Ear wax (cerumen) is one of the human body’s defense systems. The body secretes ear wax to protect your ears in multiple ways:
- Lubricating the ear
- Slowing bacterial growth
- Trapping dirt and other debris that can damage deeper ear structures
- Cleaning debris out of the ear canal by shedding the wax
Causes of ear wax blockage
Normally, the ears regulate ear wax production and self-clean. A small amount of wax moves to the opening of the ear, naturally washing away or falling out. New wax is secreted to replace it. However, sometimes the ear can become clogged with too much wax, which can harden and become impacted within the ear.
A medical cause of ear wax blockage is unknown, though some individuals may overproduce ear wax. Most frequently, people cause a blockage when trying to remove ear wax themselves. Cleaning ear wax using cotton swabs (Q-tips), hair pins, paperclips or other objects often pushes the ear wax deeper into the ear canal instead of cleaning it out. You can also injure your ear or rupture your eardrum.
Signs and symptoms of ear wax blockage
Signs and symptoms of earwax blockage may include one or more of the following:
- Feeling of pressure or “fullness” in the affected ear
- Ringing in the affected ear (tinnitus)
- Hearing loss in the affected ear
- Itchiness in the affected ear
When to see your doctor or audiologist for an ear wax blockage
The inner structures of your ear are delicate and can be damaged easily by excess earwax. If you are experiencing signs and symptoms of a blockage, you should not try to remove the blockage yourself. You may not even have a blockage, as the symptoms may indicate a different medical problem. There is no way to diagnose an ear wax blockage without having someone else look inside your ears.
You should never try removing excess ear wax in these situations:
- You have had ear surgery
- You have a rupture (hole or perforation) in your eardrum
- You are having ear pain or drainage
Attempting to remove blockages yourself may result in temporary or permanent ear damage. Your doctor or audiologist can diagnosis an ear wax blockage by looking inside your ear with an endoscope.
Ear wax removal treatments
Your doctor may use one or more techniques to dislodge the impacted ear wax.
Micro (meaning microscope) suction requires detailed ear anatomy knowledge and training on how to safely use the equipment required. Usually, microsuction is performed by ear, nose and throat specialists (ENTs), surgeons, audiologists and sometimes nurses who have had further training. Microsuction does not use any liquid and is safe to use after ear surgery or with a perforated eardrum.
A microscope and a bright light are used to see inside your ear. A pump attached to a tube is then used to suction out only the ear wax blockage. This procedure is thought to be safer than flushing or irrigation.
Your audiologist or doctor uses a bulb syringe full of warm water to flush the wax out of the ear. To try and loosen the wax before flushing, the doctor may allow a small amount of water sit in the ear. This method may cause minor discomfort and dizziness or nausea may be present during the procedure. Flushing isn’t always effective and there is a chance that bacteria may enter the ear during the process.
Your doctor may opt to use a water pick/spray device instead of a bulb syringe to irrigate and flush out the blockage. However, this is not the preferred method for ear wax removal, as it causes discomfort and has the potential to damage the ear. If you have or suspect you have a ruptured eardrum, tell your doctor immediately. This procedure should never be done on a patient with a ruptured ear drum due to the risk of infection.
Curette or cerumen spoon
Some research indicates this to be the best and most effective method of ear wax removal. A curette is a small curved instrument, which detaches the wax from the canal and pulls it out carefully. It looks like a tiny spoon with a long handle. Using an endoscope or microscope to see inside the ear canal, the curette scoops out the ear wax. Most of the time, this method is comfortable, though depending on the patient, some minor discomfort may be felt.
Candling is considered an alternative medicine procedure. In this method, a lit, hollow, cone-shaped candle is placed into the ear. In theory, the heat from the candle creates a vacuum seal and the ear wax should adhere to the candle.
This treatment is not recommended for ear wax removal. Research has shown it is ineffective and may be dangerous, resulting in burns, ear canal obstructions, perforations in the ear drum, infections, and other injuries. According to the American Academy of Otolaryngology guidelines, based on current evidence, “Clinicians should recommend against ear candling for treating or preventing cerumen impaction.” Talk to your doctor before trying any alternative remedies for removing earwax.
Self-care techniques: ear wax home prevention and removal
In cases where your ear is normally healthy (no tubes or ruptured ear drum), you may use self-care techniques to help keep ear wax from building up or remove any excess ear wax that may be blocking the ear canal.
Most of the time, the outer ear may expel a small amount of wax, which can be removed by wiping it using a clean wash cloth over your finger. If earwax buildup is a recurring problem, your doctor may recommend that you use a wax-removal medication, such as carbamide peroxide. Debrox and Murine are two common brands.
Ear wax removal drops
These solutions often use hydrogen peroxide, oils or other solutions to soften the earwax, allowing the wax to dislodge on its own. Hydrogen peroxide is thought to help the wax bubble up and therefore soften the wax.
Because these drops can irritate the delicate skin of the eardrum and ear canal, carefully follow the directions enclosed in the box to avoid injury. Though ear wax drops may contain hydrogen peroxide or other oils, some research has found that distilled water alone often works best. Either option is safe for home use.
You can also make a solution at home with a 1 to 1 ration of water and vinegar; or, use drops of hydrogen peroxide. Caution! Speak with your doctor before using any home remedies.
There is some conflicting research on the safety of performing home irrigation. Some research indicates that it prevents up to half of ear wax blockage cases needing to be removed by a doctor. However, irrigation opens the ear to injury and infection, whether performed at home or in a doctor’s office. The softening agents may also cause further blockage by only loosening the outer layer of the wax, causing it to lodge deeper in your ear canal or against your eardrum, causing pain. If you choose to try home irrigation, talk to your doctor first.
- First, soften the wax. Use a clean dropper to apply a few drops of baby oil, mineral oil, glycerin, olive oil or hydrogen peroxide in your ear canal. Wait 24 to 48 hours.
- Second, squirt warm water into your ear. After the wax is softened, use a rubber-bulb syringe to gently squirt warm water into your ear canal. Distilled water may be best. Tilt your head to avoid the water spilling out. You should also pull your outer ear up and back to straighten your ear canal. When you have finished squirting the warm water, tip your head the other way to let the water drain out.
- Third, dry your ear canal. Gently dry your outer ear with a clean cloth or hand-held (hair) dryer.
You may need to repeat this technique a few times before the excess earwax falls out. If your symptoms don’t improve after a few tries, you need to see your doctor.
Caution! Never try to “dig out” the ear wax blockage
It’s tempting to try and dig or pry out the blockage, especially if it’s causing pain or irritation. Put that Q-tip down though. As previously mentioned, trying to dig out ear wax with items such as cotton swabs, paper clips and hair pins usually pushes the ear wax deeper into your ear canal and can cause serious damage to the lining of your ear canal or eardrum. Some damage may even be permanent.
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