Ear wax is a normal body substance produced by glands in the ear canal. It is called cerumen. It is a substance made of a bodily secretion, skin cells, dirt, and hair. Cerumen is produced to protect the ear. It is meant to trap objects, dust, debris and bacteria from entering deeper into the ear canal and damaging the ear. Cerumen is our body’s way of self cleaning the ear. Some people produce excessive wax just like some people sweat excessively. Sometimes wax becomes trapped in the ear canal because the canal is narrow. Wax can become harder and drier with age making it more difficult to expel. There is no hygienic reason to rid one’s ear of wax. It does not cause harm unless it becomes excessively built up and pushed deep into the ear canal impacting against the eardrum causing a temporary hearing loss. Some people make more and others make less. The consistency, color, and make up of earwax can depend on age, ethnicity, environment and diet. Research indicated that most people of Asian descent have dry ear wax while African and European descent more often have a sticky or wet consistency. Wax can change color. The darker it is, the longer it has typically been in the ear.
However, if ear wax smells it should be evaluated. Smelly ear wax is usually a sign of an underlying infection or other medical condition behind the ear wax. It is best to see a doctor for wax removal and for inspection of the ear after removal to check for infection.
What causes smelly ear wax?
Excessive ear wax can trap bacteria or water causing an ear infection or swimmer’s ear type of infection. A smell usually indicates an infection of some type. Ear infections can be bacterial or viral. Ear infections often cause drainage and can have a bad smell.
Swimmer’s Ear typically is an infection that occurs with water being trapped in the ear canal harboring bacteria. Excessive ear wax can trap water behind it making one more prone to ear infections. A foreign object in the ear could also lead to bacterial build up around the object or cause water to be trapped behind it. Excessive wax could form around it as a method of the body trying to expel a foreign object. A more serious medical condition that often has smelly ear wax as a side effect is a cholesteatoma. Cholesteatoma is a noncancerous growth in the middle ear that when left untreated can damage the middle ear and inner ear structures, ultimately leading to permanent damage to hearing and balance systems. Cholesteatomas often lead to ear infections with a constant discharge. Cholesteatomas are serious due to expanding growth into the inner ear and need to be closely monitored. Surgical removal is often needed. Another serious medical condition to rule out is ear cancer. Cancer growing in the middle ear and ear canal can cause a breakdown on the thin skin in the ear canal due to necrosis. This can lead to skin infections where smelly discharge and bloody discharge is common.
How is smelly ear wax treated?
Many people attempt to clean wax themselves before seeing a professional. Q Tips are the most common tool used to remove wax at home and often cause the most problems. Most of the time a Qtip will just push the wax further and it could be impacted against your ear drum. Over the counter kits like Debrox can work to soften and flush out wax. Often excessive wax becomes too hard and deep to be removed at home. Stay away from ear candling. Ear candling has been known to cause injury with burns to the face, outer ear and ear canal and do little to actually remove the wax. Professionals are able to remove even impacted deep wax with lighted tools, softening agents The use of suction and irrigation may be needed for deep hard wax. A new method of removal is the earigator. It is a machine made to irrigate the ear with water but the water pressure is regulated to withstand the pressure of the eardrum without damage. If you have smelly ear wax, see any ENT (Ear, Nose, and Throat Doctor) An ENT has the proper skills and tools to not only remove the wax, but to see what is the cause of smelly discharge (infection or other medical condition) Wax can be removed by softening with the use of peroxide or other over the counter softening agents and removed professionally with a pick, suction or water irrigation. The Dr. will evaluate if ear drops or further medication is needed to manage the infection.
What is the outlook for smelly ear wax?
The good news is ear wax is easily removed by a trained physician or audiologist. The majority of cases will simply be due to an ear infection easily treated with drops. However it is always best to see an ENT who can evaluate the ear and ensure a healthy ear canal and middle ear space.
Do I have too much earwax?
Wax is not a problem unless it blocks hearing, causes discomfort or is smelly, indicating an underlying medical issue.
Bottomline
If you believe you have excessive wax, call your Primary Care Doctor, Audiologist or ENT for removal. Resist the urge to stick a Qtip deep in your ear for removal and risk injuring the ear canal or your eardrum. Leaving excessive ear wax alone in the ear can cause hearing loss, pain, pressure, discomfort, and even dizziness and ringing in the ears. If you have pain, discomfort, or a foul odor, call your ENT for a full treatment and evaluation of the ear.
