If you’ve had trouble hearing lately, or you’ve had ear pain or ringing in the ear, the culprit could be too much ear wax.
Having some wax in your ears is normal, and helps protect your ears from outside dirt and germs. But impacted ear wax—when the wax, or cerumen, builds up in the ear canal and causes blockage—is a significant cause of acute, temporary hearing loss. It also can prevent your doctor from performing a thorough ear exam.
A common problem
Approximately 1 in 20 adults, and 1 in 3 older adults, has an ear wax impaction. Some 12 million people in the U.S. seek medical care for wax removal each year. Those at especially high risk include people with narrow ear canals, and people who regularly wear earplugs or hearing aids.
“Hearing aids are a very common cause of impaired wax clearance,” notes Matthew Stewart, M.D., Ph.D., assistant professor of otolaryngology and head and neck surgery at Johns Hopkins Hospital. “Especially in those who wear amplification devices during all their waking hours.”
How doctors diagnose and treat it
Cerumen—the medical term for ear wax—helps keep our ears clean and infection free. The fatty substance, produced by sweat glands inside the ear, moves slowly through the ear canal. Along the way, it picks up dirt, dead cells, bacteria, and other debris. Ear wax usually dries up and flakes off.
But a plug of wax can become stuck, or impacted, in the ear canal, causing temporary hearing loss. In older adults, ear wax tends to get harder and thicker, making it more difficult to flake off. Besides difficulty hearing, symptoms of ear wax impaction include ear pain, the feeling that your ear is clogged and ringing in the ear.
The Academy of Otolaryngology-Head and Neck Surgery Foundation recently issued updated guidelines to help doctors more easily identify patients who have impacted ear wax.
To diagnose the condition, your doctor may look in your ear canal with a tool called an otoscope. If an impaction is found, your doctor may treat you or send you to a specialist called an otolaryngologist.
There are several ways to clear ear wax. After a doctor rules out problems related to your ear canal or eardrum, he or she may use irrigation or ear syringing for ear wax removal. He may do this by flushing your ear with water or with a small, curved instrument called a curet or a suction device.
Or your doctor may direct you in how to use an irrigation kit at home. Over-the-counter eardrops soften ear wax so that it can be easily drained. They can be used alone or with a syringe or similar device filled with warm water.
Hydrogen peroxide may also be used to soften wax for drainage. But patients with a history of ear surgery or a ruptured eardrum should never try to remove wax on their own.
If you’re predisposed to buildup, your doctor might recommend placing a cotton ball soaked in mineral oil in the external ear canal for 10 to 20 minutes once a week to help prevent accumulation.
What to avoid
Finally, some removal methods should be avoided because they are ineffective and potentially dangerous. These include:
• Cotton swabs, bobby pins, paper clips, and toothpicks. Some wax may come out on these items, but all they actually do is push wax deeper into your ears, which could cause irritation, injury, or infection.
• “Ear candling” or “ear coning,” in which a hollow candle or cone of waxed paper is placed in the ear and then set on fire. This procedure can result in burns or perforation of the eardrum and there’s no proof that it works.