Does BJJ cause Cauliflower Ear? A Deep Dive into this Combat Badge

Last Updated May, 2024

Two MMA fighters face off, displaying cauliflower ear

Hey there, jiu-jitsu enthusiasts! If you've been around the Brazilian Jiu Jitsu (BJJ) or combat sports community for a while, or even just taken a quick peek, you've probably noticed some martial art fighters sporting a common condition that's colloquially known as "cauliflower ear."

But what exactly is it, how do we get cauliflower ear, prevent cauliflower ear, and why is it so prevalent in the grappling world?

The Science Behind Cauliflower Ear

First, let's take a scientific angle. According to medical literature, cauliflower ear, or auricular hematoma, happens when the ear experiences trauma or repetitive impact. This leads to blood collecting between the cartilage and the skin of the ear. If this blood is not drained promptly, the healing process cannot begin and it can cause the outer ear cartilage to die. As a result, the ear takes on a lumpy, shriveled appearance, similar to - you guessed it - a cauliflower!

A Timeline: From Impact to Reshape

Initial Trauma (0-24 hours)

At the core of cauliflower ear is trauma. The ear, particularly the outer part known as the auricle or pinna, is made up of a thin layer of skin and underlying cartilage. When the ear experiences trauma, such as from strikes, friction, or compression, small blood vessels (capillaries) within the ear can rupture

Hematoma Formation (24-48 hours)

Once these blood vessels rupture, blood starts to accumulate in the space between the skin and the ear cartilage. This fluid buildup is a collection of blood is known as a hematoma. Hematomas are the body's natural response to injury, as blood rushes to an injured site. However, in the case of the injured ear, the space where this blood accumulates is confined, leading to swelling and pain.

Cartilage Starvation (48-72 hours)

Cartilage is an avascular tissue, meaning it doesn't have its own blood supply. Instead, it receives nutrients and oxygen from the overlying skin. When a hematoma forms and blood collects between the skin and cartilage, it disrupts this nourishing connection. As a result, the ear cartilage may begin to be deprived of essential nutrients and oxygen.

Necrosis and Fibrosis (1-2 weeks)

Deprived of nutrients, the affected cartilage can start to die off, a process known as necrosis. The body, in its attempt to heal and respond to the injury, may also start producing fibrous tissue in the area. This fibrous tissue is tougher and less flexible than the cartilage it's replacing.

Permanent Deformity (2-4 weeks)

Over time, as more cartilage dies off and is replaced by fibrous tissue, the injured ear can take on a lumpy, irregular appearance. This is the "cauliflower" look that gives the condition its name. Once the ear reaches this state, the changes are often permanent, as cartilage does not regenerate easily.

Potential Complications (long-term)

If left untreated, a cauliflower ear can lead to complications. The accumulation of blood can become infected, leading to abscess formation. Additionally, the deformity can become severe enough to affect the ear canal shape, potentially impacting hearing.

These complications highlight the importance of seeking medical attention to prevent cauliflower ear and address issues associated with cauliflower ear.

Why is Cauliflower Ear Common in BJJ?

Now, you might wonder, "What is the strong association between cauliflower ear and BJJ?" The answer lies in the nature of this sport.

Brazilian Jiu-Jitsu involves a lot of full contact from takedowns to ground work. These exchanges place the ears in the line of fire, so to speak. Whether it's an accidental elbow while rolling, the friction from rubbing against the gi, or the pressure from a tight headlock, the ears take quite a beating.

Over a long period of time, this repeated friction can lead to developing cauliflower ear.

Grappling Exchanges That Can Lead To Developing Cauliflower Ear

Guard Play

When you're playing guard, especially closed guard, your training partners will often try to posture up and break free. In the process, they might push against your head or pin your ears using their forearms or elbows, leading to potential trauma.


BJJ is full of quick transitional movements, especially when both competitors are vying for a dominant position. During these scrambles, the ears can get caught, twisted, or crushed against close contact to the mats or your training partner's body.

Takedowns and Takedown Defense

Whether you're shooting for a double-leg takedown or defending against one, the ears can experience trauma. For instance, shooting for a takedown - when driving forward, the side of the head (and ears) can rub aggressively against an opponent.

Side Control and Crossface Pressure

When a practitioner achieves side control, one common technique is to apply crossface pressure to control the opponent's head. This involves driving the shoulder into the opponent's face, which can inadvertently put pressure on the ear.

Gi Chokes and Collar Manipulations

The gi, or kimono, in BJJ can be used for various chokes and controls. When an opponent pulls or tightens the gi around your neck, the collar might press against the ear, causing potential harm.

Headlocks and Guillotine Chokes

Moves like the guillotine choke or various headlocks involve wrapping an arm around the opponent's head. If applied with significant pressure or if the head is twisted, it can lead to trauma to the ears.


When a fellow practitioner achieves mount position on you, they can use their weight and pressure to keep you flat. To escape you will likely turn to one side and your ear may inadvertently get pressed into the mat, this pressure can cause damage over time.

Stack Passes

During stack passes, the bottom player's legs and hips are lifted, stacking them onto their own head and neck. This can lead to the ears being crushed between the mat and the practitioner's own shoulders or body.

Is Cauliflower Ear a Badge of Honor?

There's a bit of a cultural aspect to this as well. In the BJJ community, having cauliflower ears is often viewed as a badge of honor or a testament to one's dedication and time on the mats.

It's like a visual cue, signaling that the person is a seasoned fighter. That being said, not everyone is a fan of this look, and some even take preventive measures or seek treatment to avoid or reverse it.

Preventing Cauliflower Ear in BJJ

Wear Ear Protection

In sports like wrestling and BJJ, where ear trauma is prevalent, wearing ear guards or headgear as preventative measures is highly recommended. This protective equipment is designed to distribute the force of impact and reduce direct trauma to the ear and helps prevent cauliflower ear. If you wear headgear, you can prevent further trauma to the injured ear.

Stay Aware During Rolling

While it's impossible to predict every move your opponent makes, maintaining a certain level of awareness can help. For instance, if you're aware of a tight guillotine coming or feel excessive pressure around your head, adjusting your position can sometimes help in reducing direct ear trauma.

Proper Hygiene

Though not a direct cause of cauliflower ear, infections can exacerbate any swelling or trauma. Ensure you clean your ears and wear clean gear. Moreover, it's essential to keep the mats and training environment clean to prevent bacterial infections.

Treatment of Cauliflower Ear

Immediate Medical Attention

If you suspect that you've developed an auricular hematoma, it's crucial to seek medical attention promptly. The sooner the accumulated blood is drained, the better the chances of preventing permanent cartilage damage.

Draining the Ear

A common pain free procedure involves using a sterile needle or syringe to aspirate the collected blood. This procedure should always be performed by a medical professional to prevent complications. Other methods can be problematic.

Compression Dressings

After draining, a compression dressing is often applied to the ear to prevent the space from filling up with blood again. This dressing needs to be kept in place for several days.


In some cases, antibiotics might be prescribed to prevent infections, especially if there was any break in the skin. Anti-inflammatory medications can also help reduce swelling and pain.


In severe cases, or if the cauliflower ear has become chronic, surgical intervention might be required to correct the deformity and improve the ear's appearance.

By understanding both the preventive measures and potential treatments for cauliflower ear, you can make informed decisions about your BJJ journey. Remember, while some see it as a badge of honor, it's always best to prioritize your health and well-being.

Whether you choose to wear battle scars with pride or wear ear guards to avoid them, the most important thing is to enjoy the art and sport of Brazilian Jiu-Jitsu safely!

Wrapping Up

So, there you have it! Cauliflower ears, while deformed ears is a common sight in the BJJ and mixed martial arts world, is a result of repeated trauma to the ear. And while some wear it as a badge of honor, many athletes prefer to take preventive measures for solid protection against permanent damage.

No matter where you stand on the topic, it's essential to be informed and make decisions that are right for you. Remember, BJJ is not just about the physical battle but also about understanding and respecting the intricacies of the human body.

Roll safe and take care of those ears!