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[Earwax]
Earwax: Why Its There and How To Remove It
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Veröffentlicht am Nov 17, 2021
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When was the last time you thought about earwax? Last month? Last year? Maybe you’ve never really thought about it, beyond knowing it’s there: that yellowish, sticky substance. We know earwax serves a purpose, but we might be a little fuzzy on the details. Then again, there’s no reason to spend too much time pondering this mild, mostly unseen body secretion—or is there?
Earwax (clinical name cerumen) is an oily, waxy discharge secreted by tiny sebaceous and sweat glands in the outer part of the ear, commonly called the ear canal. While it might look dirty, earwax serves as a cleanser and creates a barrier to protect the ear canal against injury, infection, water, and foreign objects. Earwax also has a slightly acidic composition, which repels fungus and bacteria that would otherwise be attracted to the dark, moist atmosphere of the inner ear. Researchers have found several antimicrobial peptides in earwax which, when combined, increase in their strength and effectiveness.
Earwax serves a role in protecting the delicate workings of the ear. While earwax is designed to coat the ear canal, it was not intended to stay there. As skin cells inside the ear grow and shift, the earwax travels with them through the ear canal, picking up dead skin cells, hairs, and other particles along the way. Think of it as the ear’s natural trash collector. (Fun fact: The smell of earwax also repels small insects who attempt to fly or crawl into the ear. If an insect does enter the ear canal, it will become caught in the earwax and expelled from the ear along with other unwanted particles.)
As old earwax and debris moves outward from the ear canal and flakes off, new earwax moves in to begin the process anew. However, earwax can build up and cause issues, especially among older people and those who wear hearing aids. Too much wax can become impacted—meaning it creates a blockage—and cause hearing loss.
Impacted earwax—the term for too much earwax building up in the ear canal—is a common problem. In fact, it’s the leading cause of conductive hearing loss. Conductive hearing loss is very often temporary, but it can still make daily life communication difficult. The reasons are obvious: if there’s a blockage or barrier in the ear canal, sound isn't able to reach the middle ear as easily and everything, including voices, may become muffled.
Often, impacted earwax has no symptoms. In other cases, the symptoms are so common (diminished hearing, a feeling of fullness or clogging in the ears, itching, coughing or an earache), they are mistaken for a head cold. Many people only discover they have impacted earwax when their physician looks in their ears as part of a routine check-up.
How does this issue occur? Earwax can become impacted when we try to clean our ears and force the cerumen further down into the canal. Wearing hearing aids can sometimes have the same effect.
Aging is also linked to impacted earwax. As we age, the consistency of our earwax changes, and it flows less easily through the ear canal, which can lead to buildup. One study found 35% of hospitalized patients over age 65 suffered from impacted earwax, and 75% demonstrated improved hearing after it was removed.
For the reasons mentioned above, it’s important to keep earwax under control and the best way to do that is to get your ears cleaned by a professional. If you have symptoms of earwax buildup—such as muffled hearing, ringing in your ears (tinnitus), or a feeling of fullness in one or both ears—it's best not to be probing on your own. Medical assistance is strongly advised by most healthcare professionals and renowned centers like the Mayo Clinic.
Given how delicate the eardrum and ear canal are, earwax removal is always performed most safely and easily in a clinical setting. Also, a trained professional can evaluate what’s really going on; that is, whether your issue is impacted earwax or another condition.
If excess earwax is the culprit, the most common techniques used by doctors are scraping or scooping the wax from the ear with special tools or using an irrigation device (similar to a water flosser) to soften the earwax and flushing and/or suctioning it out.
For more details on why you should let a professional do the job, and what an appointment involves, read Earwax Removal: Why You Need a Professional Cleaning.
In a word, no. While it's true that you can buy any number of over-the-counter (OTC) earwax removal kits or use other home-made solutions (see below), it's not the best way to deal with the problem.
Treating your earwax yourself can be difficult—and even dangerous in some cases. You can’t see inside your ear, nor do you have the specialized tools to properly execute earwax removal procedures. Even OTC irrigation therapies can be dangerous if used improperly, as residual or trapped water can create a moist environment in the ear that sets the stage for infection.
Also, you lack the training to diagnose and resolve the issue. “Sometimes what seems like earwax is actually debris from a condition requiring treatment, and sometimes earwax can cause dysfunction of your hearing devices,” said Danica Billingsly, AuD, Assistant Professor of Audiology at Northern Illinois University. “It's impossible for you to tell from the outside what is happening on the inside—even with a camera and light, you do not have the knowledge to recognize normal versus abnormal.”
To learn more, read Is It Safe to Remove Earwax Myself?
While the consensus is that ear cleaning is best left to the professionals, there are certain situations in which you may want to take matters into your own hands.
“In some cases, home care might be part of a comprehensive overall ear-management plan,” Billingsly told HearingTracker. “However, such a plan should be led by a provider with experience in ear care and with knowledge of your specific ear health. Without such a plan, it is possible to do permanent damage to your ear or hearing.”
If you are following expert guidance, here are some possible techniques:
For more details on these techniques, read How to Clean Your Ears at Home.
People who wear hearing aids are at a significantly higher risk of developing impacted earwax. Placing a hearing aid, or any object, in the ear for an extended period prevents the normal flow of earwax, thus increasing the risk of buildup. Blocking the ear entrance with a hearing aid may also stimulate glands in the ear canal to produce even more ear wax, potentially worsening the issue. And the longer earwax sits in the ear canal, the harder it becomes and the more difficult it is to remove.
But the damage is a two-way street: Earwax is one of the leading causes of hearing-aid repairs. The acidic properties of earwax can degrade the hearing aid’s electrical components over time. It may also clog up vents and receivers, impacting how well the hearing aid allows you to hear.
If you wear a hearing aid with an earmold, it is not unusual to find earwax on the earmold. A buildup of earwax on the hearing aid can cause significant damage, ranging from feedback issues, reduced sound, improper fit, or increased hearing loss.
If you wear a cochlear implant, the mechanism that allows you to hear is past where any earwax would build up, so wax buildup would not impact hearing ability. If earwax gets on the external components, it could clog the microphones, causing increased difficulty. Having impacted earwax removed, however, is still important for cochlear implant users, even if it is not impacting hearing abilities.
Because hearing aids and implants block the ear from completing its natural cleaning process, hearing aid users should be checked for impacted earwax on a regular basis. The American Academy of Otolaryngology-Head and Neck Surgery Foundation recommends that people who wear hearing aids have their ears checked every three to six months. This can easily be done by your audiologist or hearing-care provider during routine hearing aid check follow ups or a primary care physician as part of a regular examination and does not require an ear nose and throat specialist.
Daily cleaning of hearing aids is necessary to prevent damage caused by earwax. Wax traps, which prevent wax from reach internal components of the hearing aids, should be replaced regularly. Many times, patients replace them on a monthly basis to ensure no wax buildup is occurring. Wax traps are very tiny, and it doesn’t take much wax to clog them up. Discuss with your audiologist whether a routine for changing them applies to you.
Many of us know that clogged-ears feeling that occurs during air travel. It usually resolves quickly as the pressure in our ears returns to normal – no big deal. But if, under other circumstances, you have the sensation of your ears being blocked and that you aren’t hearing as well as usual, it’s troubling. What could be going on?
“There are many reasons why your ears might feel plugged or clogged, ranging from earwax accumulation to a serious condition in the middle or inner parts of your ear,” Billingsly told Hearing Tracker.
To determine what’s causing this problem, seek a medical evaluation. “A professional can help you make a plan for your next steps, whether that is earwax removal, a referral to an ENT for treatment of a possible medical condition, or a hearing evaluation by an audiologist to determine a change in hearing,” Dr. Billingsly said.
For more insight onto this situation, check Why Do My Ears Feel Clogged?
If you've tried to have earwax removed but your hearing has not improved, the best next step is to see a hearing care provider.
In most cases, hearing loss associated with impacted earwax is temporary, and removing the blockage resolves the issue. But if impacted earwax is left in the canal for too long, it can lead to lasting damage to the ear and, in some cases, permanent hearing loss. So, it's best to address the issue with the help of a skilled professional.
“In my opinion, it's important to first confirm that all the ear wax has been removed,” writes Audiologist Nikki Degeorge Weaver, AuD. “When you are removing wax at home, you cannot be sure it is all removed unless a trained person can look into the ear with an otoscope. If you are using Q-tips [which all audiologists strongly recommend against!], you may see some wax on the Q-tip, but it also may be pushing more wax down in your ear further, which could block sound. If you use an ear wash, sometimes the fluid gets behind the wax and causes a blockage of some hearing until the rest of the wax and solution are removed.
“Seeing an audiologist who can make sure all the wax has in fact been removed,” continues Dr. Weaver. “If not, most audiologists will remove the wax for you. If your ears are clear, he or she can then complete a full diagnostic hearing test to determine if hearing loss is present and if so, where the hearing loss is coming from, if it's likely a permanent hearing loss, etc. After this is determined, he or she can give you treatment options or refer you to another professional if needed.”
Uncomfortably itchy ears are a “double trouble” kind of problem. Not only is this symptom extremely annoying, the act of scratching—in an effort to get relief—can exacerbate the situation.
“Itchy ears can have many causes, from dry skin to a fungal infection, or even a reaction to a soap or shampoo,” Dr. Billingsly said. Impacted earwax is a common trigger, and surprisingly, too little earwax can also cause this symptom.
What’s most important in treating this issue: Getting proper care. Too often, people go at the itch with their finger or a cotton swab and wind up making the problem worse.
“If your ears are itchy, discuss that with your care providers. And if they are incessantly itchy, produce discharge, or cause pain, seek medical care,” advised Billingsly.
For more details on symptoms, causes and treatment, click here to read Why Are My Ears Itchy?
Earwax is completely normal, but too much of a good thing can cause health and hearing issues. By following the advice above, you’ll be able to keep your ears in top condition and know when to seek professional care.
Mara Brooks ist eine langjährige Journalistin und gebürtige New Yorkerin, die jetzt in Barre, Vermont lebt. Sie ist Kommunikationskoordinatorin für die Community of Vermont Elders und Redakteurin der Gemeindezeitungen The Charlotte News und The Hardwick Gazette. In ihrer Freizeit studiert Mara Jura und klassische Musik.
Dr. Gerhart ist eine Audiologin mit Erfahrung in der Pädiatrie bis zur Geriatrie, die in verschiedenen Umgebungen gearbeitet hat, einschließlich Privatpraxis und HNO-Kliniken. Sie leitete zuvor das Audiologie-Programm im Philadelphia School District. Ihre Leidenschaft ist es, Menschen mit Hörverlust zu helfen, den größtmöglichen Nutzen aus ihren Technologien zu ziehen und sie auf ihrem Weg zu besserem Hörvermögen zu begleiten.
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