What is cauliflower ear?

If you have walked into a BJJ gym or wrestling room, or have watched any UFC event ever, you undoubtedly noticed the deformed ears of some or all of the individuals involved.

This wrinkled and potentially bulbous appearance of the ears of many grapplers and fighters is known as cauliflower ear.

If you participate in BJJ or any art that involves potential traumatic contact to your ears, cauliflower ear is a reality of the game.

This article breaks down everything you need to know about cauliflower ear in BJJ.

By the time you finish reading, you will know what cauliflower ear is, how it happens, how to treat and avoid it, and whether it’s something you should worry about at all.

What is cauliflower ear?

Cauliflower ear is a condition that occurs when the external portion of your ear is hit or otherwise struck with physical force.

Common grappling examples include takedowns that involve using the side of your head for leverage, fighting out of chokes and headlocks and any technique in BJJ that involves contact to the ear.

If the damage is sufficient or repetitive, the layers of cartilage and connective tissue in your outer ear can separate and fill with blood and other fluid.

Initially, the ear will be tender, swollen, reddish-purple, and painful to the touch. If left on its own for hours to days, the cartilage in the surrounding area will die and fibrous tissue will form across the injured location. 

The tissue leads to a hardened mass in the damaged area that typically becomes pain-free and returns to its original color but retains the bulbous mass permanently.

This results in the final distinct appearance of cauliflower ear.

The location and degree of the initial trauma, as well as any treatment or lack thereof afterward, will determine the ultimate look of fully hardened cauliflower.

Cauliflower ear treatments

If you do get the beginnings of cauliflower ear, you will probably feel it pain-wise and when you touch your ear you’ll notice the puffy swelling.

To minimize the aesthetic effects of cauliflower ear, you must get it drained as soon as possible. 

Often, this is done with a syringe that pierces the skin and sucks out the blood and fluid. We recommend seeking a qualified medical provider for this service.

After drainage, you need to compress the area so that everything sticks together, and more fluid does not build back up. Doctors will often stitch the ear skin to the cartilage or use a compression clip to keep everything in place for a week or two until healing is complete.

You must also prevent further damage and disturbance to the area, or the ear will fill back up with blood and potentially be worse.

You must drain the fluid before the tissue dies and begins to harden. This process begins a few hours after the initial trauma and takes a few days to weeks before being fully hardened. 

Once the cauliflower ear is completely hardened, surgery is the only treatment option if you want a normal-looking ear.

While you will probably be advised to avoid training for a bit after a cauliflower ear treatment, if you do go back to the mats, you should wear headgear at least until your ear is healed and keep it clean to avoid infection.

Note that having good medical professionals drain your ear is the best method to stop serious deformity and prevent infection.

While many athletes will have a teammate drain their ears for them, this is far more likely to result in recurring cauliflower ear and poses a risk of infection.

How can I avoid cauliflower ear?

Other than avoiding BJJ, wrestling, or any contact altogether, the only effective preventative measure is wearing headgear when you train and especially during live rolling.

This gets tedious and its uncommon to see someone with years on the mat who still wears headgear. However, wrestling headgear is the only real method for preventing the damage during training.

Why does cauliflower ear look different on different grapplers?

The location and degree of damage to the ear play a pivotal role in the ultimate appearance of cauliflower ear.

You probably notice a range of cauliflower ear appearances on a spectrum from slightly monkey-eared to full-blown Shrek. This depends on your original ear anatomy and the extent of the damage.

Additionally, treated cauliflower ear often results in a more subtle deformity that may not be recognized by non-grapplers.

Why doesn’t everyone in BJJ have cauliflower ear?

Some grapplers have serious cauliflower ear, while others seem unaffected.

The structure of your ear and its baseline softness determine how susceptible your ears are to the initial trauma that leads to cauliflower ear.

Additionally, the techniques you favor in BJJ and how often you train also determine your likelihood of trauma resulting in cauliflower ear, although it would be tough to avoid any ear contact altogether.

We do not recommend changing your game to avoid cauliflower ear. But if you tend to go for double leg takedowns, you are probably more susceptible than someone who pulls guard and sweeps.

Finally, grapplers who have about with cauliflower ear that gets quickly drained and healed anecdotally seem to be less susceptible to further cauliflower ear in the same spot, although this is not always the case.

Is cauliflower ear dangerous?

Although it is painful and potentially aesthetically undesirable, cauliflower ear is not very dangerous.

The biggest health risk of cauliflower ear is getting an infection. This is far more likely to occur if you try to drain it yourself or have a non-medical professional do it for you but is fairly avoidable if you follow basic hygiene and let the area heal.

Beyond infection, the biggest risk is appearance.

This is largely subjective.

Some grapplers want to avoid cauliflower ear at all costs, while others may see it as a badge of honor or indication of commitment to the sport.

If you are a professional BJJ artist or MMA fighter, you probably do not care about having some cauliflower ear.

That being said, it will certainly stop your modeling career in its tracks for anything other than BJJ Gis and fight gear.

For corporate, medical, or legal professionals who need to appear civilized in their day-to-day lives, cauliflower ear may be a bigger concern.

If you fall into this camp, you should consider wearing headgear when grappling.

Cauliflower ear in BJJ: the bottom line

Cauliflower ear is a common condition amongst BJJ grapplers, wrestlers, MMA fighters, and other contact athletes.

Cauliflower ear may or may not be a desirable appearance for you, however it is largely safe provided you mitigate the risk of infection.

Cauliflower ear is relatively easy to treat if you catch it immediately after the trauma. However, surgery is required for removal if the area completely hardens.

Cauliflower ear is not a big deal whether you treat it or not unless it completely blocks your ear canal, but it is painful at first.

Regardless, if you want to avoid the condition, wear wrestling headgear while grappling.

If you do not want to wear headgear, buckle up, have fun, and embrace the cauliflower!