Earwax, or cerumen, is an antibacterial agent that protects and lubricates the ear canal. But accumulations of earwax can cause feelings of pressure, ringing in the ear, dizzy spells and coughing. It even can cause partial hearing loss, particularly if you have excessive wax in both ears.

OUTWARD BOUND

Despite the name, earwax is not wax. It’s a mixture of skin cells, hairs and water-soluble secretions. Movements of the jaw (from talking, chewing, etc.) produce movements in the ear canal that cause earwax to migrate toward the outer opening. There, it dries and flakes away. The amount of earwax that is produced roughly equals the amount that’s eliminated.

It’s fine to use a washcloth to swab away the yellowish residue that can accumulate on the outer portion of the ear. What you don’t want to do is swab inside the canal itself.

WHAT GOES WRONG

Some people produce more earwax than others or expel it more slowly. The ear canal is only about a quarter-inch in circumference. Once about 80% of the opening is blocked, or impacted, you can experience a hearing loss of up to 40 decibels. That’s enough to make it difficult to hear normally.

About one in 20 American adults suffer from impacted earwax. People who use earplugs have an even higher risk because the frequent removal/insertion of these devices increases wax production and pushes wax farther into the canal. It’s best not to use earplugs unless you really need them. You can protect your ears from loud noises by wearing noise-blocking headphones or earmuffs. If you spend a lot of time in the water, you usually can prevent swimmer’s ear (an outer-ear infection) by applying a few drops of an over-the-counter drying agent, such as isopropyl alcohol, immediately after swimming.

People with hearing aids and those who use earbuds with their cell phones and iPods also are more prone to earwax accumulation and may need to have wax buildup removed every three to six months.

EASY TO REMOVE

You can remove earwax yourself…

Important: Patients with diabetes and/or impaired immunity—from chemotherapy, AIDS, etc.—should never irrigate their ears themselves. It increases the risk for necrotizing otitis externa, a dangerous infection that can spread to surrounding bones in the skull.

• Presoften with water. Studies show that irrigation to remove earwax is more effective when the wax is presoftened. Put a few drops of body-temperature water into your ear canal, using a medical dropper. Hold your head to the side so that the water doesn’t drain out. Wait 10 to 15 minutes. Then…
• Irrigate. Once the wax has softened, use a bulb syringe to flush the canal gently with water. Don’t squeeze the bulb hard—too much water pressure can damage the eardrum. Aim the water at the side of the ear canal.

Helpful: Before shooting in the water, grip the top of the ear with one hand and pull it back and out, away from the head. This straightens the ear canal so that water can reach the entire length.

If you don’t have a bulb syringe, you can use a dental irrigator, such as a Waterpik. Use the lowest pressure setting…aim the water jet at the side of the canal…and keep flushing until you see wax coming out.

Seek professional help if you’ve irrigated and you still have symptoms.

Source: Richard M. Rosenfeld, MD, MPH, professor and chair of otolaryngology at SUNY Downstate College Medical Center in Brooklyn, New York, and senior consultant for Guidelines Development Task Force Newsletter for the American Academy of Otolaryngology-Head and Neck Surgery Foundation, based in Alexandria, Virginia.