Dealing with Ear Wax

Ear, Nose & Throat Care

By Dr Rekha Balachandran

Ear wax or cerumen as it called in medical terms, is produced by special glands in the ear canal. It serves as a cleaning agent with protective, lubricating and antibacterial properties.

Ear wax is produced in the outer part of the ear canal, not deep inside the ear. It moves out by itself, assisted by movements of the jaw. When the wax is pushed in too deep (usually due to cotton bud use) and presses onto the eardrum, it becomes painful.

Does the ear need to be cleaned?

The old saying that nothing smaller than your elbow should go into the ear, still holds true. Ears need to be cleaned only when there is so much ear wax that it causes symptoms (wax impaction). The symptoms of wax impaction are: ear pain or fullness; some degree of hearing loss; noises in the ear especially on chewing or moving the jaw; and ear itch.

How is impacted wax removed?

In most cases, impacted wax needs to be softened before it can be removed. You can try placing a few drops of baby oil or commercial wax solvent drops in the ear for a week or two.  After instilling the solutions, you need to massage the ear and lie down with the ear facing upward for about 5 minutes. Once the drops are instilled the wax will absorb the liquid and in some cases expand slightly, worsening the blocked sensation. A common mistake is to start using cotton buds after instilling the drops in hope of getting the wax out.  The cotton buds only causes the wax to impact further in the ear.

If you have a history of discharge from the ear or a suspicion that your ear drum may have a perforation, please consult a doctor before using any oil or wax solvent products as it may cause more harm.

Seeing an ENT doctor for wax removal is preferred when the ear canal is narrow, the eardrum has a perforation or a ventilation tube, if you have had previous surgery to the ear or when other methods have failed.  Wax removal is usually done by using a suction device and special miniature instruments under a microscope to magnify the ear canal.

Ear candling – a safe alternative?

Ear candles are not a safe option as they may result in serious injury. Ear candling has caused documented cases of ear obstruction due to the melted wax, burns and ear drum perforation.

Is there a way to prevent excessive wax build up?

There is no way to prevent excessive wax from building up. Those with narrowed ears, history of recurrent ear infections, ear surgery or radiotherapy to the head area are prone to excessive wax build up. However, inserting cotton-tipped swabs or other objects in the ear canal is strongly not advised.  If you are prone to repeated wax impaction or use hearing aids, consider seeing your doctor every 6 to 12 months for a checkup and routine preventive cleaning.

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