Today’s challenge is to make earwax interesting. It’s an extremely common problem among my patients, and a little education won’t hurt. I do recognize that the subject is unappealing and not discussed in polite company, but we all have it; so here’s an earful.
History tells us that in medieval times, earwax was used by scribes to prepare pigments. The 1832 edition of American Frugal Housewife recommended earwax to prevent the pain resulting from a wound from a nail. It also suggested that earwax was a good remedy for cracked lips. Before waxed thread was commonly available, seamstresses would use their own earwax to stop the cut end of a thread from fraying. That sounds pretty ingenious to me.
Earwax is also known as cerumen. It is a sticky combination of sebum (sloughed off skin cells from inside the ear) and secretions from glands in the outer ear canal. There are basically two types – wet and dry. The type depends on your genetic makeup. Almost all of those with African or European ancestry have the wet type of earwax, and almost all East Asians, Pacific Islanders, and Native Americans have the dry type. Earwax color can range from bright orange to dark brown. Adults tend to have harder and darker earwax, while children typically have softer, lighter wax.
Earwax is a good thing:
■ It protects us in a way similar to that of eyelashes and nose hair. Earwax shields us from bacteria, dirt, and other microorganisms that might get into the sensitive inner ear and cause irritation, inflammation, or infection. The waxy substance traps and essentially suffocates whatever might collect (and breed) in the ear canal, and has antimicrobial properties.
■ Similar to tears, earwax lubricates our ears. Without adequate amounts, our ears would feel dry and itchy.
■ It makes our ears self-cleaning. When we chew, we help keep earwax churning slowly from the eardrum to the ear opening, where it normally dries up, flakes off, or falls out.
Since our ears are self-cleaning, we should never stick anything in them…in theory. We’ve all heard this. Are cotton-tipped swaps used by most of us, including doctors? Absolutely. Be aware, however, that we may actually be pushing wax further into the ear, where it can block the ear canal. This affects hearing, and earwax is the most common cause of partial hearing loss.
As we age, earwax may become more of an issue. The skin of the ear canal becomes drier, making it more difficult for earwax to drain normally. Cilia, the tiny hairs in the ear, tend to increase with age and trap more earwax. Hearing aids, ear buds, and earplugs may block the drainage of earwax. Those who suffer recurrent ear infections or some skin conditions may tend to accumulate more earwax.
Symptoms of excessive earwax accumulation include frequent ear infections, tinnitus or ringing in the ears, pain or itching in the ear canal, partial loss of hearing, dizziness and vertigo, and the sensation of plugged ears.
So, what is the safest way to clean our ears? Let’s start with what NOT to do. Ear candling, also called ear coning or thermal-auricular therapy, is an alternative medicine practice purported to improve general health and well being, and to remove earwax. A hollow candle is used to soften and suction out wax. Ear candling may be dangerous and ineffective. Hot wax is simply not a good thing to have anywhere near the ear canal and eardrum.
If you have diabetes, a weakened immune system, a tube in the ear, or a perforated eardrum, do not attempt to remove earwax yourself. However, most healthy people can remove earwax by softening it with drops of baby oil, mineral oil, glycerin, hydrogen peroxide, or an easily found commercial product like Debrox. Once softened, the wax can be washed out by gently squirting water into the ear canal with a rubber-bulb syringe.
Your primary care doctor or an Ear Nose and Throat doctor (ENT) can remove earwax by washing, vacuuming or scraping out the wax. Don’t hesitate to see your doctor if your hearing has worsened, if you have ear pain, or experience blood coming from your ear canal. And, don’t forget to donate that excess earwax to your local seamstress.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.