Cauliflower ear is caused by repeated trauma to the ear. Athletes most susceptible are wrestlers and boxers, but football players can also develop it. The injury doesn’t immediately put you out of commission, but if it is not treated properly, you can be left with a permanent deformity, and possibly hearing loss.

To find out the best cauliflower ear treatment, we talked with Robert Rodriguez, a personal trainer with USA Wrestling.

Because of the several steps you must take to rid yourself of it, “cauliflower is very difficult to treat,” Rodriguez says. “And I’ve treated a whole bunch of them!

“First you have to wait a couple days for the ear to finish bleeding out in the channel. Then we aspirate it and take all the blood out before it coagulates—because [if you don’t do that], you’re stuck with a deformity.”

Cauliflower Ear Treatment

Following the draining, a trainer applies pressure to the ear to make sure it won’t refill. This process takes an athlete out of the game for at least three to five days, because while pressure is being applied to the ear, his blood pressure can’t rise too high. “Once he starts getting his blood pressure up by wrestling, running or doing strenuous activity, that molding will get pushed out of the way and refill,” Rodriguez says.

A collodion cast—consisting of gauze, cotton balls and collodion [a chemical solution used as an adhesive to close small wounds]—is the most commonly used compress. Trainers soak the gauze and cotton balls in collodion, then wrap it close to the head. “As the collodion dries, it hardens and puts pressure in the ear,” Rodriguez explains; “then you put a piece behind the ear and wrap an ace bandage around the head to form pressure, which prevents the ear from refilling.”

Wrestlers can still compete with cauliflower ear. And because cauliflower treatment takes them off the mats for a while, many choose to hold off on the pressure treatment. “If it’s in the middle of the season and they’re getting ready for or competing in major tournaments, we prefer to wait until afterwards,” Rodriguez explains. “Otherwise, [the ear] will refill, and we’ll have to do the whole process again.”

Rodriguez stresses that if you wait until the end of the season to completely treat the injury, you must be vigilant about draining your ear to avoid permanent damage. “Some athletes choose to get it drained three or four times a season so they can continue wrestling while avoiding the deformity,” he says. “If you let cauliflower ear harden and calcify in the ear channel, then you’ve got what you’ve got. It won’t refill again, because all that space is taken up by all that tissue. Then you have to have a plastic surgeon fix it.”