Doctor, explain earwax
Insight into causes and treatment of
Never put anything smaller than your
elbow in your ear! Cotton swabs are for cleaning bellybuttons-not ears. You have
probably heard these admonitions from relatives and doctors since
childhood...read on to find out what they meant.
The Outer Ear and
CanalThe outer ear is the funnel-like part of the ear you
can see on the side of the head, plus the ear canal (the hole which leads down
to the eardrum).
The ear canal is shaped somewhat like an
hourglass-narrowing part way down. The skin of the outer part of the canal has
special glands that produce earwax. This wax is supposed to trap dust and dirt
particles to keep them from reaching the eardrum. Usually the wax accumulates a
bit, dries out and then comes tumbling out of the ear, carrying dirt and dust
with it. Or it may slowly migrate to the outside where it can be wiped off. The
ear canal may be blocked by wax when attempts to clean the ear push wax deeper
into the ear canal and cause a blockage. Wax blockage is one of the most common
causes of hearing loss.
Should You Clean Your
Ears?Wax is not formed in the deep part of the ear canal
near the eardrum, but only in the outer part of the canal. So when a patient has
wax blocked up against the eardrum, it is often because he has been probing his
ear with such things as cotton-tipped applicators, bobby pins, or twisted napkin
corners. These objects only push the wax in deeper. Also, the skin of the ear
canal and the eardrum is very thin and fragile and is easily injured.
Earwax is healthy in normal amounts and serves to coat the skin of the
ear canal where it acts as a temporary water repellent. The absence of earwax
may result in dry, itchy ears.
Most of the time the ear canals are
self-cleaning; that is, there is a slow and orderly migration of ear canal skin
from the eardrum to the ear opening. Old earwax is constantly being transported
from the ear canal to the ear opening where it usually dries, flakes, and falls
Under ideal circumstances, you should never have to clean your ear
canals. However, we all know that this isn't always so. If you want to clean
your ears, you can wash the external ear with a cloth over a finger, but do not
insert anything into the ear canal.
What are the symptoms of wax
- partial hearing loss, may be progressive
- tinnitus, noises in the ear
- fullness in the ear or a sensation the ear is plugged
Most cases of earwax blockage respond to home
treatments used to soften wax if there is no hole in the eardrum. Patients can
try placing a few drops of mineral oil, baby oil, glycerin, or commercial drops,
such as Debrox®, or Murine® Ear Drops in the ear. These remedies are not as
strong as the prescription wax softeners but are effective for many patients.
Rarely, people have allergic reactions to commercial preparations. Detergent
drops such as hydrogen peroxide or carbamide peroxide may also aid in the
removal of wax. Patients should know that rinsing the ear canal with hydrogen
peroxide (H2O2) results in oxygen
bubbling off and water being left behind; wet, warm ear canals make good
incubators for growth of bacteria. Flushing the ear canal with rubbing alcohol
displaces the water and dries the canal skin. If alcohol causes severe pain, it
suggests the presence of an eardrum perforation.
When Should I See My
If you are uncertain whether you have a hole (perforation or puncture) in
your eardrum, consult your physician prior to trying any over-the-counter
remedies. Putting eardrops or other products in your ear in the presence of an
eardrum perforation may cause an infection. Certainly, washing water through
such a hole could start an infection. In the event that the home treatments
discussed in this leaflet are not satisfactory, or if wax has accumulated so
much that it blocks the ear canal (and hearing), your physician may prescribe
eardrops designed to soften wax, or he may wash or vacuum it out. Occasionally,
an otolaryngologist (ENT specialist) may need to remove the wax using
What are other possible causes of
- perforated eardrum
- middle ear infection (otitis media)
- external ear infection (otitis externa)
- acoustic trauma
© 2004 AAO-HNS/AAO-HNSF
Please read our disclaimer. Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with Dr. Hector N. Hernandez or other healthcare professional. If you have a medical problem, contact us for diagnosis and treatment.