Is it too late to drain my cauliflower ear?

My brother has cauliflower ear but did not suffer an injury. How could he have gotten cauliflower ear then?

• My brother is 25 years old and in the past month has developed cauliflower ear. He has gone to the doctor five times to have it drained and right now his left ear is about the size of a quarter. His doctor doesn't know how this happened because my brother isn't in wrestling or fighting, and has had no injury to his ear that could have caused this to happen. My brother has suffered from staff in his left ear since he was a baby, and tends to pick at it his ear a lot out of habit. Do you think this is a contributing factor? I'm really concerned because the longer it takes to heal, the more damaged his cartilage will be. If anyone knows any information, please let me know. -Concerned Sister

• Answer:

  What causes cauliflower ear? The ear is vulnerable to blunt trauma. When the ear is struck and a blood clot develops under the skin, or the skin is sheared from the cartilage, the connection of the skin to the cartilage is disrupted, causing cauliflower ear. The cartilage of the ear has no other blood supply except that supplied by the overlying skin. When the skin is pulled from the cartilage, and/or separated from the cartilage by blood (as with accumulated blood from injury or inflammation) or infection, the cartilage is deprived of important nutrients. Ultimately, the cartilage dies and the risk of infection is increased. Untreated, the ear cartilage begins to contract on itself forming a shriveled up outer ear, known as the cauliflower ear deformity. Once there is cartilage death and scarring (fibrosis), the resulting deformity is generally permanent. The ear may also appear pale, due to loss of blood supply. In some cases, cosmetic procedures may improve the appearance of the ear. Cartilage damage may also result from piercing the upper ear in the cartilage. Piercing can lead to a type of ear cartilage infection called auricular perichondritis, which can result in cauliflower ear. An even more rare cause of cauliflower ear is from the inflammation of cartilage in relapsing polychondritis.