What does it mean if there is a milky white, paste-like substance on the eardrum, and what should be done?

Generally, the presence of a milky white, paste-like substance on the eardrum may be caused by factors such as earwax buildup, water in the ear canal, fungal external otitis, suppurative otitis media, or external auditory canal eczema. Depending on the specific condition, patients can choose appropriate management methods such as routine care, medication, or surgical treatment. A detailed analysis is as follows:

1. Earwax Buildup

When earwax is not cleaned for a long time, it mixes with shed skin cells from the ear canal and gradually becomes thick and sticky, forming a milky white paste adhering to the eardrum. Do not attempt to dig it out yourself; instead, visit a hospital where a doctor can safely remove it using professional tools. Avoid touching the ear canal with sharp objects during daily routines.

2. Water in the Ear Canal

After bathing or swimming, water entering the ear canal can cause earwax to absorb moisture, swell, soften, and form a milky white paste that sticks to the eardrum. Tilt your head toward the affected side immediately to allow water to drain naturally, and gently wipe the outer ear opening with a clean cotton swab to keep the ear canal dry.

3. Fungal External Otitis

A moist ear canal promotes fungal growth. The metabolic products of fungi mix with secretions, forming a milky white, paste-like substance accompanied by itching in the ear canal. Under medical guidance, treatments may include ketoconazole ear drops, fluconazole capsules, or hydrogen peroxide solution, along with regular ear canal cleaning.

4. Suppurative Otitis Media

Bacterial infection causes inflammation in the middle ear. When the eardrum perforates, pus flows out and accumulates on the surface of the eardrum, appearing as a milky white paste, often accompanied by hearing loss. Follow medical advice to use medications such as cefuroxime axetil tablets, ofloxacin ear drops, or chloramphenicol ear drops. In severe cases, tympanic membrane repair surgery may be required.

5. External Auditory Canal Eczema

Allergies or irritants may trigger eczema in the ear canal. Dried exudate from the mucous membrane forms a milky white, paste-like substance, often associated with a burning sensation in the ear canal. Under medical supervision, treatments may include desonide cream, loratadine tablets, or zinc oxide ointment. Avoid exposure to allergens such as pollen.

Maintain good daily habits: avoid frequent ear picking, wear earplugs during showers to prevent water from entering the ear canal, keep the ear canal well-ventilated and dry, and stay away from damp, hot environments. If abnormal discharge from the eardrum is noticed, do not delay seeking medical attention to determine the underlying cause promptly—this helps effectively prevent worsening of the condition.