What is ear wax?
Ear wax is a build-up of dead cells, hair, foreign material such as dust, and cerumen. Cerumen is the natural wax produced by glands in the ear. It forms a protective coating of the skin in the ear canal. Small amounts are made all the time. Flakes or crusts of ear wax break off and fall out of the ear from time to time.
The quantity of earwax made varies greatly from person to person. Some people form plugs of earwax in their ear canal. This may cause a feeling of fullness and dulled hearing. It can feel uncomfortable. A hard plug of ear wax can also sometimes cause 'ringing in the ear' (tinnitus) or even a mild type of dizziness (vertigo).
A plug of ear wax is not a serious problem, more a nuisance. You only need to remove ear wax if it is causing symptoms such as dulled hearing. Ear wax may also need to be removed for fitting of a hearing aid, or if a doctor or nurse needs to examine your ear drum.
Note: do not try to clean the ear canal with cotton wool buds, etc. This can make things worse, as you will push some ear wax deeper inside. It may also cause an ear infection. So, let the ear clean itself.
What can I do if ear wax builds up and causes symptoms?
Ear drops
Ear drops alone will often clear a plug of ear wax. You can buy drops from pharmacies. For example, olive oil, almond oil, sodium bicarbonate, and sodium chloride ear drops are commonly used for this purpose. Warm the drops to room temperature before using them (let the bottle stand in the room for about half an hour). Pour a few drops into the affected ear. Lie with the affected ear uppermost when putting in drops. Stay like this for 5 minutes to allow the drops to soak into the ear wax. The ear wax is softened and it often breaks up if you put drops in 2-3 times a day for 2 weeks. Flakes or crusts of ear wax often fall out bit by bit. You may not notice the wax as it comes out of your ear. If ear drops are not successful at removing the wax then you may wish to consider micro-suction which can be sought privately.
Micro-suction
Micro-suction is used to remove excess or impacted wax from your ears. A small suction device is placed into the ear canal. Any excess wax that is seen down the ear canal through a microscope is suctioned out. Micro-suction is the safest and most effective way to remove wax without using water or pressure. The ear and the eardrum are viewed clearly during the procedure and the clinician can assess the health and condition of your ears. Most people tolerate micro-suction very well. Most impacted wax can be removed first time and without pain. This is not a service provided by your GP surgery. There are many places which offer private micro-suctioning – an example is Specsavers.
Ear syringing
During ear syringing the ear canal is washed out with warm water. Irrigating the ear with water will usually clear plugs of earwax. But it is only safe if the plug of earwax has been softened. Irrigation when the wax is hard increases the risks of perforating the ear drum. Therefore, use ear drops (such as olive oil ear drops) to soften wax 2-3 times a day for 2 weeks before you have ear syringing. If you have not used ear drops as directed then the irrigation is not likely to be successful.
There are risks associated with ear syringing. These include:
· Failure to remove ear wax or is pushed further down the canal.
· Pain/discomfort.
· Dizziness/vertigo.
· Nausea/vomiting.
· Perforation or the ear drum.
· Ear infection.
· Worsening of pre-existing tinnitus.
Ear irrigation may not be advised if you have certain ear problems. In particular, if you:
· Have had complications following this procedure in the past.
· Currently have grommets in place (grommets are small plastic tubes placed in the eardrums in an operation).
· Have had ear surgery in the past (apart from grommets that have come out at least 18 months previously and you have been discharged from the hospital ear department).
· Have a cleft palate (even if it has been repaired).
· Have an ear infection or have had an ear infection in the previous six weeks.
· Have recurring infections of the ear canal (recurring otitis externa).
· Have, or have had, a burst (perforated) ear drum.
Can I prevent a build-up of ear wax?
Some people are troubled by repeated build-up of ear wax. In this situation, to prevent ear wax building up and forming a plug, it is recommended to use ear drops regularly - for example, olive oil ear drops, once or twice a week to keep the wax soft and minimise build up.