At Home Earwax Removal
What is Earwax?
Earwax is a mixture of numerous chemical and physical elements coming together to form the yellow to brown substance we see in our ears including;
keratin (dead skin cells)
squalene (a natural moisturising lipid)
sebum
alcohol
cholesterol
long chain fatty acids
amino acids
small particles (dust/pollen) blown into the ear canal
There are 2 main types of earwax and which type you have will depend on your genetics:
wet earwax is the type produced by people who's ancestors are European, African, some South Americans and some parts of East Asia
dry earwax is usually produced by people who's ancestry comes from some parts of East Asia, South and Central Asia, native North American Indians, Pacific Islanders and some South Americans
The simple answer to this is that, under normal circumstances, you don't. Your ears have their own self cleaning process called 'epithelial migration'. Like the rest of your skin, the thin layers of skin in your ear canal (epithelium) need to be constantly replaced. The skin is produced from the centre of the tympanic membrane (eardrum) and grows out to the edges of the drum and then along the ear canal in a corkscrew type of motion. Dead skin cells fall into the ear canal and help to form earwax (approximately 60% of earwax is dead skin cells). If the earwax remains soft then this process, along with jaw movements, helps to carry the earwax out of the ear canal. If the earwax hardens however, this can disrupt the process as it is more likely to stick to the wall of the ear preventing the migration of the skin caught behind it. Keeping the earwax soft using an olive oil spray won't prevent ear wax build up, but can aid your ears natural cleaning mechanisms, especially as we age and the production of natural oils like sebum and squalene are reduced.
It is not recommended for someone to try to clear the wax themselves. There are many devices you can buy quite cheaply online but without knowing the anatomy of your ear, or being able to see what you are doing, these solutions often lead to the problem being made worse, or increase the risk of you causing damage to your ears. Hopi or ear candles are also dangerous and are not recommended for use in wax removal by a significant majority of ENT professionals in the UK.
There are a number of methods for performing earwax removal which are currently approved in the UK. No method of earwax removal is completely risk free and there are certain physical or neurological conditions which could exclude you from being suitable for some of these procedures. The method chosen by the health care professional will be the one they deem to be safest, dependent on your medical history and/or your experience of any previous ear wax removal procedures. You can see the methods of earwax removal we use here.
Your body produces many things which don't sound or look pleasant such as bile or phlegm, but which are important for your health. The same applies for ear wax, which contrary to popular belief, is actually a good thing to have in small quantities. Earwax has a number of functions which are beneficial to your ear health including:
it absorbs excess moisture which helps to maintain the temperature and humidity in the ear canal
earwax is naturally bacteriostatic and helps to control the growth of bacteria or fungii which would otherwise thrive in the dark, warm, moist environment
it helps to moisturise the ear canal reducing the build up of dead skin cells
It prevents the ears from becoming too dry and itchy which becomes more common with age
It is acidic with a typically average pH of 6.1 which helps it's anti-microbial properties. This is also beneficial in keeping small insects from entering the ear canal
Therefore it is not usually necessary to remove earwax unless there is a clinical need or it is causing a problem such as:
the build up of earwax is blocking the ear and affecting your ability to hear normally
the earwax is causing tinnitus (usually temporary until the blockage is cleared)
the earwax has become hard and impacted (usually from the incorrect use of cotton buds or Q-tips) leading to pressure or pain in the ears
the wax is causing feedback issues with a hearing aid wearer
Why Do I Have Earwax?
How Do I Remove Earwax?
Some practitioners don't advocate any preparation of earwax prior to removal. Trying to remove hardened earwax without preparation increases the risk of damage to the ear canal..
At Ear Health Matters we prefer clients to help prepare the earwax for removal by using an olive oil spray [1] for a few days prior to the appointment. Using olive oil spray helps to reduce the risk of damage to the delicate skin of the ear canal as the wax is removed. It is also a good idea to use olive oil spray as we age to help maintain the ears own self cleaning mechanism.
[1] not recommended if you have a perforated eardrum, mastoid cavity, or have been advised previously by your GP / ENT consultant not to.
Do I Soften Earwax for Removal?
Quiz Answers:
cotton buds or Q-tips are most often found in the baby aisle or department of a store. This is because they were originally designed to clean and dry between the fingers and toes of babies, which are very close together when born
despite what your mum told you, or taught you to do, cotton buds are in fact not at all safe to use in your ears. You are more likely to push earwax deeper into the ear canal and compact it, making it harder to remove. There is also the danger of damaging the ear canal or in worst case scenarios, perforating the eardrum, causing bleeding, tinnitus and hearing loss. In fact every pack of cotton buds carries a warning stating NEVER insert a cotton bud into your ears or nose'. So the answer is 0cm
This is a trick question as no method of earwax removal is 100% safe. Risk factors include but are not limited to, discomfort or pain, tinnitus, dizziness, hearing loss, trauma (which can be from a minor scratch to a larger cut and bleeding, or perforation of the eardrum). Many of these things can be temporary or permanent. The most important thing is that you make sure that the person performing the procedure has the correct training, experience and knowledge of ear anatomy necessary to minimise the risk factors. You should also feel comfortable with them as earwax removal can be a very invasive procedure
False. The most common cause of hearing loss is the ageing process (presbycusis) where the fine hair cells in the inner ear are damaged. In the 'normal' hearing ear, earwax would need to fully occlude the ear canal and form a little plug to cause significant hearing loss. For hearing aid wearers a partial blockage can cause hearing and feedback (whistling) issues if it sits in front of the sound outlet of the hearing aid.
Of course this will vary occasionally from one person to another and some people will produce significantly more earwax than average and others significantly less. As we age the rate of growth of skin in the ear canal slows down and the natural migratory cleaning process becomes less efficient. At the same time the production of squalene or oil in the ear canal is reduced, which can make the ears dry and itchy. Without moisturisation more dead skin cells build up in the ear canal, increasing the amount of earwax produced. It is advisable as we age to use olive oil spray to help aid the ears natural cleaning processes.
Take This Quick Earwax Quiz (answers at the bottom of the page)
In which aisle of a store or pharmacy would you usually find cotton buds or Q-tips?
What is the depth in cm that you can safely enter a cotton bud into your ear canal?
What is the only safe method of earwax removal?
True or False? - Earwax is the main cause of hearing loss
Microsuction is currently the preferred method for ear wax removal.
Earwax is removed from the ear via a metal tube in a similar way to saliva being sucked from your mouth at the dentists. A vacuum pump is used to create suction which can be used to gently ease the earwax from the ear canal.
Micro suction is more invasive than irrigation and in some cases may not be the safest option to use.
The clinician may use magnified glasses (loupes), or a large ENT style microscope to get a good view of your ear canal during the procedure. In some cases an endoscopic solution may be used
Earwax Removal Services
Irrigation (what most people call syringing) uses warm, water to flush the earwax from the ear. Irrigation via a syringe is no longer considered safe as the practitioner could not determine the amount of pressure being used and this could lead to greater risk of damage to the ear canal or ear drum. Irrigation cannot be used on clients with perforated ear drums, mastoid cavities or a cleft palate (even if repaired). Other conditions may not rule out using this method but would warrant caution which the health care practitioner will be able to discuss with you at the appointment. The practitioner should dry the ear thoroughly after irrigation via any method.
At Ear Health Matters we use two methods of irrigation.
The Guardian Projet 101 is a small pump designed to inject a single stream of warm water into the ear canal. The pressure is controlled so is safer than the old hand held syringe method. The water passes beyond the earwax and rebounds off the eardrum pushing the earwax along the ear canal and out of the ear
The Bionix Ear Wash Spray is a trigger bottle or pressure pump device which uses a specially designed tip which injects 3 streams of water along the walls of the canal which makes it very gentle and clients have reported finding it very therapeutic. It's very effective at clearing wax close to/on the ear drum, where micro suction wouldn't be advised
In some cases it may be possible to remove the earwax with an instrument such as a wax probe, wax pick or wax scoop. Larger sheaths or flakes of wax may be removed using forceps. It is not recommended you use instruments or implements to try to clear the ear wax yourself as it is more likely the earwax will be pushed deeper into the ear canal and become impacted or make contact with the eardrum. You should avoid buying and using cheap implements such as those sold online as you are more likely to cause damage to your ear canal, ear drum or even your hearing.
Microsuction
Your body produces many things which don't sound or look pleasant such as bile or phlegm, but which are important for your health. The same applies for ear wax, which contrary to popular belief, is actually a good thing to have in small quantities, as it has a number of functions beneficial to your ear health (you can find out more about ear wax here). A build up of ear wax however can cause numerous issues (which are usually temporary) such as pain, tinnitus, hearing loss and dizziness and there becomes a clinical need to have it removed.
At Ear Health Matters we prefer clients to help prepare the earwax for removal by using an olive oil spray* for a few days prior to the appointment. Using olive oil spray helps to reduce the risk of damage to the delicate skin of the ear canal as the wax is removed. It is also a good idea to use olive oil spray as we age to help maintain the ears own self cleaning mechanism.
*not recommended if you have a perforated eardrum, mastoid cavity, or have been advised previously by your GP / ENT consultant not to.
Irrigation or Ear Wash Spray
Instrumentation