Ear Wax

For most people, ear wax is more of a nuisance, like sweat. In fact, ear wax is a drier form of sweat. It’s normal for people to produce wax (called cerumen) to varying degrees, but sometimes, excessive production can cause trouble. Cerumen production has as a protective function: it keeps bacteria and fungi in check, and helps to self-cleanse the ear canal. Normally, the skin of the ear canal grows by migrating outward from the eardrum to the outer ear canal. Cerumen is produced only in the outer 1/3 of the ear canal, where there are hairs. As the skin sloughs off, it pushes cerumen outward, falling out in small amounts.

 

One of the most common problems that occur is if cerumen blocks your ear canal completely, causing hearing loss. All you need is a tiny pinpoint opening around the cerumen to hear normally, but anything such as  water, your finger or Q-tip usage and block this small opening, and cause hearing loss. This is why there is a saying, “never put anything larger than your elbow in your ear”. Even worse, a few times every year, I someone that accidentally ruptures his or her eardrum while using a Q-tip, especially if a child accidentally bumps the elbow, or the person goes too deeply.

 

 

For most people, over the counter wax softening ear drops such as Murine or Debrox can soften the wax, allowing it to come out more freely. Sometimes, it melts the wax to the point it closes your canal completely, causing hearing loss. Removal by a doctor (usually with flushing or small instrument) usually takes care of it. An ENT doctor like myself, has many more options for cerumen removal, such as a binocular microscope, suction equipment, and microscopic tools to more gently remove the wax.

 

If you are prone to wax buildup, some people come in routinely (every 6-12 months) for a cleaning. Others wait until they get into trouble. A common (scientifically unproven) home remedy is to place hydrogen peroxide or mineral oil drops on a regular basis. This helps to soften the wax, promoting the self-cleaning process.

 

One last note about ear wax removal. There is a widely promoted way of removing ear wax that one may find in health food stores or salons. It’s called candling or coning. It claims to remove not only ear wax, but also cleans the sinuses, relieves headaches, etc. The mechanism is simple: the paper that’s bought is rolled into a cone and the small end is placed in the affected ear. The other end is lit with a flame, and it is allowed to burn halfway and extinguished. When the paper is opened up, one sees yellow-brown wax debris. If your were to take that brown wax and analyze it, you would find that it is paraffin wax and not human wax. The paper is coated with a light layer of wax, and this is what melts and shows up inside the paper.

 

Sometimes the hot wax goes into the ear canal and causes a burn to the ear canal or even perforates the ear drum. I see this 2-3 times every year. This is a multibillion dollar industry, and despite some warnings by the health agencies, it still goes unchecked. I believe that there is a place for alternative and complementary medicine, but there are some things, even within Western medicine, that is obvious quackery.

Otolaryngology – Head & Neck Surgery

(212) 315-9058