Why your ears make wax
Your ears are self cleaning! Ear wax is a completely natural substance that actually works to lubricate the skin in your ear canal and to kill germs. Ear wax is a mixture of the dead skin cells from your eardrum and ear canal mixing with an oil produced by the sebaceous glands. Normally, this mixture works its way slowly down the ear canal to the opening. Sometimes it gets built up and needs to be removed. Having a lot of ear wax is perfectly normal and doesn’t mean that you or your ears are dirty. Nothing needs to be done about it unless it is causing a problem.
Impacted wax can cause temporary hearing loss or tinnitus. It also can make your ears feel blocked and itchy. A truly sudden loss of hearing may be something more serious, it should be evaluated by your physician or an otolaryngologist, an ear specialist, as soon as possible to get the appropriate treatment. See your doctor if you have ear pain, drainage or bleeding. Although anyone can have a buildup of wax, it is more common for older adults. As we age the wax gets dryer and does not move as naturally down the canal. People who wear hearing aids are more apt to have ear wax that needs to be removed. Excessive ear wax can also block hearing aids and make them whistle when they are in your ear.
Should you clean your ears?
Ear wax that does not cause symptoms or block the ear canal should be left alone. Many people clean their ears by rinsing their ears gently with warm water in the shower and then drying them with a towel. Removing a little bit of wax from the opening of your ear canal and the folds of your outer ear using a tissue or face cloth is absolutely fine. Everyone has heard the saying “don’t put anything smaller than your elbow in your ears!” The ear canal is actually pretty narrow and something like a Q tip or a cotton swab can easily get stuck. Never use anything pointed or sharp like a bobby pin or tooth pick, you can seriously scratch the ear and cause an infection.
Using a cotton swab can be very satisfying, but it also can be very dangerous! Only use a cotton swab around the outer folds of your ear and at the entrance to the ear canal. Cotton swabs may remove some wax, but they often just push the wax in deeper and could make the blockage worse. There is always the very real danger of puncturing your eardrum or scratching the ear canal if you push the Q tip, or another foreign object, in too far or too hard. Audiologists, and others who look in your ears, can always tell if you use Q tips because cotton swabs leave a neatly packed wall of wax behind!
Ear wax removal drops are sold over-the-counter in pharmacies. They usually have a softening ingredient as well as a bubbling agent to remove the wax. Popular home remedies to remove excessive ear wax include using rubbing alcohol and diluted hydrogen peroxide. Unfortunately, both of these methods can be very irritating to the skin of your ear canal and may leave you with dry and itchy ears. Different oils have also been tried as a home remedy to remove wax, generally they will soften it but it still won’t come out on its own. Any procedure to remove ear wax should not cause any pain. If you put a liquid in your ear it might feel funny but should not hurt.
Softening the wax is really just the first step in removing it. It usually does not come out by itself. Often after you soften it, it may form more of a plug against the ear drum which can be very unpleasant. Some of the over the counter wax removal kits include a little bulb syringe which can be filled with warm water to flush out the softened wax. You have to be very careful to use water that is at body temperature so that the water does not make you dizzy. It also has to be clean water to avoid introducing bacteria into your ear. Washing your ears with water from a bulb like this is called irrigation and it can work well once the wax is softened. Irrigation should not be used if you have had any surgery on your ears or if you have had a hole in your ear drum. This is because the water could force the wax into your middle ear or cause damage to the ear. Irrigation is often used by doctors and audiologists to remove wax and is a very safe and effective procedure when done professionally.
Some home remedies, like ear candling, are dangerous. Ear candles are hollow cones of fabric coated with wax that are placed in your ear canal and lit with a match. The claim is that the warmth created by the flame creates suction which melts and pulls the wax out of your ear. The Academy of Otolaryngology has published clinical practice guidelines for ear wax removal, making it very clear that ear candling is not a safe or effective method. The FDA has also issued warnings to consumers that ear candling is unsafe. They have had reports of serious burns, damage to the ear and hearing loss. There are other self removal tools that look like little corkscrews and picks that are sold over the counter and online to remove wax. These should also be avoided because they are not very effective and can actually damage your ear canal and ear drum.
In conclusion, ear wax is a normal and natural substance that the ear uses to clean and lubricate the ear canal. If it is not bothering you, it should be left alone to do its job. Over-cleaning your ears, like with frequent use of cotton swabs, can leave your ears very dry and itchy. Some people do need to have the wax removed. It is generally safe to start by softening it at home and trying irrigation as long as you don’t have the conditions mentioned above. Many of the well known home remedies and over the counter ear drops will soften the wax but not completely remove it. Unfortunately, most of us are unable to look deep into our ears to check that it all gets removed. If your ears feel blocked, if you have tinnitus or increased hearing loss you should be checked by your healthcare provider or audiologist to have your ears evaluated and professionally treated.