FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

RUNNING EARS, WAX BLOCKAGE AND FOOTBALLS

Question: I was having trouble hearing, so I went to my doctor. He found the trouble. My ears were full of wax. My hearing is back to normal now that my ears are clean. I felt a little foolish about this entire problem. How common is this ear wax problem, and what is the best way to remove it?

Answer: Don't feel embarrassed about taking any health problem to your doctor. Helping individuals deal with embarrassing problems is what we doctors are trained to do. We don't find the problems embarrassing at all. In fact, a problem like your blocked ear canals is one of the most rewarding for us because it is fairly easy to provide a cure. No miracle surgery or wonder drug is required. It just takes removing a little bit of wax.

Ear wax, called cerumen by doctors, is produced as a thick liquid by special glands in the ear canal. When the wax is exposed to the air it becomes thicker yet and may even dry into small flakes. As new wax is formed, it pushes the old wax out of the way and toward the opening of the ear. The old wax then, as flakes or thick "goo," falls from the ear. I've had patients say "my ears are running" when this happens. It is, however, a totally normal and desirable event when increased wax is the cause.

Obviously, this normal sequence of events doesn't always happen. The wax that is produced can be thicker and drier than ideal making it difficult for the older wax to be forced out of the ear canal as new wax is manufactured. This wax build-up is common in those over 50, but it is not restricted to older individuals.

A more common cause for a wax blockage of the ear canal is the result of using cotton-tipped swabs to clean inside the ears. Individuals who try to clean their ears with these swabs may be successful if the amount of wax that is present is small. However, if there is already a moderate amount of wax build-up, the swab only packs the wax further into the ear canal, converting the soft wax into a hard lump that will not come out of the ear in the usual fashion. People who wear ear plugs for hearing protection or those who dig in their ears with pencils and similar items can have the same problem.

So as you may have guessed, having one's ears blocked by cerumen is fairly common. In my practice I see several people with this every week.

The best way to remove wax from the ear may be to avoid packing it into a hard lump. My recommendation for this is to put nothing in your ear smaller than a football! Wash the outside of the ear with a wash cloth like you do your face, but don't poke a corner of it down the ear canal. The natural body processes usually keep the ear canals clear and the skin healthy without other intervention.

There are some individuals that seem to have repeated problems with wax build-up despite doing everything they should. These people can see their doctor periodically to have their ears cleaned out or they can do it themselves.

The doctor can clean your ears by "digging" the wax out with aid of magnification to avoid injuring the delicate ear drum and skin of the ear canal. He or she may also use a syringe to squirt water into the ear at an angle so that it splashes against the top of the ear canal. The water swirls inside the canal and lifts out the wax.

You can also use this "water removal" method at home. A rubber bulb ear syringe available in most drug stores at a reasonable price is a great tool for producing the gentle and controlled stream of water necessary for this task. If the wax has become very hard, it may be necessary to soften it with a few drops of mineral oil, Cerumenex, or similar products. After a few minutes, or as long as over night, the wax can then be flushed from the ears with body temperature water. However, before you start washing your ears with ear syringe, I recommend that you talk to your family doctor to make sure using one is OK, since there are a few ear conditions that make this method of wax removal a bad idea.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.