Ear pain with water coming out: what to know

Clear fluid after swimming may be trapped water irritating the ear canal, but pain and continuing drainage can suggest inflammation or infection. Thick, cloudy or bad-smelling fluid is more concerning for infection. Fluid after a cold may occur when pressure affects the middle ear, and a sudden watery or blood-stained discharge can occur if the eardrum has been injured or perforated. Earwax buildup can also block drainage and hearing, although it usually does not cause ongoing watery discharge. Colour and appearance alone cannot establish the cause.

Gently wipe fluid from the outer ear and keep the canal dry. Do not swim, use cotton buds, flush the ear, or insert drops unless a clinician has checked the ear. Do not try to seal the opening with tissue or objects. A pharmacist can advise on suitable pain relief, while a clinician can inspect the canal and eardrum and determine whether treatment is needed. Bring details of recent swimming, injury, cleaning or a cold.

Arrange prompt medical assessment for any painful ear that is draining, especially when there is reduced hearing, fever, dizziness, swelling, or worsening pain. Seek urgent help after a head injury, with blood from the ear, severe dizziness, facial weakness, or marked illness. Do not delay because fluid has stopped if pain or hearing change remains.

Is the fluid coming from the ear canal or behind the eardrum? Is there a perforation, and should the ear stay dry? Would I need antibiotic treatment, or is another approach safer?