The condition itself is the result of untreated or poorly treated auricular hematoma. The clinical picture progresses from :
(1) injury to the ear causing persistent, throbbing pain that lasts long after the causative event.
(2) possible fibrocartilage fracture.
(3) swelling, local heat, tenderness, followed by the development of a hematoma after several hours, initially between cartilage and overlying skin, visible to the naked eye
(4) tissue hardening and the development of early fibrous tissue in about 14 days, and
(5) the resulting keloid mass, development of new cartilage, and permanent deformity of the external ear characterized by skin wrinkling, thickening, and contraction at the site of injury.
To prevent the formation of a cauliflower ear, initial treatment of an acute hematoma should include ice packs and pressure bandages. Aspiration, or several drainings with application and frequent changing of a pressure dressing may be necessary.