“What can I do about ear wax?” is a question that many patients ask of ENT physicians. Most patients do not have significant wax problems that cause complete impaction, or filling, of the ear canal. In fact, very few patients have complete wax impaction that can cause symptoms, such as hearing loss or ear pain.
The reason few patients have significant ear wax problems are because the ear canal slowly pushes the wax out, essentially cleaning itself. However, some patients may have trouble because the wax their glands produce is thicker; or the ear is not as good at cleaning itself as others. Thus, they are more likely to develop wax impaction.
The most common symptoms patients note with a wax impaction is hearing loss and a “fullness or pressure” in their ear. Less common complaints are ear pain or drainage. Some patients note an itching sensation, which is mild inflammation of the skin in the ear canal, that is commonly attributed to long-standing ear wax.
Many patients can prevent impactions by using some home remedies. Patients can use a fluid mixture and gentle irrigation with a rubber bulb syringe. Common mixtures include a 1:1 mixture of hydrogen peroxide and water, or a 1:1 mixture of rubbing alcohol and white vinegar (acetic acid). Flushing the ear canal every few weeks will often clean the ear and prevent wax impaction.
If this does not work to relieve the symptoms, then an over-the-counter wax removal kit may be beneficial. This device attempts to soften the ear wax and allow gentle removal. An older technique that is not used commonly today is ear wax candles.
Patients that still have trouble despite these maneuvers should be seen by an ear specialist. ENT physicians have a microscope for improved visualization, as well as small curettes and suctions that aid in wax removal. This can be done in the office, typically completed within 15 minutes.
A technique that often should be avoided is the use of cotton swabs, or Q-tips. This commonly will just push the wax deeper in the ear canal, making the problem worse. Additionally, there is a risk of injury to the ear canal or ear drum, which may cause permanent hearing loss.
Ear wax plays an important role in preventing ear infections, but can cause problems for patients as well. Any questions or concerns can be further discussed with your local ENT physician.
Robert Wilson, MD.