Smelly Ear – Causes of Foul Ear Odor, Bad Ear Smell

An offensive smelling odor from the ear is often assumed to be a sign of infection but there are a few other non-infectious causes that also need to be considered. The odor may be associated with an ear discharge, ear wax or occur on its own for no clearly identifiable reason. Due to the rather small entrance to the ear canal (concha cavity), an odor emanating from the ear without any discharge is not easily detectable unless there is close contact.

Normal  Ear Wax

The lining of the outer ear has sebaceous and ceruminous glands that secrete sebum and cerumen respectively. It often mixes with squamous debris that sloughs off from the lining and outer surface of the ear drum to form a more solid consistency that is known as earwax. Cerumen has a host of functions including :

  • trapping dust and dirt that may enter the ear canal
  • expelling sloughed off cells, debris, dust and dirt from the canal
  • lubricating the sensitive canal lining which is exposed to the environment
  • inhibiting the growth of bacteria and fungi that enter the ear canal
  • repelling insects and other small organisms that may enter the ear

Earwax is often bitter tasting due to its chemical composition and this is also helpful to repel small insects from entering the ear canal. It also has a mildly foul odor as a result of its composition, as well as the dead cells, bacteria and fungi that it traps on a daily basis. However, the odor is not so prominent as to be offensive and ‘smelly’.

Causes of a Smelly Ear Odor

Hygiene

Excessive cleaning of the outer ear is more likely to result in offensive odors than the untouched ear canal. This is in stark contrast to other parts of the body where a foul odor is a sign of poor hygiene. By interfering with the microenvironment of the outer ear through cleaning with cotton wool cue tips, matchsticks or hair pins, the normal cleaning mechanism is disturbed. The chance of injury and infection is greatly increased (otitis externa / swimmer’s ear). Usually the discharge is odorless and clear but can progress as described below under infections.

In addition, ear wax may become impacted and in rare cases may perforate the eardrum and contribute to cholesteatoma formation.

Other factors that may also affect the ear canal and disrupt the cerumen is water in the ears (bathing, swimming pool), detergents, shampoos and allergic reactions usually due to these substances entering the outer ear.

Smelly Ear Infections

An infection of the outer and middle ear (otitis externa and media) is the most common cause of a smelly ear discharge (otorrhea). A purulent discharge may appear white to pale yellow initially. Initially the discharge may be odorless but can progress into a foul smelling odor. With more chronic infections (like chronic otitis media)  or discharge that is not easily expelled, the color may change to yellow to green. The reason for this is explained under Green Mucus. Necrotizing otitis externa is a more likely cause of a smelly ear discharge.

Most of these infections are due to bacteria although fungal infections (otomycosis) may also be responsible. Discharge in a fungal infection is usually not as pronounced and may sometimes present just with a clear thin discharge (serous). Otomycosis usually affects the outer ear.  Immunocompromised patients are more likely to experience chronic (persistent or recurrent) fungal infections of the middle ear (consider mucormycosis).

Cholesteatoma

A cholesteatoma is a keratin mass in the middle ear. It may be congenital (present from birth) or acquired and predispose the middle ear to chronic infections. In addition, it may cause erosion of the surrounding tissue and even the skull. In a cholesteatoma, the tympanic membrane (eardrum) may be intact. While there is no perforation, ear discharge is still able to exit into the outer ear through a retraction of the eardum.

A cholesteatoma causes a chronic but scanty offensive smelling ear discharge. In the early stages, the condition is often painless and apart from the discharge, only an impairment of the hearing may be noticed. A cholesteatoma is a serious condition that needs immediate medical attention by an ENT specialist (otolaryngologist).

Tumors

Cancer of the ear can affect the outer, middle or inner ear, although temporal bone cancer may responsible in outer ear lesions. In the outer and middle ear, the cancer may cause ulceration and erode surrounding tissue. A foul smelling blood stained discharge and pain is often noted although at times this may not be present. It nevertheless has to be considered as a possible cause especially if there is any degradation of the sense of hearing.

Other Symptoms

A smelly ear is a symptom that may be accompanied by other symptoms such as :

  • Ear pain
  • Partial or complete hearing loss
  • Dizziness
  • Ear discharge
  • Ringing in the ears

However, no other symptom may be presented beyond the foul odor emanating from the ear.

Treatment

The treatment depends on the underlying cause. Recurrent infections needs to be treated appropriately, and in most cases this is bacterial and requires the use of antibiotics. Cotton wool impregnated with corticosteroids may be packed into the ear to reduce swelling of the ear canal. This is a temporary measure. A cholesteatoma and tumors requires surgical removal by an otorhinolaryngologist (ENT surgeon). Cleaning of the ear canal must be avoided altogether to allow the area to heal and for the normal microenvironment within the ear to restore.

Related Articles

  1. Ear Problems

References

  1. Cholesteatoma. Emedicine

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  • Haneef Sabree

    I have partial hearing loss, ringing in the ear….when I’m anxious I get dizzy spells and migraines and once a week a thick gooey, stinky wax that smells like butter milk and cookie dough comes out… This happened one time in 2014, back then it lasted 2 weeks but then my hearing returned.
    In early march of this year, 2015, it lasted a week……I pulled the stink gunk out, and my hearing came back fully…..then a week later, the partial hearing loss, ringing and migraines came back ( those symptoms heightened mostly when I was under highly stressful situations) the migraines and dizziness happens usually when I am stressed, but it has been a total of 3 straight weeks where the ringing has been constant and partial hearing loss!

    Today Apri 10th 2015, my left ear itched and I felt to see why and I pulled out some of the funky buttery dough smelling goo out….however the hearing is NOT better and I can still tell there is a TON of wax stink still in my left ear?

    I also have an infected tooth on my left back bottom molar and I am getting it pulled this Thursday because I believe this is what is causing the hearing loss via the infection spreading to there from the tooth…..I hope this the cause?

    If not I think it may well be a tumor 🙁
    If so, I hope I can afford to get it surgically removed( and don’t die from it) and then that will help my hearing comes back

  • Hi Haneef. It is possible that there is more than one condition at play here. It is really difficult to say with any certainty and hopefully you have seen an ENT specialist (otorhinolaryngologist). If not then you should see an ENT as soon as possible. Attempting to treat the condition(s) in a ‘hit and miss’ fashion is just delaying a proper diagnosis and treatment. You could end up delaying proper treatment to the point where your hearing does not recover. Speak to your family doctor as soon as possible about a referral to an ENT specialist.

  • BeeFrmNYC

    You need to see an Ear nose throat specialist or an hearing doctor fast as you don’t want to risk permanently lposing your hearing if they can save it And get to the root of the cause of what’s causing these symptoms.

  • Thank you BeeFromNYC. As you can see we have provided the user with the same advice 2 months ago.

  • Diky

    I had done a surgery at childhood for right ear discharge. Now
    I am 28 years old hearing also lost, now I have a bad smell form right ear every time after do
    clean also. What should I do ?

  • Hi Diky. If your hearing was fine after the surgery then your current hearing loss may not be related to your childhood. This could be an entirely new and different problem. You need to have this checked up by a doctor and preferably an ENT specialist. It could be an infection which is relatively common but it could also be due to less common ear disorders like a cholesteatoma. Speak to your doctor as soon as you can.