At Ear Care Lab, we are experts in all matters relating to ear wax and its safe removal. We have safely treated thousands of patients over several years and are proud to offer a service that is second to none. This article details all you need to know about ear wax, its symptoms and its removal.
What is Ear Wax?
Ear wax is a waxy material produced by sebaceous glands inside the ear. It cleans, lubricates and protects the lining of the ear by trapping dirt and repelling water. Ear wax is slightly acidic and has antibacterial properties. Without ear wax, the skin inside your ear would become dry, cracked, infected or waterlogged and sore. It is extremely important to remember that due to its protective properties, a thin layer of wax left on the lining of the ear canal, following procedures such as syringing and microsuction, is extremely beneficial. The aim of ear wax treatment is not to completely eliminate ear wax.
Ear wax can be wet or dry, hard or soft. Soft ear wax is more common in children and hard ear wax is more likely to cause problems. 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. Some people produce more ear wax than others. It usually falls out of your ear gradually, in small pieces or flakes. Sometimes, ear wax can build up and harden, creating a blockage called a “plug”. As well as causing discomfort, an ear wax plug can also cause temporary hearing loss because it blocks your ear canal. Once the blockage is removed, your hearing will improve.
Causes of Ear Wax
Some people are naturally more susceptible to developing a blockage in their ear, for various reasons. Blockage, or impaction, also occurs when the wax gets pushed deep within the ear canal. Ear wax blockage affects about 6% of people and is one of the most common ear problems doctors see. Your risk of developing problems from a build-up of ear wax is increased if you have:
- narrow ear canals or ear canals that aren’t fully formed
- a lot of hair in your ear canals
- bony growths in the outer part of your ear canal – these are called osteomata
- a skin condition of your scalp or preauricular area
- hard wax
- a history of recurrent impacted earwax
- repeated ear infections
Elderly people are more at risk of having ear wax problems because ear wax becomes drier with age. Your chances of developing an earwax blockage are also increased if you:
- Use cotton buds – they can push ear wax deeper into your ear and pack it together harder, creating an ear wax plug
- Wear a hearing aid or earplugs, which can stop ear wax falling out of your ear naturally
Ear Wax Symptoms
Ear wax doesn’t usually cause problems, but a build-up of ear wax can lead to a blocked ear or fullness sensation, ear pain/discomfort and hearing loss. Too much ear wax can also cause other symptoms, including:
- Ringing in the ear
- Itching or drainage from the ear canal
- Vertigo or Dizziness
Treating ear wax build-up
In most cases, ear wax falls out on its own, so there’s no need to remove it. However, if it’s completely blocking your ear canal and causing hearing loss or discomfort, it may need to be removed. Indications for earwax removal include:
- Difficulty in examining the full tympanic membrane (ear drum)
- Otitis externa – external ear canal infection
- Wax occlusion of the external ear canal
- As part of the workup for conductive hearing loss
- Prior to taking the impression for hearing aid fitting
- Suspected external ear canal or middle ear cholesteatoma
- As part of grommet insertion or middle ear surgery
- Patient request
Ear Wax Removal Treatments
Ear Microsuction is where a special suction device is used to remove the ear wax under a microscope or a special light loupe with magnification. The procedure is quick, safe and painless. This technique is offered by the Ear Care Lab as the safest and most efficient method of removing ear wax.
Aural Toilet treatment uses an instrument called a Jobson Horne probe. A Jobson Horne probe is a thin metal or plastic instrument with a small ring at one end that the specialist can use to remove earwax from your ear canal. We sometimes have to use instruments like this in order to gently help wax come out.
Ear drops for Ear Wax Removal
Ear drops can be used to soften and loosen the ear wax. Ear drops should not be used if you have a perforated eardrum. Ear drops vary in composition from olive oil, to sodium bicarbonate to hydrogen peroxide based drops available in many pharmacies. Olive oil is generally completely harmless but sodium bicarbonate and hydrogen peroxide based drops can be quite irritant to the ear canal so must not be used for prolonged periods.
Ear irrigation or Ear Syringing is often used in many GP surgeries. Ear Syringing involves using a pressurised flow of water to remove the build-up of ear wax. Ear Syringing is not as effective as Ear Microsuction in many cases.
What is Ear Microsuction?
Microsuction is a technique for removing ear wax or debris using either an ENT (Ear Nose and Throat) binocular operating microscope or specialised magnification loupes (similar to the type dentists use). This allows the clinician to look in the ear canal in great detail and use a very fine sterile suction device at low pressure to remove the wax. This process is not dissimilar to using a tiny vacuum cleaner inside the ear to remove the wax. Occasionally we may need to use other instruments to remove hard wax (such as Jobson Horne probes or micro forceps).
Using microsuction means that we can visualise the external ear canal and its contents in great detail while having minimal physical contact with the earlobe. This makes the process more comfortable for patients. Preparation of wax with olive oil ear drops is not usually necessary but may make the procedure faster and more comfortable for the patient. This is discussed in more detail in the FAQ section.
Why is Ear Microsuction Better Than Ear Syringing?
There are a variety of reasons why microsuction is superior compared to the traditional forms of wax removal (e.g. ear syringing or irrigation, ear drops). Ear microsuction is:
- better tolerated
- more effective
- usually does not require weeks of waiting for drops to soften the wax. It may be performed on the same day you decide to book your appointment