What is cerumen and why is it a problem?



Ear wax, or medically known as cerumen, is naturally produced by the body to protect the ears. Cerumen is comprised of dead skin cells, hair, and secretions from the ceruminous and sebaceous glands of the ear. It is made by the outer third of the ear canal. Cerumen provides lubrication to the ears and contains anti-microbial properties to prevent infection of the ear. Accumulation of cerumen in the ear most commonly arises when people use qtips (cotton swabs) or other instruments to clean their ears. Variations in the quantity of cerumen produced, texture of the cerumen, and patient anatomy may also contribute to cerumen build up. When cerumen becomes excessive this can cause discomfort in the ears, difficulty hearing, and impaired assessment of the ear. 

How can I safely remove ear wax (cerumen) at home?

There are many methods to safely remove ear cerumen. 

- 1) mineral oil - we recommend placing 4-5 drops of mineral oil in the ears using a dropper. Let the drops sit in the ear for a few minutes before showering. This will naturally soften the ear wax, so the body can naturally get rid of the ear wax on its own. Other safe alternatives include baby oil, sesame oil or olive oil. This is the safest method and my prefered method when advising patients. 

- 2) hydrogen peroxide - we recommend diluting hydrogen peroxide with water (50% water and 50% hydrogen peroxide). Place 3-4 drops in the ears using a dropper. Let the drops sit in the ear for a few minutes before showering. This works similarly to mineral oil and will help liquefy the wax so that the body naturally gets rid of the cerumen. Other alternatives include debrox over the counter ear drops. If you experience any burning or discomfort, please discontinue these drops and notify your doctor. If you have a hole in your ear drum, I would also avoid these drops. For this reason, we recommend discussing the use of hydrogen peroxide with your provider prior to starting this regimen at home. 

What additional methods are used to remove ear wax (cerumen)?

There are additional methods that your physician may employ to remove cerumen. 

- 1) irrigation - your physician may employ water or saline irrigation to remove cerumen. This may improve patient comfort and is generally safe for most patients. However, your physician should evaluate your ear to determine if this is appropriate for you.

- 2) dry instruments - your physician may employ specialized instruments to remove the cerumen from your ear. This may include the use of suctions or curettes to safely remove the ear wax from your ear. The use of instruments should not be attempted at home. 

What methods should be avoided when attempting cerumen removal at home?

There are many complications that can occur secondary to cerumen removal at home including damage to the ear drum or ear canal skin, or retained foreign body. 

1) qtips - as a general rule - you should never insert any objects into your ear. Qtips often push the wax further into the ear canal making the wax more difficult to remove and additionally may cause damage to the ear canal or ear drum. Other common items such as bobby pins, feathers, fingernails, cameras and curettes should also be avoided. 

2) ear candling - this is a dangerous practice and can result in permanent damage to the ear drum.

If you are concerned about possible ear wax, please visit your doctor to discuss what regimen is most appropriate for you!