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Ear Wax  

Introduction to Ear Wax

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Ear wax, also called cerumen is produced in the outer ear canal and additional stuff like oil, sweat and dead skin. The major component of ear wax is keratin, which is formed from the dead cells. Formation of ear wax is a part of body’s defense mechanism and is necessary for trapping dirt and preventing the microorganisms from reaching the tympanic membrane or the eardrum, thus causing harm to it and later damaging the middle and inner ear. While the presence of very little wax in the ear increases the threat of infection, extra wax may also cause infection and hearing loss.

There are two types of ear wax.

  • Dry wax: This is also known as rice-bran wax and contains 20% fat.
  • Wet wax: This consists of approximately 50% fat. It can either be hard or soft.


Problems caused owing to excess wax:

PIn most cases, accumulation of ear wax is moderately harmless, and can be easily treated. The following problems may arise if there is excessive accumulation of ear wax, leading to the formation of a wax plug.

  • Ache in the ear.
  • Feeling of fullness in ear.
  • Mild deafness.
  • Trapping of bacteria in the wax, leading to infections.

 


Signs and Symptoms of Ear wax    

  • Ear pain
  • Reduced hearing
  • Hearing loss
  • Ringing in the ears
  • Sensation of fullness in the ears

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Causes of Ear Wax

Blockage owing to ear wax is caused when the wax is pushed deep inside the ear canal. The major causes include the following:

  • Usage of things like ear buds, hairpins, safety pins and rolled napkin corners to clean the ears.
  • Usage of earplugs and hearing aids.

 


Diagnosis of Ear Wax

Ear wax blockage is diagnosed by a detailed history and also examination of the ear using an instrument called the otoscope.  

 

Treatment of Ear Wax

An otologist or a professional treats the ear wax through direct visualization or the doctor should have access to a microscope. A small plastic spoon called a curette can be used to remove wax.

Other methods used include the following:2

  • Irrigation method, which is conventional and widely accepted.
  • Water jet devices.
  • Candling method.

All these methods do have their advantages and disadvantages; hence, the physician takes care, such that no harm is caused to the middle ear.

 

Different methods of removal of ear wax

Cerumenolytics:
These are the wax softeners, which partially dissolve and soften the ear wax. A cerumenolytic is instilled 15 to 30 minutes prior to irrigation. Other than the commercial medicinal ones, baby oil, mineral oil, and glycerine can also be used for this purpose.

The chosen cerumenolytic agent is brought to body temperature prior to use to prevent vertigo. The patient lies down with the affected ear up. Couple of drops are poured in that ear. The patient is supposed to remain in that position to retain the liquid in the ear.

Irrigation:
This is also widely known as “syringing”. Water, saline, commercial prescription-strength eardrops, and hydrogen peroxide can be used to irrigate or syringe the ear. With the head upright, using a bulb syringe, the liquid is squirted into the ear canal, aiming at the roof of ear canal. This can be repeated couple of times for a satisfactory result. Once irrigation is done, drops of alcohol are rubbed into the ear to dry up the water. 

Curettes and loops:
When the ear wax is particularly thick or resistant to removal, a curette is often used in the physician's office. It is a loop of wire that is used to hook and remove the wax. It is important to understand that this procedure is little tricky and needs professional medical expertise as it can damage the ear drum.

 

 OTC medication for ear wax

Over-the-counter ear wax removal drops can be either water based or oil based. Water based ones are a composition of hydrogen peroxide, sodium bicarbonate, and acetic acid.

Among oil based organic solutions are olive oil, propylene glycol, glycerine, and others. These preparations are best for small to moderate amounts of wax. Some preparations are enzyme based, although they are not as advisable because of known allergic reactions.

Earwax removal kits are also available in stores and can be effective in removing wax build up. Prior to using them, do talk to your doctor for the correct method of use.

 

Home Remedies

Ear buds - a strict no-no: Though these might sound most convenient and easy to grab but are not recommended as ear buds can further push the wax deeper in the ear canal, making it all stacked up.

Tried and tested remedy: The safest home remedyis to dissolve the wax with a solution of paraffin (or mineral) oil for 4-5 days. Then syringe the ear with a warm 1:1 water-vinegar solution. The preferred is apple cider vinegar.

 

Self care of the ear wax 

  • Use OTC eardrops, earwax removers, or mineral water to soften wax.
  • Use an index finger wrapped in a warm washcloth to remove wax from outermost area of the ear after bath.
  • Never push objects such as cotton buds, swabs or clips into the ear canal in an effort to dislodge wax.
  • Direct a jet of warm water (not hot) at the outer ear in to soften and loosen wax, then wipe it off with a clean towel.
Do not ignore the following symtoms 
  • Earache, fullness in the ear, or a sensation that the ear is plugged
  • Partial hearing loss, which may be progressive
  • Tinnitus, ringing, or hearing noises in the ear
  • Itching, odour, or any discharge
Word of caution 
  • Do not put any medication without the doctor’s permission if there is a perforation (hole) in the ear drum.
  • Refrain from sticking hairpins, paper clips, ear buds, match sticks, and other such things inside the ear.

Remember: In terms of cleaning and hygiene, here rules are little different. Taking proper care of your ears doesn’t mean cleaning them daily. Understand that earwax is a natural, self-cleaning agent that should not be repeatedly and regularly removed, unless it causes a health problem.

 

Do's and don'ts of ear wax

Do's

  • Try eardrops containing a wax solvent.
  • Dry the inside of your ear with a hair dryer set on low after showering or shampooing your hair.

Don’ts

  • Do not use cotton swabs, bobby pins, or other objects to clean the ear.
  • Do not try to remove earwax if you have ear pain or a discharge that looks    different than earwax, if you suspect a ruptured eardrum, if you have had ear surgery, or if you have tubes in your ears.

 

Advice from your doctor

Your doctor can:

  • Remove excess wax using a small, curved instrument called a curette.
  • Flush out the wax using a water pick or a rubber-bulb syringe filled with warm water.
  • Remove excess wax using suction while inspecting the ear with the aid of a microscope.
If earwax buildup is a recurring problem, your doctor may recommend wax-removal medication, such as carbamide peroxide, every four to eight weeks as a preventive measure. These drops can irritate the delicate skin of the eardrum and ear canal, hence should be used sparingly and only on the advice of your physician.

Written by: Healthplus24 team
Date last updated: October 01, 2012