What Is Ear Wax?
Ear wax, or cerumen, is a substance our body creates to keep the ear canal clean and healthy. The noxious smell keeps things from crawling in and antimicrobials to help keep bacteria growth to a minimum.
What Causes Ear Wax?
There are two different glands that produce ear wax in the outer one-third of the ear canal. This secretion, along with dead skin cells and hair, make up the often-sticky substance. The glands are modified apocrine and sebaceous glands that work together to make ear wax (Stoeckelhuber et al, 2006).
Is It Safe to Remove Ear Wax?
When too much ear wax is produced, and it is prevented in some way to make its natural journey out of the ear canal, it can obstruct the ear canal. It is better to let the ear wax/cerumen naturally progress out of the canal and just wipe the entrance of the canal out with a clean cloth (National Library of Medicine, n.d.).
But sometimes a professional is needed to remove more impacted cerumen from the ear canal. If wax is very dry and has been in the canal for a long time, it can adhere to the canal wall and in some cases, a layer of skin can be taken when the wax is removed. It is better to have a trained, qualified professional remove it.
Should I Remove My Ear Wax?
Once an audiologist or hearing care professional can see the pattern of build-up and the type of ear wax is produced, a home plan can be made for safe removal at home. Safe ways to remove never involve ear candling or sticking anything foreign in the ear (such as “home remedy currents”) that can just be bought over the internet. The ear canal can have areas into the head that become very narrow, the isthmus, in which the ear cannot “push” the wax back out. Many times, when people try to do the removal without a professional at least in the beginning, they do more harm than good (McKenney, 2020).
How to Remove Ear Wax
Once an audiologist can determine if the ear drum is intact, if there is an over production, then a plan can be made for home removal. A note of caution, ear wax is there for a reason and under normal circumstances, self-cleaning by removing ear wax all of the time increases the chances of bacteria growth in the ear canal.
Many times, especially with hearing aid wearers, an audiologist will advise a wash a couple of times a year (can be different depending on the person and production) a rinse in the shower with body temperature water with a little hydrogen peroxide or apple cider vinegar in the water can be used.
There are also over-the-counter softening ear drops that help the wax dislodge from the canal walls as well. After the drops have set in the ear for a time, self-irrigation can be used. Do not use ear canaling or any sharp object in the canal on yourself or another unless specifically trained.
How Not to Remove Ear Wax
Although there are many options that appear on a web search, most are not safe for home use. The first one-third of the ear canal’s structure has cartilage beneath the skin, then the canal narrows as it enters the skull and under the layer of skin is bone. The skin is rather thin in the canal and even a wisp of cotton can scratch and in some cases a blood blister, or hematoma can form (Cedar Sinai, 2018).
As we age, this is more inclined to happen. The canal is not straight either, not being able to see what you are doing and not knowing the landscape can lead to abrasions and heighten the risk of infection.
Ear candling does not work; the “dirty” that shows from canaling is actually from the candle not the ear. Cotton swabs do more harm than good as well. People are not as gentle as they think, scratch the canal, and often push the wax too far down the canal to work its way out naturally.
What Is an Ear Wax Blockage?
When too much ear wax is produced, or prevented to work out of the ear canal, ear wax or cerumen can build up enough to block the canal. If the wax obstructs the canal completely it can inhibit hearing.
Symptoms of Ear Wax Blockage
You may have ear wax blockage if you feel a full-like sensation, or plugged-up clogged feeling may be present when there is a blockage. Itching, tinnitus (ringing in the ears), and sometimes dizziness may also be symptoms/signs of too much ear wax.
Who Is at Risk for Ear Wax Blockage?
Hearing aid wearers, especially those who have tight fitting or solid parts down into the canal may produce more ear wax. The body identifies the hearing aid as a foreign body and produces more wax to “push” it out. But the hearing aid is placed in the canal every day (or it should be!) and pushes back and at times, the wax may get pushed to the section of the canal in which it doesn’t migrate out of the canal.
Using cotton swabs to “clean” canals stimulates the glands to produce more wax, pushes it too far down the canal, and actually creates the blockage the individual was trying to prevent.
Who Should You See for Ear Wax Blockage?
A trained audiologist is the best professional to see, some state licensure laws prevent some to practice this specialty, so it is important to check state laws. But for many audiologists this is a favorite skill to use in clinic. Many insurance companies do not cover an audiologist to do this procedure and it is often an out-of-pocket expense, but well worth using the trained audiologist who works in this area daily.
Diagnosis of Ear Wax Blockage
An audiologist and other medical professionals use an otoscope to look into the ear canal. Some have a video version of an otoscope and the canal can be shown on a video monitor, which can be very interesting for those who want to learn more about their ear canals.
What to Expect During an Ear Wax Removal Procedure
There are different types of removal. Tools such as curette and alligator tweezers can be used to quickly remove most wax, especially if a complete blockage hasn’t occurred yet. Suction can be used to pull wax out and finally there is removal by irrigation. When irrigation is used, it is important the audiologist or medical professional use body temperature water, as having it too hot or too cold can cause vertigo since the ears balance center is very close to the ear canal (Seltzer, 1957; Nall, 2019).
How to Reduce the Risk of Ear Wax Blockage
Only use a soft clean cloth to clean the outside of the ears, see an audiologist regularly, and don’t stick anything down inside the ears, except hearing protection and hearing aids!
Think You Have an Ear Wax Blockage? Find an Audiologist.
If your ears have a full-like or clogged sensation, you may have an ear wax blockage. Find an audiologist near you to help remove your blockage and to put an at-home plan in place for ear wax removal.
Cedars Sinai. (2018) Is it really dangerous to clean my ears with cotton swabs? www.cedars-sinai.org/blog/is-it-really-dangerous-to-clean-my-ears-with-cotton-swabs.html (accessed June 22, 2022).
McKenney J. (2020) What is ear candling? WebMD. www.webmd.com/cold-and-flu/ear-infection/what-is-ear-candling (accessed June 22, 2022).
Nall R. (2019) What to know about ear irrigation. Medical News Today. July 25. www.medicalnewstoday.com/articles/325857 (accessed July 15, 2022).
National Library of Medicine. (n.d.) Medline Plus: Ear Wax https://medlineplus.gov/ency/article/000979.htm (accessed June 21, 2022).
Seltzer A. (1957) Vertigo: its relation to was in the swimmer’s ear. AMA Arch Otolaryngol. 65(5):466-468. https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/598062#:~:text=Au–ral%20vertigo%2C%20which%20may%20occur,the%20internal%20ear%2C%20or%20labyrinth (accessed July 15, 2022).
Stoeckelhuber M, Matthias C, Andratschke M, et al. (2006) Human ceruminous gland: ultrastructure and histochemical analysis of antimicrobial and cytoskeletal components. Anat Rec A Discov Mol Cell Evol Biol 288(8):877-84.