How to remove earwax safely

“Sometimes, trying to clean them causes more problems than it’s worth,” “Ears are like self-cleaning ovens. When the outer layer of skin in the ear canal sheds, the wax will fall out with it.”

What is earwax and what is its function?

Ear wax (cerumen) is produced by the ear to clean and protect itself.

Ear wax lubricates and cleans the ear canal by trapping micro-organisms, dirt and other irritants and migrating them out of the ear.

Sometimes, the wax builds up and becomes compacted, known as ‘earwax impaction’. This can lead to symptoms such as mild deafness and a sensation of fullness inside the ear.

How common is earwax impaction and what are its implications?

2-6% of the population suffer from ear wax impaction. It’s often experienced in patients over 65 years of age with up to 65% of over 65s reporting impaction. Effects can include hearing loss, pain, itching, tinnitus, vertigo, painful inflammation of the ear and chronic cough.

What causes earwax build up?

Some people are prone to produce more earwax than others; and excess wax doesn’t automatically lead to blockage. Using cotton tips can push wax deeper and is not a recommended way to remove ear wax.

Below are some common causes of earwax build up:

– Overproduction of ear wax: Ears can simply produce more wax than is possible to move naturally out of the ear.

– Cotton tips: The use of cotton tips to clean the ear may push wax deeper into the ear, making it more difficult to remove.- Physiology: A narrow ear canal can hinder the natural removal process and ear wax can accumulate.

– Hair: A large amount of hair in the ear canal can obstruct ear wax from moving naturally out of the ear.

– Environment: Working in dusty or dirty environments, particularly outdoors, can lead to dirt or debris building up and trapping wax in the ear.

– Frequent hearing aid and earphone use: These can prevent the wax from moving naturally out of the opening of the ear.

Earwax removal methods to avoid

Cotton swabs

Earwax removal candles

Microsuction for Earwax Removal

Microsuction is the most commonly employed technique for manual removal of wax. The main advantage of this technique is that it is performed under direct vision, and so can be used in clinical scenarios where irrigation would be contraindicated. It is also usually quicker than irrigation, and does not expose the ear canal to moisture. A recent study by Prowse and Mulla looked at the efficacy of microsuction, and found that in a study population of 159 patients, the procedure was successful in clearing the wax in 91% of cases.

References 1. National Institute for Health and Care Excellence (NICE). Earwax [Clinical Knowledge Summaries]. 2012; http:// cks. nice. org. uk/ earwax (accessed 25 Mar 2020).