Ear Wax

The ear canal is lined with modified sweat glands that produce a waxy oil (made of proteins) called cerumen, better known as ear wax. Ear wax functions to collect external debris, suppress growth of micro-organisms, and provide a barrier to incoming foreign bodies. The glands that produce ear wax are concentrated in the outer half of the ear canal. Also, the color, hardness and quantity of cerumen can vary between people and, for most people, the ear wax migrates to the outer edge of the ear canal and falls out naturally. Sometimes thick hair growth or stray hair from a haircut can add some obstruction to the natural clearing of cerumen from the ear canal. Q-tips can be a problem because they can tamp ear wax deeper into the canal.

The ear canal is also lined by the same skin that covers all other parts of the body. Therefore the ear canal skin can suffer from both the collection of dead skin (dandruff) and chronic skin problems of eczema and psoriasis – chronic dermatitis (which causes itchiness).

Micro-organisms (bacteria and yeast) also commonly reside in ear canal. They can overgrow and cause blockage, swelling, a discharge with and without pain. This occurs most frequently in the presence of water and perspiration or when the ear canal is blocked for long periods by ear plugs, a foreign body or hearing aids.

Symptoms of a wax impaction

fullness in the ear or a sensation that the ear is plugged
a sudden hearing loss (hearing usually returns completely after removal of the blockage).
new noises in the ear (tinnitus)
earache

These are also symptoms of a more serious problem and we encourage you to have your ear examined.

Prevention

Most cases of ear wax blockage can be prevented at home.

Mineral oil, baby oil, glycerin, or commercial drops can be used to soften wax in the ear. There has been a recent warning that commercial ear wax softeners, such as Cerumenex or Debrox, may increase the risk of an external ear infection. Perhaps the most effective method is a few drops of hydrogen peroxide, applied with soaked cotton or a dropper.
After the hydrogen peroxide bubbles for a few minutes, clean the ear with a wash cloth or tissue.
This prevention may be necessary once a week.
These ear drops are not recommended for people with ventilation tubes or ear drum perforation.

Treatment

These materials are usually not as effective once the ear canal has become blocked. After trying to soften the wax, try irrigating the ear canal to flush it out. Never irrigate the ear if the eardrum is not known to be intact, because irrigation with a ruptured eardrum may cause ear infection and pain.

Irrigation requires body-temperature water (cooler or warmer water may cause brief but severe dizziness). With the head upright, straighten the ear canal by holding the external ear and gently pulling upward. Use a syringe or other commercially available product to gently direct a small stream of water against the ear canal wall next to the wax plug. Tip the head to allow the water to drain. Irrigation may need to be repeated several times. This can be done over a sink, in a bath tub or shower.

Never irrigate the ear if the eardrum is not known to be intact, because irrigation with a ruptured eardrum may cause ear infection and pain. Do not irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik) because the force of the irrigation may damage the eardrum.

After the wax is removed, the ear should be dried thoroughly. A few drops of alcohol in the ear or a hair dryer set on low may be used to help dry the ear. For regular users, consider a commercial ear dryer (www.DryEar.net)

Warning ! Ear candling, or coning, is a commercial product which sells for between $2 and $10. They can be made of linen or cotton soaked in wax (beeswax) or paraffin. After burning the candle in the ear canal, the melted wax creates a low-level vacuum that draws wax and other debris out of the ear canal. Some Ear candling proponents even claim that impurities are removed from the inner ear, the facial sinuses, or even the brain itself. A number of other unproven health claims have been attached to this ritual.
Side effects: Candling does not always work, may add to the debris in the ear canal and poses several dangers, the most serious of which involve burning caused by the hot wax. People who have ear tubes, a perforated ear drum or a repaired ear drum should avoid candling.

Professional ear wax cleaning
We recommend the safer, and often less expensive, option of having a health care provider clean and examine your ears.
Health care providers remove ear wax with irrigation, suction or a small tool (curette). Occasionally, the wax must be removed with the help of a microscope. Cleanings can be scheduled routinely.

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