What could be more exciting than a blog about ear wax? Several times a day I have patients come in with their ears blocked by wax. Some have tried to get it out themselves. Others have seen their primary care docs or nurses. Others are repeat visitors. Most are having problems hearing and some are having pain or pressure. Often they seem slightly embarrassed to come in with “such a minor problem.”
The reality is that ear wax is a significant and vexing problem for a lot of people. Wax is a modified skin oil, mildly antiseptic, and is good for trapping dust and other things. For most people, the ears will naturally move the wax out – and if we leave things alone, all will be well. For others (and I am actually one of these folks), it will build up and become a problem.
Home remedies are often more harmful than helpful. Cotton swabs are used by – IMHO – a shocking number of people. And, most of them get away with it. The problem is that with a swab we are counting on the wax to stick to the cotton and come out. There is no way to get BEHIND the wax. So, if not all of the wax comes out, the swab will likely pack it in deeper where real trouble can develop.
It is like muzzle-loading a cannon. Which is why I call them “Satan’s Sticks.” I tell my patients that the Devil himself owns the factory that produces them. That may be overstating it a little.
Don’t even get me started on ear candles. Just read the Wikipedia article on that hocus-pocus.
Using an over-the-counter wax removal kit, which usually has some hydrogen peroxide to soften the wax and make it easier to flush out, is better. However, if people wait for the ear to be full, it just doesn’t work. What I tell people is that if they want to try this, they should set a phone alarm or calendar reminder and do it every two months, starting with clean ears. More often than that a dry, itchy eczema will develop. Less often, and the build-up will be too much.
In my practice, I have a big ear microscope and a set of micro tools which allow me to clear out almost any wax impaction with minimal discomfort. My friends in primary care, who don’t have the same equipment, usually can only do irrigations, which may or may not work. When flushing doesn’t work, they send their patients over to see me. Most patients who have had cleaning both my way and with the water choose to never have the water again.
To close, don’t be embarrassed to come and see us! It is actually an interesting challenge to remove wax. Plus, I get the satisfaction of instantly curing a problem. Win-win!
