A perforated eardrum isn’t something you can ignore. It’s not just a minor earache that goes away on its own. That thin membrane separating your ear canal from the middle ear does more than just transmit sound-it protects your inner ear from germs, balances pressure, and keeps water out. When it tears, everything changes. Pain hits fast, hearing mutes, and suddenly, you’re stuck wondering: how long will this take to heal, and what happens if I don’t protect it?
How Long Does a Perforated Eardrum Take to Heal?
There’s no one-size-fits-all answer. Small holes? They often close up in three to six weeks. Larger tears? That can stretch to two or even three months. The key is size and cause. A tiny tear from a loud explosion or a pop during a flight heals faster than a big rupture from a long-standing ear infection or something stuck in the ear canal.
Here’s what to expect week by week:
- Days 1-3: Pain peaks, then starts to drop. You might hear popping or buzzing. If the pain doesn’t ease by day three, don’t wait-see a doctor.
- Week 2-3: The body starts building new tissue at the edges of the tear. Pain fades. Hearing begins to improve, but it’s still muffled.
- Week 4-6: New tissue strengthens. Most people notice better hearing and less pressure in the ear. This is when you need to be extra careful-your ear is still fragile.
- Week 6-8: If healing is on track, the eardrum is mostly closed. Pressure normalizes. Hearing should return close to normal.
But if you’re still dealing with drainage, muffled hearing, or dizziness after eight weeks, it’s not healing properly. That’s not normal. It means you might need more than just time.
What Slows Down Healing?
Healing isn’t automatic. It’s fragile. One wrong move and your recovery stalls-or worse, gets infected.
Water is the biggest enemy. Showering? Swimming? Even a splash in the sink can introduce bacteria into your middle ear. Moisture turns a simple tear into a chronic infection. Studies show that people who keep their ear dry heal 70% faster than those who don’t.
Other things that hurt healing:
- Blowing your nose too hard: That pressure shoots straight into your middle ear and can reopen the tear.
- Flying or scuba diving: Sudden pressure changes stress the healing membrane. Wait until your doctor says it’s safe.
- Cleaning your ear: Cotton swabs, Q-tips, or anything you stick in there? Don’t. You’re not helping-you’re pushing debris deeper or tearing the tissue again.
- Ignoring infection: If you have yellow or bloody discharge, fever, or worsening pain, you’ve got an infection. Antibiotics are needed-oral or drops. Left untreated, this can lead to mastoiditis, a serious bone infection behind the ear.
How to Protect Your Ear While It Heals
Protection isn’t optional. It’s the difference between healing on its own and needing surgery.
Here’s what actually works:
- Keep it dry: Use waterproof silicone earplugs when showering. If you don’t have those, pack a cotton ball soaked in petroleum jelly into the outer ear. Replace it after every shower.
- Don’t swim: Not even in a pool. Saltwater or chlorine doesn’t matter-water is water. Wait until your doctor confirms the eardrum is fully closed.
- Use prescribed ear drops only: Never use over-the-counter drops unless your doctor says so. Some can damage the inner ear if the eardrum is broken.
- Take pain relief wisely: Acetaminophen or ibuprofen helps with discomfort. Avoid aspirin if you’re bleeding-it can thin the blood and worsen drainage.
- Blow your nose gently: One nostril at a time. Don’t pinch both and force it.
- Avoid loud noises: Even music through headphones can create pressure. Keep volume low until healing is complete.
These steps aren’t suggestions-they’re medical protocols backed by Mount Sinai, Mayo Clinic, and Stanford Health Care. Skip them, and your chances of complications jump from 5% to over 20%.
When Do You Need Surgery?
Most perforations heal without surgery. But if it’s been more than three months and there’s still a hole, or if you’re losing hearing that doesn’t improve, it’s time to see an ENT specialist.
Two common procedures:
- Myringoplasty: For small holes. The doctor applies a patch-sometimes made of gel, paper, or even your own fat tissue-to help the eardrum grow back. Takes 10 to 30 minutes. Success rate? 85-90% with modern materials like hyaluronic acid or platelet-rich plasma.
- Tympanoplasty: For larger or chronic tears. The surgeon uses tissue from your own body (often from behind the ear) to rebuild the eardrum. Takes 30 to 120 minutes. Recovery is longer, but it fixes the problem for good.
Surgery isn’t the first step. It’s the backup plan. But if you’ve waited too long, skipped protection, or let infections go untreated, surgery becomes the only way to restore hearing and prevent long-term damage.
What Happens If It Doesn’t Heal?
Ignoring a perforated eardrum isn’t just about delayed hearing. The risks are real:
- Chronic ear infections: 5-10% of untreated cases develop ongoing drainage and odor. This can become a lifelong problem.
- Permanent hearing loss: 3-5% of people lose some hearing permanently, especially if the inner ear gets damaged by infection.
- Mastoiditis: Infection spreads to the skull bone behind the ear. Requires hospitalization and IV antibiotics.
- Vertigo and dizziness: If the inner ear is affected, you might get spinning sensations, nausea, or balance issues.
These aren’t rare outcomes. They’re preventable. The same studies that show healing timelines also show that following basic protection rules reduces the need for surgery by 70-80%.
When to Call Your Doctor
You don’t need to wait for disaster. Watch for these red flags:
- Pain that gets worse after day three
- Any discharge-clear, yellow, green, or bloody
- Hearing doesn’t improve after two weeks
- Dizziness, ringing in the ear, or facial weakness
- Fever or swelling behind the ear
If any of these happen, call your doctor. Don’t wait for it to get worse. Early treatment stops small problems from becoming big ones.
Bottom Line: Healing Takes Time, But Protection Takes Action
A perforated eardrum sounds scary, but most people heal completely if they follow the rules. The key isn’t magic-it’s consistency. Keep the ear dry. Don’t poke it. Don’t blow your nose like you’re clearing a clogged drain. Take pain relief as needed. And if it’s not getting better in six weeks, see a specialist.
Healing isn’t passive. It’s active. Every time you skip a shower cover or blow your nose too hard, you’re delaying recovery. But if you protect it right, your eardrum will repair itself. And in most cases, you’ll be back to normal hearing without surgery, without complications, and without lasting damage.
Can a perforated eardrum heal on its own?
Yes, most small perforations heal on their own within three to six weeks. Larger tears may take up to two or three months. The key is protecting the ear from water, pressure, and infection. If healing doesn’t start within two weeks or worsens, see a doctor.
Is it safe to fly with a perforated eardrum?
No. Flying creates rapid pressure changes that can reopen the tear or delay healing. Wait until your doctor confirms the eardrum is fully closed-usually after six to eight weeks. If you must fly, ask about pressure-equalizing earplugs, but don’t rely on them alone.
Can I use ear drops if I have a ruptured eardrum?
Only if prescribed by a doctor. Many over-the-counter ear drops contain ingredients that can damage the inner ear if the eardrum is broken. Antibiotic drops may be safe if the doctor confirms they’re appropriate. Never self-medicate.
How do I shower with a perforated eardrum?
Use waterproof silicone earplugs or pack a cotton ball coated in petroleum jelly into the outer ear canal. Replace it after every shower. Avoid letting water run directly into the ear. Bathe instead of showering if possible, and never submerge your head.
Will I lose my hearing permanently?
In most cases, hearing returns fully once the eardrum heals. Permanent hearing loss occurs in only 3-5% of cases, usually when infection spreads or the injury is severe. Following protection rules cuts this risk dramatically.
What happens if I ignore a perforated eardrum?
Ignoring it increases the risk of chronic infection, persistent drainage, vertigo, and even bone infection behind the ear (mastoiditis). It also raises the chance you’ll need surgery later. Most complications are preventable with simple, consistent care.
