Ear Wax (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Earwax definition and facts
- What is ear wax?
- Why does earwax vary in color and texture?
- Is it OK to remove earwax blockage?
- What causes wax in the ears to build up?
- What signs and symptoms are related to excessive or impacted (plug) earwax?
- Is ear candling safe?
- What are the treatment guidelines for impacted earwax removal?
- What over-the-counter (OTC) products remove earwax build up safely at home?
- Is it OK to use Q-tips or other objects to remove excess earwax?
- Find a local Ear, Nose, & Throat Doctor in your town
Is ear candling safe?
Ear candling involves placing a hollow candle (made from a fabric tube soaked in beeswax) in the ear canal and burning it, with the goal of creating a suction force for removal of wax from the ears. According to the American Academy of Otolaryngology- Head and Neck Surgery, ear candling or ear coning is not considered a safe option for ear wax removal. Studies have shown that the procedure does not create a vacuum that can remove the wax effectively, and it the wax left inside candle is from the candle itself, not from the ear. The procedure also carries health risks that include burns to the ear canal, development of new blockage of the canal from the candling wax, ear infection, and perforation of the eardrum.
What are the treatment guidelines for impacted earwax removal?
In January, 2017, the American Academy of Otolaryngology- Head and Neck Surgery released new practice guidelines to treat impacted earwax. This guideline was endorsed by a number of other medical organizations including the American Academy of Pediatrics (AAP). This guideline discusses four ways to care for and manage impacted earwax.
- Observation, since many impactions or blockages may clear on their own
- Softening agents, known as cerumenolytics. These are oils or ear drops that soften or break up the wax to help in removal.
- Irrigation, or ear syringing. This is clearing the wax using a stream of warm water into the ear canal. This can sometimes be done at home. This method is not suitable for people who have frequent ear infections or who have a perforated eardrum or surgically inserted ear tubes.
- Physical removal using a suction device or instrument. This should always be done by a doctor or other health-care professional.
What over-the-counter (OTC) products remove earwax build up safely at home?
Many people will respond to treatment with natural and home remedies, for example:
- Use a few drops of warmed olive oil, mineral oil, almond oil, baby oil, or glycerin ear drops or sprays in the ear to soften the wax.
- Use hydrogen peroxide drops.
- Over-the-counter (OTC) products are available for wax removal, such as Debrox or Murine Ear Drops.
- Syringe bulbs or irrigation home kits
If the ear still feels blocked after using these drops, call a doctor for an exam. If you try OTC earwax softeners, it is imperative to know that you don’t have a punctured (perforated) eardrum prior to using the product. If you have a punctured eardrum and put softeners in the ear it may cause a middle ear infection (otitis media). Similarly, simply washing the ear with a punctured eardrum may start an infection. If you are uncertain whether or not you have a hole in your eardrum, consult a health-care professional.
When wax has accumulated so much that it blocks the ear canal (and interferes with hearing), a health-care professional may need to wash it out (known as lavage), remove it by suctioning, or remove it with special instruments. Alternatively, a doctor may prescribe ear drops that are designed to soften the wax (such as trolamine polypeptide oleate-ear drops [Cerumenex]).
Is it OK to use Q-tips or other objects to remove excess earwax?
Most attempts to clean the ears by using cotton swabs only result in pushing the wax further into the ear canal. Wax is not formed in the deep part of the canal near the eardrum, but only in the outer part of the canal near the external opening. So when a doctor sees with wax pushed up against your eardrum, he or she knows that it often is because you have been probing your ear with things like Q-Tips, bobby pins, or twisted napkin corners. These objects only serve as ramrods to push the wax deeper into the ear and can lead to problems.
The skin of the ear canal and the eardrum is very thin and fragile, and is easily injured. The ear canal is more prone to infection after it has been stripped clean of the "good," coating-type wax. Doctors see many perforated eardrums as a result of the above efforts. If you have symptoms or signs of impacted earwax consult with your doctor.
American Academy of Otolaryngology- Head and Neck Surgery. "EarWax and Care."
Rogers, N., MD. et al. "Ear wax removal: Help patients help themselves." J Fam Pract. 2011 Nov; 60(11): 671–673.
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