What you need to know about earwax

Earwax is a yellowish, waxy material inside the ear that originally comes in the ear canal from the sebaceous gland. It is known as cerumen, as well.

Earwax lubricates, cleans, and protects the lining of the ear canal. This is accomplished by repelling water, trapping dirt, and ensuring that insects, fungi , and bacteria do not pass through the ear canal and damage the eardrum.

Earwax consists primarily of skin shed layers.

It contains:

  • keratin: 60 percent
  • saturated and unsaturated long-chain fatty acids, squalene, and alcohols: 12–20 percent
  • cholesterol 6–9 percent

Earwax is highly acidic, and its properties are antibacterial. The ear canal without earwax will become dry, waterlogged and vulnerable to infection.

Nevertheless, it may cause issues when the earwax accumulates or becomes hard, like hearing loss.

Read on to learn more about the problems with earwax and how to manage them.

Symptoms of earwax problems

A lady having warwax
Earwax can be annoying when it builds up, but prodding can both make it worse and cause damage to the ear’s sensitive tissues.

When too much earwax builds up and gets strong, it can shape a plug which blocks the ear. A blocked ear can be uncomfortable and has the ability to impair hearing.

A blockage in the earwax can cause the following symptoms:

  • an earache
  • an ear infection
  • itchiness
  • tinnitus, which is a ringing in the ear
  • a feeling of fullness in the ear
  • vertigo, or a sense of being unbalanced that can lead to dizziness and nausea
  • a cough, due to pressure from the blockage stimulating a nerve in the ear

The abnormal earwax buildup is the cause for many defects in hearing aid.

When attempting to remove earwax, it is important never to put something in the ear.

Placing cotton swabs and other objects in the ear can push the earwax into the channel further down and make the problem worse.

Causes

People who produce much earwax are more likely to have an earwax blockage and impaction, which is where the wax is pushed deep within the ear canal.

Swimming may cause excess earwax to happen to some people.

Hearing aids and earplugs keep wax from dropping naturally out of the ear, contributing to its accumulation within the ear. The use of products to remove earwax or alleviate itching will make the accumulation worse.

Such items include:

  • cotton swabs, or Q-tips
  • bobby pins
  • keys
  • napkin corners

Those items can push the wax into the ear canal deeper. They can also harm the sensitive ear tissues, potentially resulting in permanent damage.

People should be under the supervision of a health care professional performing any cleaning or removal of earwax.

Risk factors

Some people are more likely to experience earwax problems than others. People who appear to have more earwax stored in their ears include:

  • individuals whose ear canals are narrow or not fully formed
  • people with very hairy ear canals
  • people with osteomata, or benign bony growths, in the outer part of the ear canal
  • those with certain skin conditions, such as eczema
  • older people, because earwax tends to become drier and harder with age, which increases the risk of impaction
  • people with recurring ear infections and impacted earwax
  • individuals with lupus or Sjogren’s syndrome

People with learning difficulties often have earwax problems, but the reason for this is unclear.

Home remedies

Impacted earwax often comes out after using ear drops for around 2 weeks.
Impacted earwax often comes out after using ear drops for around 2 weeks.

One way of eliminating excess earwax at home is to wipe a washcloth around the outside of the ear.

Alternatively, a pharmacist may provide advice about appropriate over-the-counter ( OTC) treatments.

People can also use the following solutions as ear drops which are usually also available from a pharmacy:

  • hydrogen peroxide, a mild antiseptic that is useful for cleaning wounds
  • baby oil, almond oil, or olive oil
  • glycerin
  • mineral oil

People should tilt their heads to use the ear drops so that the affected ear faces upwards, place one or two drops in it, and wait in this position for 1–2 minutes. Then they should tilt their head so the ear faces down and allow any fluid to drain out.

If people do this twice a day, usually the earwax will come out within 2 weeks. Especially at night it appears to do that when a person is asleep.

People should never try to extract earwax using a cotton swab or any other item. Inserting objects into the ear canal can damage sensitive tissue in the ear, exacerbating the impaction.

Medical treatment

Earwax diagnosis
If home remedies do not work, a doctor can help to remove earwax.

If home remedies aren’t effective, people will seek medical advice instead of trying to remove the earwax itself.

A doctor will examine the ear using a medical device called an auriscope, or otoscope. We will test for an earwax accumulation, and decide whether it has been compromised or not.

Earwax usually falls out on its own. Treatment is only required if an earwax blockage causes discomfort or hearing loss. A doctor possibly would remove the earwax in such cases.

In this end, there are many approaches, including those below:

Ear drops

The doctor will prescribe or recommend ear drops for softening the wax and making removal easier. People should use drops in their ears at room temperature.

Usually, the wax will soften in a few days ‘ time and slowly come out alone.

A person with an acute ear infection or a perforated eardrum should not use ear drops.

Ear irrigation

If ear drops aren’t working, the doctor may recommend an irrigation procedure.

To dislodge and remove the plug, the doctor will apply a high-pressure flux of water to the ear canal.

Historically, doctors used a metal syringe to irrigate the ear, which had a slight risk of damage.

Now, at body temperature, there are electronic ear irrigators that squirt a carefully controlled water flow into the ear canal.

Pressure control keeps the initial pressure as low as possible. It may be necessary to hold the ear at different angles to ensure that the liquid reaches every part of the ear canal.

If the person has had a severe earwax impact, the doctor may need to look several times during the irrigation process with an auriscope inside the ear.

Ear irrigation is not painful but it may seem strange to have water squirting into the ear.

A person might also experience additional symptoms, in which case the doctor will further examine to see if there is an infection.

If irrigation does not remove the wax, the individual may need to continue with drops to soften the earwax, and then repeat the irrigation. Until irrigating, the doctor may put water in the ear for some 15 minutes.

If this doesn’t work, the doctor might consider seeing a specialist in ear, nose , and throat (ENT).

When is irrigation not suitable?

In all circumstances, ear irrigation isn’t suitable for everyone. If any of the following factors are appropriate, the method may be unsuitable:

  • The person has had ear surgery in the last 12 months.
  • A child has a tympanostomy tube, also called a grommet, which is a small tube that doctors insert to allow ventilation of the middle ear.
  • Another foreign body is blocking the ear canal.
  • The person was born with a cleft palate.
  • The individual has a perforated eardrum or has had one in the last 12 months.
  • The person has or has recently had otitis media, which is an infection of the middle ear.
  • There is a mucous discharge from the ear, which could indicate an undiagnosed perforation.

Anyone who has had any complications following previous irrigation, such as extreme vertigo or discomfort should not undergo this procedure again.

Manual removal

If irrigation is not an option or is unsuccessful, either microsuction or manual removal may be recommended to clear the ear canal.

Microsuction uses a small tool to suck earwax out of the ear.

Manual removal can include cleaning the ear and scraping out any earwax using a thin instrument with a small hoop at the end.

Other devices which may be used by doctors for this treatment include curettes, spoons and hooks.

The doctor would also need to use a special microscope to help them see what’s going on.

If the patient still has hearing issues or tinnitus after removal of the earwax, they will need a hearing loss test to check for other issues.

Ear candling

The authors of an editorial on the website of the American Academy of Audiology have expressed concern about an alternative earwax therapy called ear candling, ear coning, or thermo-auricular therapy.

It includes inserting into the ear a hollow cotton or linen tube, lighting the end, burning it for about 15 minutes, and then taking it out.

There will always be a substance in the stub of the candle that resembles earwax, but studies have found no evidence to indicate wax is removed from the ear by this method.

In addition , studies investigating this practice have shown no earwax is removed at all. People who have tried it have reported problems in the ear, such as burns, eardrum rupture and candle wax or other blockages.

The editorial authors conclude, “Ear candling isn’t reasonable, rational, safe, or effective, and it should just never be done.”

The United States Food and Drug Administration (FDA) does not support ear candling, and has not approved this procedure.

Complications

Impacted earwax can result in ear infections if a person is not receiving care. The infection will very rarely spread to the base of the skull and cause meningitis or cranial paralysis.

Vertigo is also likely if the earwax presses against the tympanic membrane, or eardrum. This symptom can cause nausea and a feeling of movement even when a person stays still.

Takeaway

Using cotton buds
Use cotton buds only for the outer ear

Impacted earwax can be frustrating but with home remedies or medical treatment, it is usually easy to resolve.

People should ask a pharmacist to prescribe a few ear drops first. When these aren’t working, they will receive medical assistance.

Never placing something inside the ear is important, because doing so will make the issue worse, and can cause permanent damage.

Use cotton buds only ever to purify the outer parts of the ear, and never prod or poke the inner parts.

If this thing doesn’t go away, you will see a doctor.

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