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Earwax is produced by glands in the ear canal. Although scientists are still not completely sure why we have earwax, its purpose is to trap dust and other small particles and prevent them from reaching, and potentially damaging, the eardrum. Normally, the wax dries up and falls out of the ear, along with any trapped dust or debris. Everyone makes ear wax but the amount and type are genetically determined just like hair color or height. Some people have ear canals that are smaller than average or shaped in a way that makes it difficult for the naturally occurring wax to get out of the canal causing wax impactions.
Blockage, or impaction, also occurs when the wax gets pushed deep within the ear canal. Earwax blockage affects about 6% of people and is one of the most common ear problems doctors see.
• The most common cause of impactions is the use of Q-tips (and other objects such as bobby pins and rolled napkin corners), which can remove superficial wax but also pushes the rest of the wax deeper into the ear canal.
• Hearing aid and earplug users are also more prone to earwax blockage.
Symptoms of an earwax impaction include:
• Decreased hearing
• Ear pain
• Plugged or fullness sensation
• Ringing in the ear
• Itching or drainage from the ear canal
WHEN TO SEEK MEDICAL CARE FOR EARWAX
If at-home removal of wax, using over the counter ear drops, is unsuccessful
If you suspect you have a perforated eardrum (recent ear infection, injury by something poked into the ear canal, sudden severe pain followed by ear drainage, sudden hearing loss, especially after a very loud noise, bleeding from the canal, or pressure change from scuba diving)
If you develop drainage from your ear
If you experience severe ear pain, fever, or continuing hearing loss
WHEN TO GO TO THE HOSPITAL
If you have a severe spinning sensation, loss of balance, or inability to walk
Persistent vomiting or high fever
Sudden loss of hearing
EXAMS AND TESTS
A doctor can diagnose earwax blockage (or eardrum perforation) by listening to your symptoms and then looking into your ear with an otoscope (ear-scope).
EARWAX TREATMENT AND SELF-CARE AT HOME
You may try a few earwax removal methods at home unless you have a perforation (hole) or a tube in your eardrum.
Over-the-counter wax softening drops such as Debrox and Murine or warmed mineral oil may be put into the affected ear and then allowed to drain out after about five minutes while holding the head to the side, allowing the drops to settle. Sitting up again will let the drops drain out by themselves.
A bulb-type syringe may be used to gently flush the ear with warm water. Ear-Clear is a warm-water irrigation device that is available online for about $25-30. It is very important not to use forced water such as a Water Pik, because this may cause damage to the eardrum.
Ear candling is not recommended. The procedure uses a hollow cone made of paraffin and beeswax with cloth on the tapered end. The tapered end is placed inside the ear, and an assistant lights the other end, while making sure your hair does not catch on fire. In theory, as the flame burns, a vacuum is created, which draws the wax out of the ear. Limited clinical trials, however, showed that no vacuum was created, and no wax was removed. Furthermore, this practice may result in serious injury.
MEDICAL TREATMENT FOR EARWAX BLOCKAGE
The doctor may remove your earwax with a small plastic spoon called a curette, or by irrigating your ear with warmed water, sodium bicarbonate, or other prescription-strength eardrops.
PREVENTING EARWAX BLOCKAGES
Earwax blockage can be prevented by avoiding the use of cotton-tipped swabs or Q-tips and other objects that push the wax deeper into the ear canal.
Complications of Earwax Blockages
• Perforated eardrum
• Middle-ear infection
• External-ear infection (swimmer’s ear )
• Permanent hearing loss from acoustic trauma