Ear wax is a mixture of secretions from glands and exfoliated skin. It is a normal substance in the ear canal. As wax migrates out of the ear, it may mix with hair and other particles. Ear wax protects the skin of the ear canal and kills germs.
Most people do not need a regular schedule to prevent ear wax build up. The body has a natural mechanism of eliminating ear wax, it slowly migrates outwardly. Some people may need to have their ears cleaned at times.
Ear wax build up or impaction may be caused by the following factors:
- Narrow ear canal-some people have narrow ear canals and others acquire narrow ear canals after injury or multiple outer ear infections
- Obstruction in the ear canal-any growth in the ear canal that causes obstruction may lead to ear wax build up.
- Diseases of the ear-this make it difficult for ear wax to come out, e.g skin problems that cause a lot of skin cells to shed and cause ear wax build up
- Too much ear wax production-some people make more ear wax than others and this may lead to ear wax build up.
- Age-related changes in ear wax or lining of the skin-as we age, ear wax gets harder and thicker. This makes it harder for the natural ear cleaning mechanism to be effective.
- Bad cleaning habits-some people use cotton buds to try clean out their ears. This tends to push the ear wax deeper into the ear canal instead of out. This gradually leads to ear wax impaction.
The symptoms of ear wax impaction include:
- Trouble hearing
- Ear discomfort
- Tinnitus or ringing in the ear
- Pain in the ear
- Ear fullness or feeling like the ear is plugged
There are several treatments to remove impacted ear wax. These treatments are offered only to people who have bothersome symptoms. They do not recommend treatments for removing ear wax in people who have no symptoms, even if their ears are impacted.
In some cases, ear wax is removed in people whose ears are impacted and who can’t clearly explain their symptoms. This can include young children, elderely adults, and people who have trouble thinking clearly.
There are several different ways to remove ear wax:
- Ear drops – Special ear drops can soften ear wax and help it to drain out. Ear drops are not usually safe for people with an ear infection or damage to the eardrum.
- Rinsing – In some cases impacted ear wax can be removed by squirting water into the ear to rinse it out.
- Special tools – Use of a special tool to remove ear wax. There are different types of tools that can do this safely. These include small sticks, hooks, and spoons. There are also tools that use suction to pull the wax out.
The procedures used to remove ear wax do not cause pain. Ear irrigation may cause you to feel funny but will not hurt.
If the ear canal is completely blocked by ear wax, then removal of ear wax should return your hearing to pre-blocked levels.
Cotton buds can remove some wax but they tend to push the ear wax deeper into the canal eventually leading to ear wax build up.
Most patients with conditions predisposing to ear wax accumulation (eg, eczema, outer ear infections) cannot prevent recurrent episodes of ear wax accumulation and the need for ear wax removal.
If you have a history of recurring symptomatic ear wax impaction (>once per year despite ear wax removal) and otherwise normal ears use a cotton ball dipped in mineral oil and place in the external canal for 10 to 20 minutes once per week (combined with eight hours of not using a hearing aid overnight, if applicable). This helps to liquefy the ear wax and aid the normal elimination mechanisms, thereby potentially reducing the number of visits per year for ear wax removal.
Routine cleaning of the ears by a doctor or nurse every 6 to 12 months is also suggested.
Chronic and routine use of cotton buds or ear drops that remove wax should not be performed.
The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.
- Schwartz, Seth R., et al. “Clinical practice guideline (update): Earwax (cerumen impaction).” Otolaryngology–Head and Neck Surgery1_suppl (2017): S1-S29.