Last Updated December 20th, 2021
Why do we have ear wax?
Earwax, which is medically termed as cerumen is a waxy substance produced by the human body to protect the ears. The structure of the cerumen is generally waxy and the color may vary from orange, grey, red, or yellow. The main function of the cerumen is to protect the external ear canal. Since the ear canal is a natural opening in the body, insects, water, and pathogens can easily enter the ear canal.
Cerumen helps in preventing these external factors from entering the ear canal and protects the eardrum from infections. The production of cerumen can vary from person to person. Few people produce less cerumen whereas some may produce more cerumen.
Facts on ear wax
- Around 60% of the ear wax is made up of keratin.
- Native Americans generally produce the dry type of cerumen.
- Cerumen impaction causes 60 to 80% of hearing aid defects.
- It has been estimated that around 75000 people get ear irrigation every week in the United States.
- Studies have claimed that 99% of infections caused by pathogens are prevented due to the production of cerumen.
Why does ear wax become impacted?
Ear wax getting impacted is not a healthy sign. The human ear is designed to manage the cerumen it produces. Ear wax impaction is generally noticed when people try to use external objects such as Q-tips to clean ear wax. In the process of clearing the ear wax, Q-tips actually pushes some of the ear wax deeper inside the ear canal which can result in ear wax impaction.
Complications associated with wax impaction
The most common complication associated with cerumen impaction is the feeling of blockage in the ear. This can be associated with partial hearing loss and even pain in few cases if the wax becomes extremely hard. A persistent ear wax impaction may affect several activities of daily living. Moreover, persistent ear wax impaction may cause pressure on the eardrum leading to severe ear pain and infection.
Common signs and symptoms of ear wax impaction
Ear wax impaction is rare and generally caused by human intervention such as using Q-tips. Common symptoms associated with ear wax impaction include:
- Fullness or blockage feeling in the ear.
- Partial hearing loss with difficulty in hearing.
- Symptoms of tinnitus (a continuous whistling sound in the ear).
- Itching sensation in the ear.
- Severe pain.
- May cause vertigo (lightheadedness).
- May experience discharge and odor.
Risk factors to develop cerumen impaction
Cerumen impaction can affect anybody and everybody. Some of the most likely risk factors include:
- Regular use of earplugs.
- Use Q-tips to clean ear wax.
- People with underdeveloped ear canals.
- People suffering from mental disabilities.
- Old age people.
How is cerumen impaction diagnosed?
Diagnosis of cerumen impaction generally requires a visit to the doctor’s office. After an initial physical examination, the doctor would use an instrument called otoscope to look into the ear. This device can determine if the cerumen is impacted and how severe is the impaction.
How is cerumen impaction treated?
Cerumen impaction can be treated at home if the impaction is mild. On the other hand, if the impaction is severe, visiting the doctor’s office would be the best choice. Firstly, the severity of the impaction needs to be assessed by a medical professional. If cerumen impaction is determined, the doctor would treat it medically with the help of ear drops and ear irrigation.
The first method of medically treating cerumen impaction is with the use of ear drops. The ear drop prescribed to treat impaction is called cerumenolytic (a solution that loosens ear wax). Ear drops need to be placed inside the ear while lying down with the affected ear facing upwards. It is important to allow the ear drops to remain in the ear canal for some time. This helps the cerumen to loosen and eventually fall off. The same procedure should be continued until all the cerumen impaction clears up.
Ear irrigation is the second method of removing cerumen from the ear canal. This method is used to remove ear wax when the ear drops fail to produce results. Ear irrigation is done by applying water pressure which helps in dislodging the impaction. Electronic devices are used to perform ear irrigation where water is sprayed at a controlled speed. The water pressure is maintained adequately so that it does not damage the eardrum. This procedure is performed for a period of 15 minutes in order to remove the impacted ear wax completely.
This procedure is generally not painful but can be uncomfortable when water is sprayed inside the ear canal. If the impaction does not clear up by the first attempt, the same procedure is followed again after application of ear drops. Ear drops are placed inside the ear canal and allowed to stay in there for some time so that the wax loosens. Next, ear irrigation is performed for the second time to remove the impacted wax. If the impaction still does not clear up which is quite rare, the patient is referred to an ENT specialist who specializes in ear, nose, and throat.
ENT specialist would then examine the ear canal and assess the severity of impaction. Next, specially designed instruments such as suction device, cerumen spoon, and forceps are used to manually remove the ear wax from the ear canal.
Natural remedies for ear wax removal
This might be the simplest way to remove ear wax from the ear canal. Taking a warm water shower can help remove the ear wax naturally. Tilt the head to one side allowing water to flow inside the ear, retain the same position until the wax clears up. Repeat the same procedure for another ear. After completing this process, make sure to drain all the water from both the ears. This method of removing ear wax is considered the safest and easiest method to follow.
Sodium bicarbonate and hydrogen peroxide
Sodium bicarbonate and hydrogen peroxide can be instilled into the ears to loosen up ear wax if the cerumen is partially impacted and does not clear up with water rinses. This can also be achieved by applying olive oil or mineral oil. Both these oils are considered safe and do not cause damage to the eardrum. Sodium bicarbonate and hydrogen peroxide can also be used to soften the ear wax. Place these items inside the ear canal and allow it to soak for a couple of minutes. Next, water rinse can be performed to remove the ear wax once the wax loosens up. It is important to not place any other type of items inside the ear canal such as essential oil or baby oil since it can cause severe damage to the ear.
Wet the outer ear
Cerumen is formed when dry skin cells mix up with secretions of the sebaceous gland. The production of cerumen increases when the outer layer of the ear is dry. This increases the level of dead cells and in turn, more cerumen is produced. Moistening the outer ear canal helps in reducing the number of dead skin cells and reduces the cerumen production as well. This minimizes any type of cerumen impaction in the ear.
Alcohol and vinegar combination
A combination of vinegar and alcohol in equal parts can be mixed and placed in the ear canal with the help of rubber syringe. First, lie down on one side and place the mixture in the ear. Leave the mixture in the ear canal for a few minutes and then rinse the ear with water.
Add omega-3 to diet
Studies have revealed that omega 3 deficiency can increase the production of cerumen in the ear. Omega 3 is present in seafood in abundance. Consuming seafood regularly is the best way to improve the levels of omega 3. Omega 3 is also available in supplement form which can be consumed to meet the demands.
Unconventional methods of cerumen removal
There are numerous unconventional methods of removing ear wax such as ear candling, using Q-tips, and instilling baby oil. It should be noted that these methods are not medically approved and can cause severe damage to the ear. It is quite common to use Q-tips to remove ear wax. This method has been followed for several years but in reality, this causes more problems than solutions.
When Q-tips are used, there is a high probability that the wax is pushed further inside the ear canal. This makes the ear wax to lose moisture and become hard leading to impaction. On the other hand, many people use baby oil to dissolve the wax. This is not medically approved and hence should not be followed.
Finally, ear candling has been quite popular in recent times. Many people are trying this method to remove ear wax. During this procedure, a 10-inch long cylindrical fabric dipped in wax is placed in the ear and the end which is outside the ear is lighted.
Another name for this method is coning therapy. It is believed that the heat produced helps the wax to dissolve and come out. It is also believed that this method can remove bacteria and fungus as well. Medically speaking, this method is considered highly dangerous and definitely not safe. In fact, the medical fraternity found no evidence about the claims made with respect to the ear candling.
Can cerumen impaction be prevented?
As discussed earlier, the human body can manage the cerumen appropriately under normal conditions. Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.
Since this method of cerumen removal may cause the wax to further lodge into the ear canal, it can lead to impaction. If there is really a problem with excess cerumen production leading to impaction, it is better to consult a doctor to do the job rather than trying some unconventional methods. Other preventive methods include adding omega 3 in the diet and keeping the outer ear canal moist and clean.
- Keep the outer ear moist and clean.
- Add adequate omega 3 fatty acids in the diet.
- Seek medical attention to remove impacted cerumen.
- Avoid Q-tips to clean ear wax.
- Use Q-tips to remove ear wax.
- Keep the outer ear dry.
- Follow unconventional methods to remove ear wax.
- Use essential oils to dissolve ear wax.
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