Water Precautions After Ruptured Eardrum
You should keep water out of your ear during hair washing until the perforation heals, which typically takes 4-6 weeks for most traumatic perforations, though some may heal faster or require longer. 1, 2
Immediate Water Protection Strategy
During the entire healing period, you must protect your ear from water exposure during bathing and hair washing. The most effective method is to:
- Place a piece of cotton saturated with petroleum jelly (Vaseline) over the ear canal opening before any water exposure 3
- Alternatively, use a properly fitted earplug designed for water protection
- This protection is mandatory until your doctor confirms the perforation has completely healed 1
Expected Healing Timeline
The healing timeline varies based on the type of perforation:
- Most small traumatic perforations heal spontaneously within 4-6 weeks 1, 2
- 89% of traumatic perforations close spontaneously with an average healing time of 27.4 days 4
- All pediatric traumatic perforations in one study healed spontaneously 2
- Perforations with bloody or watery discharge ("wet perforations") actually heal faster than dry perforations, with 82% of the area healing within the first week 5, 4
Why Water Avoidance Is Critical
Irrigation should never be performed when the tympanic membrane is perforated or suspected to be perforated 3. The specific risks include:
- Water entering the middle ear can cause caloric effects resulting in severe vertigo 3
- Risk of introducing infection into the middle ear space 1
- Potential for ototoxicity if contaminated water or certain substances enter the middle ear 3
- Increased risk of developing chronic ear problems or cholesteatoma 6
When to Resume Normal Hair Washing
You can resume normal hair washing without special precautions only after:
- Your doctor confirms with otoscopic examination that the perforation has completely closed 1
- This typically requires a follow-up visit 4-6 weeks after injury 2
- Do not rely on symptom resolution alone—you need visual confirmation that the eardrum is intact 1
Warning Signs Requiring Immediate Medical Attention
Contact your doctor immediately if you develop:
- Ear drainage (clear, bloody, or purulent) 1, 6
- Worsening pain 1
- Vertigo, nausea, or vomiting (suggests possible inner ear involvement) 1, 6
- Sudden hearing loss or significant hearing deterioration 1, 6
- Facial weakness (rare but serious complication) 6, 4
Common Pitfalls to Avoid
- Never assume the perforation has healed just because symptoms improve—you need otoscopic confirmation 1
- Avoid pneumatic otoscopy or any ear irrigation during the healing period 1
- Do not insert anything into the ear canal, including cotton swabs, as this can introduce infection or cause further trauma 7, 8
- Perforations lasting longer than 6 months warrant surgical referral, as spontaneous healing becomes unlikely 6
Special Considerations
If you have diabetes or are immunocompromised, you require extra caution with water exposure, as you have increased risk of developing malignant (necrotizing) otitis externa if water enters the ear canal 3, 8.