Earwax

Never put anything smaller than your elbow in your ear! Cotton swabs are for cleaning bellybuttons – not ears. You have probably heard these admonitions from relatives and doctors since childhood – read on to find out what they meant.

The Outer Ear and Canal

The outer ear is the funnel-like part of the ear on the side of the head. The ear canal is shaped somewhat like an hourglass—narrowing part way down. The skin of the outer part of the canal has special glands that produce earwax. This wax traps dust and dirt particles to prevent them from reaching the eardrum. Usually the wax accumulates, dries out, and then tumbles out of the ear, carrying dirt and dust with it. The ear canal may become blocked by wax when attempts to clean the ear (usually with a Q-tip) push wax deeper into the ear canal causing a blockage. Wax blockage is one of the most common causes of hearing loss.

Should You Clean Your Ears?

Wax is not formed in the deep part of the ear canal near the eardrum, but only in the outer part of the canal. So when a patient has wax blocked up against the eardrum, it is often because he has been probing his ear with such things as cotton-tipped applicators, bobby pins, or twisted napkin corners. These objects only push the wax in deeper. Also, the skin of the ear canal is very thin and can easily be injured.

Earwax is healthy in normal amounts and serves to coat the skin of the ear canal where it acts as a temporary water repellent. The absence of earwax may result in dry, itchy ears. Wax also acts as an anti-bacterial coating.

Ear canals are usually self-cleaning—that is, there is a slow and orderly migration of ear canal skin from the eardrum to the outer ear. Old earwax is slowly transported from the ear canal to the ear opening where it usually dries, flakes, and falls out.

Under ideal circumstances, you should never have to clean your ear canals. However, we all know that this isn’t always so. If you want to clean your ears, you can wash the external ear with a cloth over a finger, but do not insert anything into the ear canal.

Self Treatment

Most cases of ear wax blockage respond to home treatments used to soften the wax. Patients can try placing a few drops of mineral oil, baby oil, glycerin, or commercial drops, such as Debrox®, or Murine® Ear Drops in the ear. These remedies are not as strong as the prescription wax softeners but are effective for many patients. They should not be used if there is a hole in the eardrum. Rarely, people have allergic reactions to commercial preparations.

Detergent drops such as hydrogen peroxide or carbamide peroxide may also aid in the removal of wax. Patients should know that rinsing the ear canal with hydrogen peroxide (H2O2) results in oxygen bubbling off and water being left behind—wet, warm ear canals make good incubators for growth of bacteria. Flushing the ear canal with rubbing alcohol displaces the water and dries the canal skin. If alcohol causes severe pain, it suggests the presence of an eardrum perforation.

When Should I See My Doctor?

If you are uncertain whether you have a hole (perforation) in your eardrum, consult your physician prior to trying any over-the-counter remedies. Putting eardrops or other products in your ear in the presence of an eardrum perforation may cause an infection or hearing loss. In the event that home treatments are not helpful, your physician may irrigate or flush it out. ENT specialists tend to remove wax via vaccum and a microscope since they are accustomed to performing surgery with these instruments. Furthermore, direct visualization can ensure that no injury to the eardrum occurs.

Other Possible Causes of Hearing Loss

  • perforated eardrum
  • middle ear infection (otitis media)
  • external ear infection (otitis externa)
  • acoustic trauma

What are the symptoms of wax buildup?

  • partial hearing loss, may be progressive
  • tinnitus, noises in the ear
  • earache
  • fullness in the ear or a sensation the ear is plugged