Stages of a Cauliflower Ear

Updated April 17, 2017

Cauliflower ear is a common term for a condition that is caused by auricular hematoma or perichondritis. This condition creates a serious deformity and sometimes shrivelling or loss of the outer ear and hearing loss. Cauliflower ear is not difficult to treat, especially when caused by auricular hematoma, and early diagnosis and treatment is essential for preventing permanent damage to the ear.


Cauliflower ear is caused by damage to the outer ear. Blunt trauma either causes a blood clot below the skin or shears the skin from its attachment to the ear cartilage, creating a hematoma beneath the skin. Cauliflower ear can be caused by infection, which is caused by injury or by piercing the ear cartilage. Although an injury to the ear is not necessarily a sign of developing cauliflower ear, it should be noted and the ear monitored for development of further symptoms.

Swelling and Hematoma

After the initial injury, the next stage of cauliflower ear is soreness, tenderness or pain of the outer ear. The injured area may also be red or bruised. Some swelling is also common at the initial stages of cauliflower ear. As the development of cauliflower ear progresses, a hematoma develops, which is a build-up of blood and fluid under the skin. This build-up may cause discomfort when touched.

Cartilage Death

Left untreated, the ear will continue to swell and the shape of the ear will become distorted. The cartilage of the outer ear requires a blood supply to survive. The hematoma beneath the skin disrupts the flow of blood to cartilage, depriving it of nutrients and making it vulnerable to infection. Eventually, the cartilage dies, and the ear shrivels without the structural support of the cartilage. This is one of the final stages of cauliflower ear, and the deformity may require surgery to repair, if it is repairable.

Scarring and Hearing Loss

The ear may eventually take on a pale appearance due to the disruption of the blood vessels, which supply the ear with blood and nutrients. The death of the cartilage causes scar tissues to form, which creates the distinctive shrivelled, cauliflower shape of cauliflower ear. The swelling associated with cauliflower ear can also reach the inner ear, which can cause disruption of balance and loss of hearing.

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