching or irritation inside the ear
• Fluid or discharge from the ear
• Fever if an infection is present

In many cases, symptoms begin to improve as the eardrum heals and any infection clears. If pain, discharge, or hearing changes worsen—or don’t improve—it’s important to follow up with your healthcare provider. 

What causes a perforated eardrum? 

The eardrum is extremely sensitive and can rupture when exposed to sudden stress or irritation. Even seemingly minor events can cause damage if the pressure change or force is strong enough. 

Common causes include ear infections, where fluid buildup creates pressure behind the eardrum until it tears. Physical injury—such as inserting objects into the ear or trauma to the side of the head—can also lead to perforation. Sudden loud noises, including explosions or very close exposure to blasts, may damage the membrane as well. 

Changes in pressure are another frequent cause. Activities like flying, scuba diving, or rapid altitude changes can create uneven pressure across the eardrum, especially if the ears aren’t able to equalize properly. Gentle ear care and avoiding unnecessary insertion of objects into the ear canal go a long way in reducing risk. 

How is a perforated eardrum treated? 

Any suspected tear or hole in the eardrum should be assessed by a healthcare professional. While many perforations heal without intervention, an exam helps determine the cause and whether treatment is needed. Treatment may include: 

• Diagnosis: A healthcare provider will examine the ear using an otoscope and may check hearing to assess the extent of damage.
• Monitoring: Small perforations often heal on their own within a few weeks and may only require observation.
• Medication: Antibiotics may be prescribed if an infection is present or to prevent infection while the eardrum heals.
• Pain management: Over-the-counter pain relievers or a warm compress can help ease discomfort.
• Specialist care: If the perforation doesn’t heal, a specialist may recommend patching the eardrum or, in some cases, surgery.

During healing, it’s important to keep the ear dry and avoid swimming, inserting objects into the ear, or attempting to clean it internally. 

How long does a perforated eardrum take to heal? 

Healing time varies from person to person, but most perforated eardrums mend within a few weeks. Smaller tears typically heal faster, while larger perforations or those complicated by infection may take longer. 

Temporary hearing loss is common during the healing process, but in most cases, hearing returns as the membrane repairs itself. Permanent hearing loss is uncommon, especially when medical advice is followed and complications are avoided. 

If symptoms persist beyond the expected healing period, or if hearing does not improve, further evaluation may be needed to determine whether additional treatment would help. 

Protecting your ears while they heal 

Caring for your ears during and after a perforation helps support recovery and reduce the risk of reinjury. Gentle habits—such as avoiding cotton swabs, keeping the ear dry, and addressing ear infections early—play an important role in long-term ear health. 

Key takeaways 

• A perforated eardrum is a tear or hole in the eardrum.
• Symptoms may include pain, hearing changes, or ringing in the ear.
• Many perforated eardrums heal naturally within a few weeks.
• Medical evaluation helps prevent infection and complications.
• Gentle ear care supports healing and long-term hearing health.

If you’re experiencing ear pain or suspect a perforated eardrum, talk to your primary healthcare provider. For everything else, book a free hearing test or find a clinic near you to get guidance and support for your hearing health.