Cerumen (Ear Wax)

Most people do not need to clean the ears. Ear wax is produced on the outer part of the ear canal and carried out like a box on a conveyer belt out the ear canal. What is seen on the outside can be gently removed with a washcloth.
Ear wax is beneficial to the ear. It protects the delicate skin of the ear canal from infection and debris. It also prevents the entry of water into the canal much like a coat of wax on a car. The sticky consistency traps dust and mold spores preventing them from entering deeper into the ear canal. The acidic pH of the wax further inhibits the growth of fungi and bacteria.
Cleaning with cotton-tipped swabs is detrimental to ear canal health. Removing the ears natural wax and oils will leave the skin bare and sensitive. The symptoms of this condition are itchy plugged ears that will feel like they are draining. This often leads to patients to clean their ears more aggressively, worsening the situation. Excessive wax removal is also associated with recurrent swimmer’s ear and fungal ear infections. Packing the wax into the ear can lead to a severe ear wax impaction that may require surgical removal in addition to damaging the ear canal bone. We also have several patients a year that inadvertently rupture (perforate) their ear drum which may lead to hearing loss and require surgical repair.
DO NOT EVER CANDLE THE EARS!!! This is dangerous! Claims of the benefits of ear candling are false. The wax that comes out of the ear is candle wax. We have seen patients who have burned themselves or coated their ears with soot or wax. We have seen patients who have burned a hole in the ear drum. This is not a “natural” way to clean the ear.
Some people produce excessive wax or have narrow ear canals. Over the counter products such as Debrox can be useful to remove the wax in the cases. The use of Swimmer’s Ear is discouraged as it dries out the ear canal and can be irritating. If this is not successful then the ears may need to be cleaned out manually. In our office, we use a microscope to gently remove impacted wax. Irrigation can be used for softer wax. The use of high-pressure irrigation is generally avoided because it can lead to a perforated ear drum.