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Published on March 23, 2021

Resisting that urge to dig out earwax

Ear Wax Removal

Earwax – yuck! Brown crud in your ears – why do we even have it?

Earwax may not get much love, but it protects our ear canals and eardrums from excess moisture and infection, according to otolaryngologist Douglas G. Mann, MD, of Upper Cape Ear, Nose and Throat in Falmouth. However, too much of a good thing can cause problems and excess wax needs to be removed. Blockages often occur when earwax is inadvertently packed into the ear canal by cotton swabs or hearing-aid domes.

Most people can remove wax at home, however, sometimes a health professional is needed to do the job. The clinician may gently scrape it away with a thin curette, possibly in combination with water irrigation or a mild vacuum to remove loosened bits.

“It’s a very common problem,” Dr. Mann said. “Less and less are taken care of by general physicians and other hearing professionals. My practice is inundated with earwax patients.”

Earwax, or cerumen, forms from secretions of oil and sweat glands in the ear canal, according to a Harvard Health Publishing article. Movements of the jaws cause it to slowly flow to the outside. Along the way it picks up dead skin cells and dirt, carrying them out of the canal. Daily cleaning of the wax and debris at the entrance of the ear is all that’s needed for most people, Dr. Mann said.

“Wash your ears with your washcloth and finger,” he said. “Most of the time, that will take care of it.”

Some people make more wax than typical, and wax production does seem to increase with age, Dr. Mann said. For those folks, a monthly treatment with over-the-counter earwax removal drops, hydrogen peroxide or even plain water, can soften built-up wax. Then, gently wash out the wax and liquid with a bulb syringe.

He cautioned to use only lukewarm water when rinsing the ear canals.

“If you use cold or hot water, it could make you dizzy, and you might fall,” he said.

No Cotton Swabs

Improper use of cotton swabs gets the blame for many blockages. Ironically, it happens because patients use them regularly to remove the wax that then becomes the problem.

“I totally agree that people should not use Q-tips (the well-known swab brand) inside their ears,” Dr. Mann said.

“On the Q-tips box it says do not use the product in the ear,” he said.

Indeed, on the product label is this warning: “Do not insert swab into ear canal. Entering the ear canal could cause injury. If used to clean ears, stroke swab gently around the outer surface of the ear only. Keep out of the reach of children.”

Using swabs inside the canal may remove perhaps 85 percent of the wax, Dr. Mann said, but “it will push in 15 percent. Next time, another 15 percent. Before you know it, it’s a whole lot, and packed up deep in the canal against the eardrum. By then hearing can be diminished, and it’s especially challenging to get that wax out.”

Dr. Mann reminds us that the ear drum and hearing structures are very delicate; if a person’s arm is accidentally jarred while inserting a swab into their ear, perhaps by a household member or dog pushing open the bathroom door, the result could be disastrous.

“You can perforate your eardrum, disrupt the delicate bones of the inner ear,” Dr. Mann said. “it’s not common but devastating. I’ve seen it.”

Hearing Aids and Ear Wax

While you can avoid putting swabs inside your ears, users of hearing aids must insert the devices. The plastic domes that cover the inserted end “do push wax in,” Dr. Mann said.

“No question people with hearing aids will need wax removal,” he continued. “It can be done at home for many. Some will need help.”

Hearing-aid patients at his practice and Cape Cod Ear, Nose and Throat in Hyannis, both part of Cape Cod Healthcare, can have all their hearing needs met there, including hearing aid sales, surgery for correctable problems, and wax removal.

“When we take care of ears, we take care of everything,” he said. “We’re one-stop shopping for a patient with a hearing problem.”

If patients have an appointment, they should try wax-softening drops a few days in advance, Dr. Mann suggested.

Cape Cod Healthcare’s urgent care facilities in Falmouth, Sandwich, Hyannis and Harwich also perform earwax removal. No appointment is necessary.