What is earwax and why do we have it?

Excessive earwax, or cerumen, is not a glamorous topic, but it is one of the most common reasons for a trip to the ear, nose and throat doctor. Wax impacted in the ear canal most commonly leads to ear blockage and hearing loss, but can also cause pain, and sometimes contribute to infection and dizziness. Removing the wax impaction generally leads to rapid relief of these symptoms.

Specialized glands in the skin of the outer half of the ear canal secrete wax into the ear canal. The wax serves a number of functions. Among these are lubrication of the skin of the canal, assisting in cleaning foreign debris from the ear canal, and protection against invasion of the skin by bacteria and fungi. The skin of the ear canal migrates slowly outward, dragging wax and any adherent particles toward the ear opening. When this mechanism is functioning as intended, the ear canal should be “self-cleaning.”

How does a wax impaction develop?

Wax becomes impacted in the ear for a variety of reasons. Probably the most common cause is the habit of using Q-tips to try to clean the ears. This is an extremely common routine for many people, but has the tendency to create the opposite and unintended effect of actually pushing earwax deeper into the ear canal, where it builds up and becomes impacted. Wax buildup also occurs more commonly when hearing aids or earplugs are used, since these also may interfere with wax migrating out of the ear canal. Sometimes, the consistency of a particular individual’s wax, or the condition of the ear canal skin may promote wax buildup.

How do you “clean” the ears?

Most individuals are best off leaving the ears alone, rather than taking routine steps to “clean” the ears. Since the ears are designed to be “self-cleaning”, avoiding Q-tips and other similar objects goes a long way toward avoiding the tendency of these objects to tamp down the wax against the eardrum. The most expeditious way to deal with excessive or impacted earwax is to see Dr. Lieberman to have it taken care of. There are three basic ways to remove the earwax…curettage (debridement with a tiny metal loop), suctioning and irrigation.

“Over the counter” wax removal drops can be tried, but are frequently ineffective and often result in ear infections.

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