What You Need to Know About Earwax

Earwax, also called cerumen, is a substance that is formed from secretions of the glands (sebaceous and ceruminous) found in the ear canal. Secretions from these glands mix with sloughed-off skin, normal skin bacteria, trapped water, and occasionally hair within the ear canal to form what we commonly call earwax.

Types

Earwax is a hydrophobic (repels water), protective substance. Based on your genetics, you may make one of two different types of earwwax:

• Wet: Ear wax with a higher proportion of lipids found in Caucasian and African populations.
• Dry: Ear wax with a lower proportion of lipids found in East Asian populations.

Function

Ear wax has been shown to have protective benefits to the outer ear canal. Because earwax is hydrophobic it can protect the ear from the negative effects of trapped water.

Earwax also has potential antibacterial and antifungal properties and a healthy amount of earwax may decrease your risk for ear infections like otitis externa. However, despite its benefits, too much of a good thing can lead to problems.

Causes of Excess Ear Wax

Under normal circumstances, the body has a method of removing earwax and sloughed skin through the movements of the jawbone during activities like chewing or talking. Jaw movement causes the ear wax to move from your eardrum towards your outer ear.

Also, the skin of the ear canal tends to migrate from the depths of the ear canal to the more outer parts of the ear canal as it exfoliates acting somewhat like a conveyor belt to push the wax out.

Reasons for the excessive accumulation of ear wax include:

• Lack of ear wax and sloughed skin migration: Can be the result of the normal aging process; can also be caused inappropriate ear wax removal methods
• Narrowing: Can be affected by the shape of an individual's ear canal, soft tissue narrowing (from multiple and/or severe infections of the ear canal), or increased amounts of hair in the ear canal.
• Obstruction: Bone (congenital or traumatic causes), skin sloughing, or soft tissue
• Overproduction: Trauma, trapped water, and other unknown causes

Also, common objects used in the ears can also lead to an earwax obstruction. Items such as hearing aids, music earbuds, and earplugs (noise-reducing or for swimming) hinder the natural migration of earwax.

Excess Earwax Symptoms

Too much earwax in the ear canal or an earwax blockage can cause the following symptoms:

• Reflexive cough
• Earache
• Hearing loss
• Feeling like your ears are “plugged”
• itchiness in the ear (can be a sign of infection or irritation)

Associated Conditions

Additionally, an inappropriate level of earwax can be associated with the following conditions:

• Ceruminosis: Too much earwax in the elderly related to breakdown of the natural migration of earwax out of the ear canal
• Otitis externa: Earwax helps prevent common bacterial sources of swimmer’s ear
• Tinnitus: Ringing in the ears

Removing Excess Earwax

There are several methods that can be used to remove earwax. However, if you have any of the symptoms described above you should consult a physician such as an otolaryngologist or an otologist.

Methods to avoid include:

• Ear candling
• Q-Tips or inserting other objects into your ear
• Cerumenolytics (solutions that break down ear wax or cerumen) if you have damage to your tympanic membrane or surgically placed ventilation tubes

Earwax should only be removed if you have symptoms or discomfort. The three recommended methods of earwax removal by a trained professional include:

• Cerumenolytic agents
• Irrigation
• Manual removal: Preferred method if performed by an otolaryngologist with expertise as it can reduce the risk of damage to the ear canal or eardrum.

Risks of Removal

While removal of ear wax from a trained professional is relatively safe, rare complications may occur including:

• Allergic reactions (if cerumenolytic agents are used)
• Otitis externa
• Earache
• Temporary hearing loss
• Dizziness or vertigo
• Ruptured eardrum
• Ringing in the ear
• Ear pain
• Bleeding (usually mild)
• Laceration

Preventing Accumulation

The following measures may help to prevent the accumulation of earwax. However, you should consult your doctor before trying them, especially if you have a history of ear problems:

• Dip a cotton ball in mineral oil and place in the outer ear canal 10 to 20 minutes per week
• Avoid wearing earplugs or hearing aids for eight or more hours at night
• If you are predisposed to ear wax accumulation for medical reasons, consider having a routine ear cleaning done by a healthcare professional every six to 12 months.