Earwax is a fact of life. We’ve all got it, and sometimes it gets a little gross. That leads many people to feel the need to clean out their ear canals. Show of hands, how many of you reach for a cotton swab after every shower just to be sure your ears are clean?
You’re definitely not alone if you do. But the fact is you might not have to.
“It’s really common. I don’t know if it’s cultural or passed down in families, but some people just feel like they need to clean their ears,” says Dr. Daniel Jethanamest, director of the division of otology and neurotology in the Department of Otolaryngology-Head & Neck Surgery at NYU Langone Health in New York. “Maybe people just feel like it’s something they’re supposed to do as part of their normal hygiene.”
However, the ears have a “self-cleaning mode” and for most people that’s more than enough to take care of business, Jethanamest says. “They’re just built to migrate earwax and dead skin cells and other things outwards.”
Dr. Quang Luu, an otolaryngologist with Providence Mission Hospital in Orange County, California, agrees. “The good news is, ears are usually pretty good at cleaning themselves. The action of opening and closing your mouth moves the wax along in your ear canal,” and that action will move the wax out and bring any dirt and debris with it. For most people, cleaning and drying around the outside of the ear is often all that’s needed.
“Most ear doctors will tell you that for most people, you really don’t have to clean your ears. Cleaning your ears can actually lead to more trouble than leaving them alone,” Jethanamest says. These problems can include infections or even a perforated eardrum.
Dealing With Wax Buildup
That said, some people do develop issues with their ears and need a little more intensive care from time to time. That’s because as the skin cells that line the ear canal go through their life cycle, they slough off and are replaced by new cells. When mixed with earwax, that goopy mixture can build up over time.
“Earwax is a mixture of the skin cells that have sloughed off in combination with some oils that are secreted from glands that line the skin,” Luu says.
Though many people find it unpleasant, ear wax is actually a natural and healthy thing. “Earwax is meant to lubricate the ear canal and protect it from anything getting into the ear, including dirt and irritants,” says Dr. Brad DeSilva, an otolaryngologist with the Ohio State University Wexner Medical Center in Columbus.
In addition to moisturizing the ear canal, earwax helps “slow the growth of any harmful bacteria and prevent debris from going deeper” into the ear where it could harm the eardrum, Luu says.
However, as with anything else, some people have more ear wax or a tighter canal than others, and this could become an issue if it builds up or dries out and causes irritation. “Some people have narrow ear canals or slightly stickier wax,” Luu says.
There’s a lot of variability in ears and earwax from one person to another. DeSilva notes that in some cases, earwax “can be gooey, or almost like the consistency of peanut butter,” which is more common in younger people who have more oil in their skin.
In other people, earwax can turn hard and crusty. “If you have less oil and a little more turnover in your skin cells, you can get thicker, denser, crusty earwax that can be a little hard and cause pain if it’s really hard or obstructing the ear canal,” DeSilva says.
If you’re one of these people, then you likely know how the earwax can accumulate to a point where it blocks your hearing and causes other problems such as pain, pressure or an ear infection. It’s times like those when you might need to do a little ear housekeeping.
Cleaning the Ears Can Be Risky
Otolaryngologists, or ear, nose and throat specialists, “usually don’t recommend sticking anything in the ear canal,” Luu says. That’s because it’s relatively easy to unintentionally “push the wax deeper and cause a bad blockage” that’s even more difficult to remove.
That’s a problem because “you can potentially damage your eardrum” if you push a clump of earwax too far down the ear canal, DeSilva says. “Or, you can actually hit your eardrum with the Q-tip,” which could puncture the eardrum.
Jethanamest says that usually a perforated eardrum will heal on its own in time and not cause lasting damage. But in rare cases, even just a tiny perforation of the eardrum can lead to hearing loss. You might also need surgery to repair a perforated eardrum. “These situations are rare,” DeSilva says, “but we’ve seen them periodically.”
Jethanamest says he’s seen it happen — someone is diligently cleaning out their ears and another family member bumps into them or doesn’t realize they’re in the bathroom and opens the door and jostles their arm, sending the Q-tip right into the eardrum. A punctured eardrum can be very painful and may cause hearing loss, dizziness and vertigo.
When cleaning the ear canal, it’s also not uncommon to scrape or abrade the ear canal, which creates a separate issue, DeSilva says. “The skin is fairly sensitive, leading to an abrasion in the canal.” That can open you up to infection.
“If you remove all the wax and abrade the ear canal, you actually run the risk of bacteria proliferating in cracks in the skin and causing an external ear infection in the external ear canal.” In other words, some wax is good and helps protect the ear from infectious bacteria, so you don’t want to be too aggressive in trying to remove all of it.
Another potential issue is compacting wax deep inside the ear. “Some of the wax will come out, and it’ll probably feel kind of satisfying,” Jethanamest says. “But what could actually be happening is you’re pushing a little bit inwards.”
Over weeks and months of daily cleaning, that little bit of wax can build up to a lot of wax and become impacted, leading to a worse blockage and symptoms of pain, pressure and fullness in the ear. It can be very difficult to remove impacted wax.
[READ: How to Safely Use a Neti Pot.]
How to Safely Clean Your Ears
Instead of sticking things in the ear and potentially driving wax deeper in, Luu recommends using a few drops of glycerin or baby oil in the ear canal. “A few drops placed in the ear canal over several days can help soften the wax and help it move along.”
Adding glycerin, baby oil, mineral oil or even olive oil — “any oil that you might use on the skin,” Jethanamest says — seems to work best for maintenance cleaning. “If you’ve waited until it’s totally full and packed inside, then even if you add oils at that point, I don’t think they’ll make that much of a difference.”
If adding a few drops of oil doesn’t work, you can try an ear irrigation kit. These kits, available at a local drugstore, typically include a small bulb syringe — it looks a bit like a small turkey baster — that you use to “gently instill warm water into ear canal,” Luu says. This flushing action can help loosen the sticky wax and move it away from the skin inside the ear canal, allowing it to drain.
“Any of the widely available over-the-counter ear cleaning kits are safe to use as long as the instructions are followed,” Luu says.
You can actually make your own kit at home, DeSilva says. He recommends putting a few drops of a solution of 50% hydrogen peroxide, a mild disinfectant, and 50% water into the ears to help dissolve the wax. “You can get a dropper from the pharmacy and place about five drop of half-strength hydrogen peroxide into the ear canal.”
Let the drops sit there for a couple of minutes, “then turn your head to the opposite direction to allow it to drain out. Gently dry the outer ear with a tissue when you’re finished. “If you do that for a few days in a row, that can really dissolve any obstructed wax,” DeSilva says.
And skip the ear candling, a supposedly natural way of removing ear wax that involves lighting a long candle and placing it in the ear canal to suction out wax buildup. Luu cautions that there “isn’t good evidence that ear candling, or heating the air around the ears,” actually works to suck the wax out. He also notes that some patients have reported burn injuries after trying ear candling. Plus, this method can actually deposit candle wax in the ear canal, further compounding the wax buildup problem.
DeSilva also says he doesn’t recommend candling for the same reasons. So, skip the tapers and opt for a gentle solution to dissolve the wax.
When to See a Doctor
If you’re having trouble getting wax that’s really stuck out of your ears, you should visit with your primary care provider for assistance, as they may be able to flush your ear canal for you.
With more complicated cases, you may need to see an otolaryngologist for a professional cleaning, Luu says. During this process, the doctor uses an ear microscope and instruments to remove excess wax and debris from the ear canal. “Sometimes we have to use hydrogen peroxide gas to dissolve the wax in the office before we start removing the obstruction, especially when it’s really dense and hard,” DeSilva says.
“If you seem to have persistent and recurrent problems with earwax blockage or recurrent ear infections, it’s important to see an otolaryngologist for a formal evaluation,” Luu says. Because what you think is just a blockage could be something else. “Sometimes we see people who think they have long-standing hearing loss from earwax who instead have severe nerve damage hearing loss.”
DeSilva agrees that if you have a persistent earache, pressure in the ear and hearing loss that hasn’t responded to the topical drops, it’s time to seek medical care.
Lastly, Jethanamest emphasizes that you shouldn’t use Q-tips or stick anything long and pointy into the ears. “I think the takeaway is the majority of people really probably shouldn’t be doing anything routinely” to their ears. “Just let the self-cleaning mechanism kind of take care of things. That’s probably the safest and most efficient route.”
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