Cauliflower Ears: Unraveling the Deformity Associated with Combat Sports
You may have noticed that many UFC fighters possess peculiar-looking ears and wondered about the reason behind this form of ears. These ears, often referred to as cauliflower ears, are a result of repeated trauma and injuries sustained during combat sports like Mixed Martial Arts (MMA), wrestling, Brazilian jiu-jitsu, and rugby.
The condition, characterized by a swollen and misshapen ear, has become synonymous with experienced fighters, with some even willingly inflicting damage to achieve the same distinctive look. In this article, we will delve into the world of cauliflower ears to understand its origins, causes, and implications.
What Are Cauliflower Ears?

Cauliflower ears, medically known as auricular hematoma, represent a deformity of the external ear caused by traumatic injuries. This condition occurs when the ear suffers repetitive blows or forceful impacts, leading to damage and disruption of the delicate blood vessels and tissues that supply the ear. Consequently, the ear’s shape alters, resembling the uneven surface of a cauliflower, hence the name.
Prevalence in Combat Sports
The prevalence of cauliflower ears is particularly high in sports where grappling and physical contact are frequent. Combat sports such as wrestling, Brazilian jiu-jitsu, and rugby expose athletes to the risk of ear trauma due to direct hits, friction, or compression. However, it is most prevalent and pronounced in MMA due to the often violent ground fights that put considerable strain on the ears.
Underlying Mechanism
When the ear suffers an injury, blood circulation to the affected area is compromised, impeding the proper flow of blood and vital nutrients. This restricted blood flow leads to the formation of blood clots within the ear tissue. Over time, these clots cause an accumulation of fluids, altering the ear’s shape and causing it to appear bloated and swollen.
In some cases, an infection can also contribute to the development of cauliflower ears. If the injury is left untreated, the infection can exacerbate the condition, leading to further tissue damage and deformation.
The Signature of Fighters
Ironically, despite the disfiguring nature of cauliflower ears, many combat sport athletes choose not to seek immediate medical attention for such injuries. The distinctive appearance of these ears has become a symbol of a fighter’s dedication, experience, and resilience. A fighter with cauliflower ears is often regarded as battle-hardened, showcasing their commitment to their craft and willingness to endure physical challenges.
Do All MMA Fighters Have Cauliflower Ears?

Cauliflower ears develop over time and are often linked to sports that involve ground techniques, such as wrestling and Brazilian jiu-jitsu. The constant rubbing of the ear against the floor and techniques that exert pressure on the head can contribute to the condition. However, it is essential to recognize that cauliflower ears are not exclusive to ground fighters or martial artists.
Rugby players, known for their intense physicality, are also susceptible to this deformity due to repeated rubbing of the ear, leading to the skin being pulled away from the cartilage or the formation of hematomas. Thus, any sport that involves continuous ear trauma can potentially result in cauliflower ears.
It is worth noting that while many fighters with ground-oriented techniques may develop cauliflower ears, there are exceptions. Standing fighters who primarily rely on striking techniques can also experience this condition, as can ground fighters with intact ears. The development of cauliflower ears is influenced by various factors, including the individual’s susceptibility to injuries, the frequency and intensity of ear trauma, and the sport-specific techniques utilized.
The Pain and Implications
During the initial stages, cauliflower ears can be quite painful, akin to the discomfort experienced from any blunt trauma. The affected ear may become swollen, bruised, and tender to the touch. In more severe cases, additional symptoms such as hearing loss, ringing in the ear (tinnitus), headaches, or blurred vision may arise. In such instances, it is crucial to seek medical attention promptly and refrain from further training until the ear has healed sufficiently.
However, as time passes and the condition becomes permanent, the pain associated with cauliflower ears typically subsides. The skin in the affected area can transform into scar tissue, which may reopen and bleed easily during subsequent traumas, but it generally repairs itself with less pain.
Managing Cauliflower Ears
To alleviate discomfort and reduce swelling after a fight or ear injury, applying ice to the affected ear for 15-minute intervals multiple times a day is often recommended. Seeking medical advice and treatment early on can help mitigate severe consequences and prevent permanent disfigurement.
Why Don’t MMA Fighters Get Their Cauliflower Ears Cured?

Thankfully, several methods can help treat cauliflower ears and prevent them from becoming permanent disfigurements. The most commonly used approach is to apply ice to the affected ear to reduce swelling and inhibit the formation of cauliflower ears. However, for more severe cases, seeking medical attention becomes imperative.
Medical professionals can perform a fluid drain to remove accumulated fluids, thereby preventing blood clots from obstructing blood flow in the ear. If not drained in time, the lack of proper blood flow can lead to tissue damage and, ultimately, cartilage death, resulting in a permanent deformity.
Following a fluid drain, doctors may recommend applying constant compression to the affected ear using a bandage or a silicone mold, similar to a hearing aid, to prevent re-accumulation of fluids. In some cases, a temporary drain may be inserted by a surgeon. However, opting for these medical interventions may require fighters to temporarily halt their training and competitive activities to ensure proper healing and avoid infections.
The Recurring Nature of Cauliflower Ears
One of the primary reasons why many MMA fighters do not pursue complete cures for cauliflower ears is the high likelihood of recurrence. An illustrative example is the case of Leslie Smith, whose cauliflower ear exploded during a fight against Jessica Eye in 2014. Prior to the incident, Smith had been getting her ear drained monthly due to recurring problems.
Smith’s experience highlights the challenges faced by fighters dealing with cauliflower ears. Despite receiving regular treatments, the risk of injury recurrence remains, prompting many fighters to question the effectiveness of ongoing medical interventions.
Embracing the Cauliflower Style
For some fighters, cauliflower ears become a distinctive trademark of their fighting careers. Embracing the cauliflower style is a conscious decision made by fighters who are aware of the recurring nature of the injury and the possibility that complete cures might not be permanent. Rather than interrupting their careers for treatments that may only offer temporary relief, these fighters accept and embrace their cauliflower ears as symbols of their dedication, experience, and resilience.
The development of cauliflower ears in MMA fighters is linked to practices and fights conducted without the use of protective headgear. The repetitive trauma from ground fights, where rubbing against the ear is common, contributes to the formation of hematomas, blood clots, and blockages in blood vessels. As a result, the cartilage is deprived of vital nutrients, leading to the characteristic deformity seen in fighters such as Randy Couture.
While having a cauliflower ear is common among wrestlers and jiu-jitsu practitioners due to the nature of their sport, they are comparatively less prevalent among strikers, as these fighters typically encounter fewer instances of ear trauma.
MMA fighters with cauliflower ears face a challenging decision when it comes to seeking a cure. While various treatment options are available, the recurring nature of the condition and the risk of injury during fights prompt many fighters to choose not to pursue complete cures.
The decision to embrace the cauliflower style, rather than interrupt their careers for temporary treatments, is a testament to their commitment to the sport and willingness to endure the consequences of their chosen profession. Proper preventive measures, including the use of protective headgear, can help reduce the occurrence of cauliflower ears in the MMA community and safeguard the well-being of fighters in their pursuit of excellence.