By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S EARWAX BUILDUP MAY REQUIRE PERIODIC CLEANING BY DOCTOR

Question: I went to the doctor yesterday because I couldn’t hear out of one ear. She said it was full of wax, cleaned it out and now I hear fine. This happens 2 or 3 times a year for me, but it never happens to my wife. Why do some people have wax problems and others don’t? Why do we have earwax anyway?

Answer: Cerumen, the medical term for earwax, is produced by special glands that line the skin of the outer ear canal. The wax is produced to protect the ear canal from foreign substances, such as dirt, dust and even bacteria. Cerumen also helps to keep the ear canal dry as it repels water.

In most people earwax is produced in small amounts and starts out as a thick liquid. When earwax is exposed to air, it gets even thicker and may dry into small flakes. As new wax is formed, it pushes the old wax toward the opening of the ear, and it eventually falls out, either as flakes or as a thick "gooey" substance. As earwax falls out of the ear, it takes debris with it. In this way, your ear is a natural self-cleaning mechanism.

The process I’ve outlined is what happens in the theoretical normal ear. Many of us, though, fall somewhat short of this ideal, and it sounds like you are one of those people.

The majority of humans are like your wife and go their entire lives without having to have earwax removed. Others of us are less fortunate and seem to have chronic earwax buildup. Cerumen buildup can be due several reasons, including overproduction of wax, narrow ear canals and dryer than normal wax. One or more of these could be true in your case. People who normally wear work-related instruments in their ears, like doctors with stethoscopes and construction workers who wear ear plugs, may have buildup problems as well.

The old adage about never putting anything smaller than your elbow in your ear really is true. Despite this warning, many people use such things in their ears as cotton-tipped swabs, bobbie pins or the corner of a washcloth. These actions tend to push the wax deeper into your canal and disrupt its self-cleaning motion. If there is already a moderate build-up, pushing wax further into the ear canal rather than letting it come out normally can eventually compress the wax into a hard lump that cannot easily be removed. Also, the more often you put things into your ear canal, the more likely you are to get an ear canal infection.

Some people find using a couple of drops of mineral oil in each ear canal at bedtime once a week helps prevent buildup. There are also other over-the-counter products that can be used periodically to help prevent earwax buildup. You should discuss these products with you physician before using them.

Despite your best efforts, though, you may find that you have to continue to make periodic visits to your family physician’s office for ear cleaning. He or she may use special tools and a magnifying glass to pick out hard lumps of wax while avoiding injury to the ear drum and other delicate structures of your ear. Another wax-removal method your doctor can use is to squirt water into the ear at an angle so that it splashes against the top of the ear canal. In general, I advise against using those rubber bulb ear syringes that are sold in drug stores for cleaning out your ears with water. This is because some ear conditions can make that method of wax removal a harmful practice.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.