Ear Wax

One of the common conditions that patients present in my clinic is with problems associated with trying to clean their ears to get rid of the wax within with cotton buds, hair pins and all kinds of other probes. Let me start by saying that having ear wax is not necessarily a bad thing! A normal amount of wax in the outer part of ear is in fact good. Ear wax protects and lubricates the ear canal. It also has antibacterial properties and to some extent prevents the ear from infections. In fact, when there is no wax in the ear it becomes in a dry, itchy and prone to infections. There is no need to try to “clean” your ears. Spare yourself that effort! There is already a self-cleaning mechanism in place. The skin lining the ear canal sheds and moves in a slow and orderly manner migrating towards the outer ear. In the process of this migration, the shed skin cells or keratin and the earwax move outwards towards the ear opening from where it simply falls off. Earwax formed in the outer part of the ear canal.  Attempts to remove the ear wax results in pushing it deeper into the ear canal.  Any ear wax is seen in the deep ear canal near the ear drum is likely that it has been pushed in.  Once the wax is lodged in the deep ear canal it becomes difficult for it to migrate outwards and it keeps accumulating. There may not be any symptoms. Only when the wax comes into contact with the ear drum will the patient experience pain or hearing loss. When the wax gets water logged it expands and may cause blockage of the ear. Wet wax may also predispose to fungal infection resulting in a painful ear. Symptoms of impacted ear wax may include:

• Earache, fullness in the ear
• Partial hearing loss, which may be progressive
• Tinnitus, ringing, or noises in the ear
• Itching, odour, or discharge

Treatment of Impacted Wax is to remove the wax. Dry, hard impacted wax can be difficult and painful to remove. To clean the ears, wash the external ear with a cloth, but do not insert anything into the ear canal. It is prudent to soften the wax prior to removal. This may be achieved with home remedies such as few drops of mineral oil, baby oil or glycerine. Several commercial preparations are also available over the counter. Detergent drops such as hydrogen peroxide or carbamide peroxide may also aid in the removal of wax. Irrigation or ear syringing water and saline is commonly used for cleaning. Ear syringing is most effective when water, saline, or wax dissolving drops are put in the ear canal 15 to 30 minutes before treatment. Manual removal of earwax is also effective. This is most often performed using suction, special miniature instruments, and a microscope to magnify the ear canal. Manual removal is preferred if your ear canal is narrow, the eardrum has a perforation or tube, other methods have failed, or if you have diabetes or a weakened immune system.