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ears

Ear Wax is your Friend
Ear Wax is your Friend The healthy person makes cerumen, which protects the ear canal. There is no need to remove cerumen unless it is blocking your hearing.

Ear Wax/cerumen is a natural product and is supposed to be in the ear canal. It contains useful antibiotic properties to protect against infection. It acts in the ear canal like oil on your skin.

Why do we have problems of the ear canal? It is because we are not designed for modern living, which includes shampoo, hair spray, hot tubs, showers, and swimming, to name a few. These activities remove the good wax from ears. The soap from the shampoo can get into the ear canal and dry it out. This dryness leads to itching, which in turn can lead to scratching, which can lead to infection, or external otitis. To prevent this dryness, place a few drops of baby oil or olive oil in your ear canal before you shampoo.

Those who are in the water for long periods get outer ear infection because cerumen is eventually washed out. If there is no wax, it’s like having dishpan hands, the dry skin itches causing you to scratch in your sleep. Aquatic mammals such as beavers and whales produce thick heavy cerumen at a frequent rate. If you swim daily, I recommend daily applications of baby oil.

No-No’s of ear health
  • Never dig in your ear with a pencil. The point can break off and puncture the eardrum.
  • Never dig in your ear with the end of an eraser. It will break off and a doctor will be required to have it removed.
  • Do not put alcohol in your ear canal. Alcohol dries the ear and leads to itching.
  • If you have a perforated eardrum, you must not put anything except a doctor’s prescription in the ear.
If you have a hearing loss, don’t assume it’s due to a cerumen blockage. If you have a severe hearing loss and the doctor says you don’t have a cerumen blockage, you MUST see a specialist right away for treatment of the middle or inner ear in order to restore the hearing.

I frequently see patients who complain of Tinnitus, a ringing in the ear. When cerumen impaction is causing the ringing, the cure is easy.

Soap in the ear breaks up the oils and dries the skin of its natural oil. The ear canal is like a long tube closed at one end—once the soap gets into that canal it is very difficult to remove it.

When I was just starting my residency training, my first patient was someone who had poured sealing wax into her ear canal because the neighbors were making too much noise. This wax was transparent, and I couldn’t tell which was the ear canal and which was the wax! Now that the sealing wax had hardened and was irritating the canal, there was no way to remove it except under general anesthesia by surgery. Through the years at my practice, I have removed objects from ears that include erasers, cotton from swabs, beetles, a wasp, small roach, all kinds of pieces of paper, beads and tiny plastic toys, screws, and a hearing aid battery.

Some over the counter (OTC) treatments are okay
If you are sure you have cerumen blocking your ear, it is okay to use one of the OTC earwax preparations that come with a plastic syringe for irrigation. The wax softener should soften the wax and then with warm water – should be about the temperature of your body—rinse it out. However, because it may not work, before you start the drops on Friday, be sure to make an appointment for wax removal next Tuesday. Then if the home kit doesn’t work, you can see the doctor. If it does work…you can cancel the appointment.

Most common wax removers
The most common wax removers include Carbamide peroxide (6.5%) and glycerin. Carbamide peroxide is a source of hydrogen peroxide and nascent oxygen; the effervescence caused by the release of oxygen mechanically removes debris from inaccessible regions. Physician’s Choice Ear Wax Kit contains softener, a plastic ear syringe and ear basin. Ducosate or Colace Docusate sodium allows water and fats to get into the wax. This helps soften wax material and makes removal easier.

Cautions
  • It’s not wax if there is a bloody, yellow, or green discharge from the ear canal. A dirty grey smelly discharge is usually due to a fungus infection of the ear canal. Do not irrigate these conditions unless asked to do so by your doctor.
  • It is not cerumen causing the problem if the ears are quite itchy. If you remove too much cerumen, you end up with dry ears and one step before an ear infection. What happens is that the ear canal is too dry, in your sleep, it itches and you scratch it and then the scratch becomes infected. Prevention is to place olive oil or baby oil into your canal whenever there is any itching or after all cerumen is removed.
  • Never use an old rubber syringe to irrigate your ears (or your nose). These products are usually contaminated and the rubber particles can dislodge and end in your ear. Only use a fresh plastic irrigator.
  • Ear Candling. The theory is that the heat of the candle will soften the wax and draw it out. However, this process can drip candle wax into the ear and burn the canal. In my office, I have seen three patients with burns of the ear from ear candling, and there is no evidence that it is effective.
Patients ask, “Doctor why do I have so much wax? My answer: “Wax is the end product of thinking.”

No, that’s not true. Certain people are congenitally heavy wax formers. Anything that irritates the ear canal will stimulate more wax production. For example regular use of earplugs, ear buds or hearing aids. Heavy cerumen production, although a nuisance, does not cause permanent hearing loss. The healthy person makes cerumen, which protects the ear canal. There is no need to remove cerumen unless it is blocking your hearing.



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"Ear Wax is your Friend"
   authored by:
OTOLARYNGOLOGY
Board Certified Ear Nose Throat Specialist. In private practice at Cedars Sinai Medical Towers in Los Angeles .
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Thirty one published medical articles dealing with innovations in Biofeedback, Sinusitis, Tinnitus, Voice and Scuba Diving..
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