In order to understand the methods of ear wax removal, some background knowledge is useful. 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. It 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 wax removal treatments 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, 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
Symptoms of Ear Wax Build-up
Ear wax does not 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 is no need for ear wax removal. However, if it is completely blocking your ear canal and causing hearing loss or discomfort, it may need to be removed. Indications for ear wax 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
Methods of Ear Wax Removal
- Microsuction – 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. It is considered to be the gold standard technique for ear wax removal as well as treating ear infections. This technique is offered by the Ear Care Lab as the safest and most efficient method of removing ear wax.
- Aural toilet – Where an instrument called a Jobson Horne probe is used. 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 – Ear drops can be used to soften and loosen the ear wax. They 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 (Syringing) – Ear irrigation is often used in many GP surgeries. It involves using a pressurised flow of water to remove the build-up of ear wax. It is not as effective as microsuction in many cases.