Many people suffering from earwax (also called cerumen) build-up will often complain of feeling plugged up, or are experiencing symptoms like crackling noises, the sensation of fullness, popping or muffled sounds. When I hear someone ask, “How should I clean my ears of earwax?” I typically reply, “don’t do it!” Most people have no idea how much earwax might be in the outer ear canal, let alone the exact location. Going after the earwax yourself can have a ripple of negative side effects. However, if you have a trusted person to help you with the process, you can be successful and safely remove non-occluding earwax buildup from the outer portion of the auditory canal.
Why Your Ears Make Wax
Earwax is produced by a process similar to when our bodies sweat. It secretes from your sebaceous glands from the outer third of your ear canal and combines with skin and hair cells that shed. Earwax is meant to protect and lubricate our ears. The substance can appear anywhere from oily, to soft and sticky, to quite hard. Earwax buildup can vary in color from yellowish-orange, to light brown or a dark brown. The earwax has antibacterial qualities, and it is meant to trap dirt, bugs, and other materials from traveling too far down your ear canal. Not having enough earwax can result in itchy ears. It is generally considered healthy to have some earwax in the canal, and it is best just to leave it alone.
Do’s and Don’ts of Ear Cleaning
Our bodies are designed to make earwax move out toward the outer ear (concha bowl) as we smile, talk and chew. Once in the bowl area, it can be removed easily with a washcloth or cotton swab.
If earwax needs some help moving into the bowl area, you can lie on your side and have another person lift up and back on your outer ear (pinna) and administer a couple drops of mineral oil or glycerin. The movement of the pinna helps to straighten out the ear canal, and the mineral oil or glycerin will travel down the canal and soften the wax. If the canal is not straightened, the oil may never reach the target. After 5-10 minutes, you may sit up and prepare to use a tissue to wipe the excess oil and earwax from the concha bowl. Your local pharmacy will also carry earwax removal systems where an oil and chemical are pre-mixed to work a little more aggressively to soften the wax when you insert it into the canal opening. The kit may contain a bulb syringe which can be used to direct warm water (irrigate) into the canal to help push the wax out of the ear canal and into the bowl.
If you try the irrigation method at home, either with a bulb syringe or an attachment to a water pick, be very careful as the wrong water temperature can create a feeling of dizziness and too hard of pressure can cause the water force to rupture the eardrum.
Warm water and a gentle pressure is the best combination. Irrigation can be messy, so be sure your helper has you over a sink or that a catch basin is available!
If you feel pain after irrigation or suspect the eardrum was ruptured, seek medical help immediately. There is a high risk of infection to the middle ear once the eardrum barrier has been broken and impurities from the outer ear canal reach the middle ear space. Even if the eardrum is left intact, water remaining in the outer ear canal can also occasionally trigger an outer ear infection, so drying the ear with a drop of alcohol/peroxide placed in the canal or using low heat from a hair dryer on a gentle setting can be helpful to remove moisture after an irrigation.
One method for wax removal that is NOT recommended is an ear candle. The earwax is just too heavy to actually move based on the suction created by the candle. I have witnessed ash left in an ear canal, along with the cerumen they were attempting to get out, so it really does not clean out the canal. I have also heard reports of burns resulting from the use of ear candles from my local ENT doctor; he states the burns in the canal are difficult to heal properly.
Proper tools like an otoscope or a pen light will help you to see better down into the canal, if you are going to attempt earwax removal. Avoid sharp objects in the ear, as lacerations to the ear canal can bleed easily and may take time to heal. People that are on blood thinners or are diabetic are at a higher risk for injury and infection if the removal is not done properly.
What Happens When Too Much Wax Builds Up In The Ear?
Unfortunately, if there is a lot of earwax to begin with in an ear canal, adding water or oil can cause it to expand and completely occlude the ear. Occlusion of an ear canal can also occur when a cotton swab or other device has been pushed deeper than the first part of the canal opening. Pushing too far results in the earwax getting stuck in the curved area of the canal, where there is less movement to help it move out naturally. If a person keeps pushing a cotton swab, ear plug or other object into the canal, earwax can eventually “build a wall” and create a complete blockage or impaction of wax.
Symptoms Of Impaction
When an impaction occurs, sound will be muffled, tinnitus (ringing in the ear) can get louder, and discomfort may occur. If an impaction is suspected, don’t attempt to clean the ear yourself – contact your audiologist or medical professional for assistance.
When To See A Professional
You should also see a professional if you have a decrease in hearing, pain, itching, discharge or an odor coming from the ear. An ear infection in the outer ear is possible after earwax removal and may require medication to clear. It should not hurt to hear and any decrease in hearing needs attention quickly.
Bottomline: Should You Clean Your Ears?
Bottom-line: leave your earwax alone as much as possible. Your ears were designed to be self-cleaning and the process works most of the time. The daily use of a cotton swab may actually over-dry the skin and irritate the ear canal. Irritation, in turn, can cause itching and the need for a topical cream to resolve. If you are concerned about the way your ears feel, or if they might need cleaning, ask a professional to determine your best course of treatment.
