Step Away from the Cotton Swabs! Earwax - What is it and how to manage it

by Thomas A. Powers, PhD, HIA Strategic Advisor

October 5, 2022


Social media platforms such as TikTok have provided some very interesting tips and tricks, from workout and beauty routines to home organization to personal hygiene. Some influencers provide very useful information, while others should be left in question. One trend growing in popularity over the last few years has been the ‘satisfying’ videos of earwax removal, some of which have now gone viral on social media and may have inspired an increase in at-home earwax removal products shown in TV commercials. But is it a good idea to treat your ears regularly at home? Keep reading to learn the truth about ear health, what signs to watch out for, and when you should seek professional help.


So, what is earwax, and does it really have a purpose? 

Yes, earwax has a purpose! The lining of the ear canal has glands that secrete an oily substance, earwax, that coats the ear canal. Earwax flows outward from the ear canal to trap dead cells, hairs, and debris to keep it moving out of the canal. It also keeps the ear canal from drying out.


However, when ear wax does not move out of the ear canal or the individual has an excessive production of wax, it may collect in the ear canal and eventually cause a blockage. Older adults may have more problems with ear wax because as we age, the ear wax becomes drier and does not easily migrate out of the ear canal. If the buildup continues, it may lead to pain and discomfort, as well as hearing loss. In some cases, the ear wax builds up against the eardrum and may cause balance issues. 


People who wear hearing aids or earbuds on a regular basis may have more issues with wax. This is because the devices may not allow the wax to move out of the ear canal or it may even push the wax further into the ear canal each time the device is inserted into the ear. Further, if the wax gets into the earmold or receiver (loudspeaker) of the device it may reduce the level of sound you are able to hear. This may lead you to think your hearing is getting worse when it may just be a buildup of wax.


So how do we manage earwax?

I am sure we all remember our parents telling us not to put anything smaller than your elbow in your ear. Funny, but good advice. Using cotton swabs - or worse, bobby pins or other pointy objects - to try to clean ear wax can lead to abrasions in the canal or even a puncture of the eardrum by going too deep into the ear canal.


The first safe step in managing earwax is removing the wax that may collect at the edge of your external ear. Use a damp washcloth and your finger to wipe around the ridges of your external ear.   If you are someone that has been told you produce excessive wax, you may try over the counter products (such as Debrox). This method involves putting several drops of the solution into your ear canal to start to soften the wax and allowing it to naturally move out of the canal. Some of these products come with a small bulb syringe that allow water to be squirted into the canal to help the movement of the wax. However, you need to be very cautious with this method and carefully read instructions before use. You need to be certain that you do not have an eardrum perforation (hole in the eardrum) as this may allow water to enter the middle ear and lead to an ear infection.


The best way to remove a wax buildup is to see your personal physician or audiologist. Both have training in the safe removal of earwax, and generally employ one of two methods. One involves using a curette, or a slim device that can be inserted into the ear canal to scoop out the wax. The second is the use a specialized irrigation system to flush out the wax.  For complicated cases where the wax has hardened or is very close to the eardrum, it may be necessary to consult an ear, nose, throat (ENT) physician. They may use a special microscope that provides a deep view into the ear canal to remove wax that is deeper in the ear canal. 


If you suspect you have earwax issues, then seeking out help can provide significant and immediate benefits. Most individuals that have impacted wax removed report that their hearing improved, and some even reported improvement in their balance. Keeping wax out of your hearing aids also can lead to better performance of your devices and, of course, better communication. 


So, keep your elbow out of your ear, but don’t forget about how excessive earwax can affect your hearing. Make it a point to have your ears checked and, if you wear hearing aids, visit your hearing professional for regular cleaning and maintenance.

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