Avoiding a Sticky Situation: How to Properly Manage Earwax

Brooklyn Pruter, Hearing Aid Project Administrator

Earwax, also known as cerumen, is the yellowish-brown, sticky substance found in our ear canals. While the waxy material is often seen as a nuisance, it does have an important purpose. Glands in our ear canals create earwax to protect the more sensitive parts of our auditory system from debris and other foreign bodies, which may include anything from shaving cream to small insects (Mason, 2013).

As an audiology student, I frequently get asked, “What is the best way to remove earwax?” The good news is, most people don’t actually need to do any wax management — the ear is a self-cleaning system, and a combination of jaw movement and migration of skin cells helps move earwax out of the ear canals naturally (Roland, 2008). However, some people produce more earwax than others, and it is possible to have too much earwax buildup (Horton, 2020). When a person has too much earwax, it cannot only be uncomfortable, but it can cause other symptoms such as itchiness, dizziness, tinnitus (ringing or buzzing in the ears), or hearing loss (Roland, 2008).

There are a few ways to safely manage earwax, but there are also some common methods that are not recommended by healthcare professionals.

1. Cotton swabs, bobby pins, toothpicks, and other small objects
   1. You may have heard the saying, “Don’t put anything smaller than your elbow in your ears!” It may seem silly, but it is actually good advice to follow. Sticking small objects like cotton swabs in the ears may cause more harm than good. It may give you some relief in the moment, but more often than not, you are actually pushing ear wax further into your ear (Roland, 2008). Earwax deep in the canal can also cause several problems, including dizziness, tinnitus, hearing loss, or more pain (Roland, 2008). Additionally, if you stick the object too far into the ear canal, you run the risk of damaging your eardrum which will be very painful (Mason, 2013).
2. Ear Candling
   1. Another popular ear wax removal method is ear candling. This technique involves putting a lit, hollow, candle into the ear canal to remove wax. The idea is that as the candle burns, it creates a suction effect that pulls earwax out of the ears. It is important to note that there is no scientific evidence that supports ear candling as an effective wax removal technique (Roland, 2008). In fact, it can be a dangerous practice—candle wax may drip into the ears, burns on the face and ears are possible, and it can even cause a punctured eardrum (Beatty, 2020). This practice can also actually push wax further into the ear canals.

Luckily, if you do need some help getting rid of earwax, there are safe and effective techniques out there.

1. Visit your primary care physician, audiologist, or otolaryngologist (ENT).
   1. There are multiple types of healthcare professionals who are qualified to remove earwax. They can look in your ears using an otoscope to see exactly where wax may be sitting in your canals and whether or not it needs to be removed. If a doctor does not have the tools or comfort level to remove wax, they will make an appropriate referral to a clinician who is trained in this area (Horton, 2020). If earwax must be removed, visiting a qualified medical professional is the safest way to do so.
2. Over-the-counter drops
   1. Not all over-the-counter earwax removal products are appropriate (such as ear candling), but there are useful tools on the market such as Debrox^®. These ear drops do not remove wax, but they help soften wax. If wax is sitting in the ear for too long, it can become hard, making it more difficult to naturally work its way out of the ear canal. Debrox^® is a safe way to help the ear push the ear wax out naturally. However, do not use these products if you have an active ear infection, dermatitis, or a non-intact eardrum (Roland, 2008).

If you still feel like your ears are plugged up (even after using some drops), put the cotton swab down and go see your local audiologist, ENT, or primary care physician. Together, you can make a plan to properly manage your earwax and avoid any sticky situations in the future.

References:

Beatty, C. W. (2020, August 22). Ear candling: Is it safe? Mayo Clinic. Retrieved October 1, 2021, from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/ear-candli g/faq-20058212.

Horton, G. A., Simpson, M., Beyea, M. M., & Beyea, J. A. (2020). Cerumen Management: An Updated Clinical Review and Evidence-Based Approach for Primary Care Physicians. Journal of primary care & community health, 11, 2150132720904181. https://doi.org/10.1177/2150132720904181

Mason, P. (2013, January 8). Nothing smaller than your elbow please. ASHA. Retrieved October 1, 2021, from https://leader.pubs.asha.org/do/10.1044/nothing-smaller-than-your-elbow-please/full/.

Roland, P. S., Smith, T. L., Schwartz, S. R., Rosenfeld, R. M., Ballachanda, B., Earll, J. M., Fayad, J., Harlor, A. D., Hirsch, B. E., Jones, S. S., Krouse, H. J., Magit, A., Nelson, C., Stutz, D. R., & Wetmore, S. (2008). Clinical practice guideline: Cerumen Impaction. Otolaryngology–Head and Neck Surgery, 139(3_suppl_1). https://doi.org/10.1016/j.otohns.2008.06.026