Earwax is something familiar to all of us. Everyone has earwax for sure. The picture above shows the dry earwax type (less common), while the one below shows the wet earwax type (more common).
Not all earwax needs removal.
Reasons for earwax removal include:
- Pain in the ear
- Feeling of blocked ears
- Reduced hearing or difficulty hearing when the surrounding is noisy
- Ringing sound in the ears
- Ear discharge
- Poor hearing in children causing difficulty hearing in school, which in turn affects school grades
If you have the above symptoms, then your earwax should be removed.
The best way to diagnose earwax is to get a doctor to look into your ears with a device called an otoscope and give you further advice.
Why do we have earwax?
Earwax is part of the normal protective function of the ears.
Earwax sits in the ear canal.
Where does it come from since the ears are essentially a closed tunnel?
Earwax is the shed skin from the eardrum that starts moving out, added with the secretions from the glands1. When it works normally, the shed skin will move out, pushing the old wax out and causing it to fall out by itself.
When earwax was analysed2, we found that it contains long chain fatty acids, alcohols, squalene and cholesterol. Basically, in simple English, it came from your own body! We always used to think that it came from “somewhere out there”.
So why do some people have earwax that causes them pain, blocked ears or just doesn’t come out?
- They dig their earwax.
- Yes! Quite counter-intuitive, isn’t it?
- Digging sometimes pushes the earwax in. Remember how I just told you that the wax inside will slowly move out? Well, digging disrupts this mechanism.
- They have narrow ear canals (ear canal stenosis) and sometimes if they are really very narrow, they will require surgery.
- Their earwax type is more dry or stickier than other people’s.
- They have had previous surgeries which change the characteristics of the ear lining, such as mastoidectomy.
After my earwax is removed, how do i “maintain” the ears?
After we remove your earwax with ear suction or ear syringing, you actually do not need to maintain the ears contrary to popular belief. People are often shocked when we tell them this at the end of the procedure. The earwax protects our ears. There are exceptions though, read on…
There are about 8% of the population (about 1 in 12), who are very unfortunate. Their earwax doesn’t come out by themselves and they will need some help from professionals. Usually the doctor will tell you, or you will find that you frequently have to undergo some form of ear cleaning.
You might want to consider applying some olive oil in your ears long term.
Otherwise, most of the time, the earwax comes out by themselves and do not require any form of treatment.
I’m sure most people are familiar with this. They can be bought for less than a dollar each at the nearest convenience store. Coupled with a pair of steady hands, good lighting and an obedient
victim patient, most wax can be easily removed.
The safety and effectiveness of ear picks have not been studied in a formal clinical trial (please correct me if I’m wrong), and I’ve personally seen some problems with this.
Sometimes, the lining of the ears can be scratched or damaged which can be very painful and predispose individuals to infections.
This is a real life example of a patient who tried to dig the earwax and ended up with a big red scratch inside the external ear canal. Not very nice.
Others have ended up with a big ear infection or a big pimple (the pinkish lump on the top left) (medical term: furuncle) which requires a visit to my clinic once every few days.
The picture above is of one in the early stage, the next picture is of a growing one (from another patient).
This last one belongs to another patient who came in for treatment extremely late and as you can see, the condition is getting rather serious. He might even require minor surgery.
The “cotton bud”
The all-time favourite cotton bud.
Generally, this would work for a small amount of wax that is wet and close to the outside of the ear. For deeper or other types of wax, this can push it further in. I have seen patients who get ear infections after using these.
I would NOT recommend anyone to use this, unless you want to let doctors earn more money from cleaning your earwax which has been pushed in by this. See here for an example of what I mean.
I even had to remove the cotton bud that was left behind in the ear countless times. See here.
There were also some patients who tore their eardrum with the harmless-looking cotton bud.
Notice the tiny hole over the bottom right hand corner?
The same ear 1 month later. He is lucky that it healed.
Nothing scares patients more than bleeding from their ears
There are various types of solutions that can be placed into patients’ ears. If you are interested you can click here. My personal “favourite” is still olive oil. It is safe and non-toxic, seldom causes problems, and also happens to have other uses (think: makeup remover, moisturiser). However, please do NOT use the one above or any cooking oil. Try to get a medical grade one from us or from the pharmacy or polyclinic.
The other solutions tend to make the wax expand and might cause more pain.
The “ear spray”
Recently, there have been a few “ear sprays” being sold over the counter. I do not recommend you using any one of them unless you really want to see us soon…
When all else fails
We will need to remove them for you with professional tools.
If you wish to see the doctor for your ear issue, please download the MaNaDr app to make an appointment.
1. I O, B B, P S, M H. The organic composition of earwax. J Otolaryngol 1991;20(3):212–5.
2. Lebensohn, J.E., 1943. Impacted cerumen: Incidence and management. US Naval Medical Bulletin, 41, pp.1071-1075.
3. McCarter DF, Courtney AU, Pollart SM. Cerumen impaction. Am Fam Physician 2007;75(10):1523–8.