By Howard LeWine, M.D.
Q: How do you clear wax build up in the ear? I have small ear canals and it’s difficult for me to clear the wax build-up. I use hydrogen peroxide, but it doesn’t always help. What do you recommend?
A: Earwax (the medical term is cerumen) is the sticky substance made by small glands in the ear canal. The ears make cerumen for several reasons. It keeps the skin inside the canal moist. This helps prevent dryness and itching.
Cerumen traps dust and tiny particles and helps block objects from reaching the eardrum. In addition earwax stops bacteria from multiplying, so there is less chance of infection.
As the earwax dries, it moves out of the canal naturally, taking debris with it. Although the wax feels dirty, it actually helps keep the ear clean.
In general, you should only remove earwax if it causes discomfort, difficulty hearing, ringing in the ear (tinnitus) or coughing. (Pressure against the eardrum can trigger a cough).
Cotton tip swab such as Q-tips get some wax out, but have a tendency to push some in deeper. Over time, this can make the situation worse. This is especially true for children who have smaller ear canals.
Since most ears are “self-cleaning,” the best way to deal with extra wax in your ears is just to clean the outside of the ear with a washcloth and let the earwax move outward.
I realize that this is often not sufficient. There are several substances that help soften wax that has hardened inside the ear. In general, commercial eardrops, hydrogen peroxide, baby oil and mineral oil are safe. They should not be used if you have an active ear infection, a perforated eardrum (a hole in the ear), or you have had surgery on the ear.
Any liquid that you put into a partially blocked ear may get trapped between the wax and eardrum, and may temporarily make the blockage worse.
One caution about hydrogen peroxide: Hydrogen peroxide turns into water in the ear after the oxygen bubbles off. This leaves the ear canal moist, and can allow growth of bacteria. By gently rinsing the canal with rubbing alcohol, the water will be displaced and promote drying. If you develop pain, stop immediately; you may have an unrecognized perforated eardrum.
If none of these work, make an appointment with your doctor or an otolaryngologist (ENT specialist).
By the way, you may have heard of candling. Lighting a cone shaped candle that is placed in the ear has been falsely promoted as a way to remove impurities from the canal. And it’s not safe. It can result in a burn, hardened wax in the canal and even perforation of the eardrum.
(For additional consumer health information, please visit www.health.harvard.edu.)