Ear Wax

Excessive earwax, or cerumen, is not a glamorous topic, but is one of the most common reasons for a trip to the ear, nose and throat doctor. Wax impacted in the ear canal most commonly leads to ear blockage and hearing loss, but can also cause pain, and sometimes contribute to infection and dizziness. Removing the wax impaction generally leads to rapid relief of these symptoms.

What is earwax and why do we have it?

Specialized glands in the skin of the outer half of the ear canal secrete wax into the ear canal. The wax serves a number of functions. Among these are lubrication of the skin of the canal, assisting in cleaning foreign debris from the ear canal, and protection against invasion of the skin by bacteria and fungi. The skin of the ear canal migrates slowly outward, dragging wax and any adherent particles toward the ear opening. When this mechanism is functioning as intended, the ear canal should be “self-cleaning.”

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How does a wax impaction develop?

Wax becomes impacted in the ear for a variety of reasons. Probably the most common cause is the habit of using Q-tips to try to clean the ears. This is an extremely common routine for many people, but has the tendency to create the opposite and unintended effect of actually pushing earwax deeper into the ear canal, where it builds up and becomes impacted.  Wax buildup also occurs more commonly when hearing aids or earplugs are used, since these also may interfere with wax migrating out of the ear canal. Sometimes, the consistency of a particular individual’s wax, or the condition of the ear canal skin may promote wax buildup.

How do you “clean” the ears?

Most individuals are best off leaving the ears alone, rather than taking routine steps to “clean” the ears. Since the ears are designed to be “self-cleaning” avoiding Q-tips and other similar objects, goes a long way toward avoiding the tendency of these objects to tamp down the wax against the eardrum. If you feel you must do something to remove wax from the ears, the over-the-counter kits designed to soften wax so that it can later be rinsed from the ear canal are occasionally effective. Alternatively, you can dribble hydrogen peroxide into the ear canal to try to achieve the same effect. The most expeditious way to deal with excessive or impacted earwax is to see your ear, nose and throat doctor to have it removed under direct vision using the ear microscope.

Tips on treating earwax:

  • Do not use Q-tips
  • Over-the-counter wax removal drops can be tried, but are frequently ineffective.
  • See your ear, nose and throat doctor for removal of impacted earwax.