If you want to get technical, the name for earwax is cerumen. Earwax is healthy and serves important purposes including keeping our ear canals lubricated. A lack of earwax could cause the ears to become dry and itchy. It also acts as a protective barrier to keep anything, from dust to critters, from getting too close to the tympanic membrane, also called the eardrum. The ear canal is made up of “migratory skin cells”. These skin cells grow in such a way that the dead skin helps to move cerumen out of the ear canal. There are some individuals, who require cerumen management or the removal of earwax by a professional because of excess build up. In these cases, I believe that the shape and size of some ear canals cause earwax to build up. If you have dry or hairy ears they tend to build up earwax more quickly as well.
A common cause of earwax not being able to move outward is the use cotton swabs or “Q-tips”. The ear canal is shaped like an hourglass tipped on its side. It is wide at the outermost portion, becomes narrow in the middle, and then becomes wide again at the innermost portion of the canal. For this reason, when a person puts a cotton swab in their ear, there is a good chance that the earwax may be shoved deeper into the narrow portion of the canal.
Earwax becomes a problem when it becomes impacted (blocks the entire canal). When earwax becomes impacted people typically notice hearing loss and some feel pressure or discomfort in the canal. In certain individuals, a buildup of cerumen can cause dizziness, though this is more rare. Many primary care physicians (or nurses in their offices) are trained in cerumen management. Some audiologists and most otolaryngologists (ear, nose, and throat physicians or ENTs) perform cerumen management in their offices. Many providers will request that you use a wax softening agent such as “DeBrox” prior to coming in for cerumen management. This helps the earwax to come out easier and makes the process more comfortable for the patient.
In the office, there are different methods of cerumen management including irrigation, suction, and manual removal with a curette. Irrigation utilizes a steady stream of water to get behind the wax and flush it out. Suction involves the use of a specialized vacuum. A curette is a pick-like instrument that is used to scoop or pull out earwax.
Patients often ask me how I clean my ears. In the shower, I let warm water fill my ear canal for just a few seconds and towel dry after the shower. When necessary, I visit an audiologist or ENT . I do not use cotton swabs, bobby pins, or anything else to try to pull out earwax. I follow, and recommend that you follow, the old adage “Do not put anything smaller than your elbow in your ear”.
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