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Ear wax microsuction, untold stories...

I attend to patients with ear wax buildup in South London. Also, I help them with cleaning ear infections so the antibiotic treatment is more effective. This article reflects on some of the common questions and concerns I have experienced in doing microsuction ear wax removal. Please refer to this article for more discussion on ear wax.


Please leave your questions and comments at the end of this article.




ear anatomy - hearingnow

Figure 1 - Anatomy of the ear


Frequently asked questions about ear wax buildup and ear wax microsuction


  1. What part of the ear creates the ear wax?

  2. Why do we have ear wax?

  3. Can ear wax create hearing loss?

  4. Is ear wax buildup painful?

  5. Is it safe to use cotton buds to clean my ears?

  6. I came out of the swimming pool and my ears have been blocked since, is this ear wax buildup?

  7. I use cotton buds and never have a problem with ear wax, is this all right?

  8. What is the most natural removal technique for cleaning my ear wax?

  9. Why are my ears so itchy?

  10. Why do my ears create so much ear wax?

  11. How often should I clean my ear wax?

  12. How best to clean my ear wax?

  13. I never had any problem with excessive ear wax build-up until a few years ago, why?

  14. My child is only 7 years old and needs regular ear wax microsuction, is this normal?

  15. My ears block with ear wax as soon as I get a cold, why?

  16. How do I know if the sound of muffled hearing is ear wax buildup or blockage of the Eustachian tube?

  17. How can I manage blockage or a clogging Eustachian tube?

  18. Should I use drops to soften the ear wax before a microsuction?

  19. Does NHS provide ear wax microsuction?

  20. When is the best time to clean my ear wax?

  21. What drops should I use to soften my ear wax?







What part of the ear creates the ear wax?

Most of the ear wax is created by the cerumen glands in the outer half of the ear canal (see Figure 1).


Why do we have ear wax?

Ear wax is a defence mechanism of your body. Ear wax protects the sensitive skin of your ear canal. Bacteria and germs stuck on the sticky surface of the ear wax. It creates a waterproof layer on the inner surface of your ear canal that is healthy and protects your ears from infection.


Can ear wax create hearing loss?

I'd say yes, if not cleaned out, excessive ear wax can block the ear canal fully and create temporary hearing loss. Also, it can cause mild pain and dizziness.


Is ear wax buildup painful?

In my experience, often the ear wax build-up is not painful. However, if the patient has dry skin, over time, the ear wax build-up can get dry and hard. In such an event, the patient might feel a sense of itchiness and mild to moderate pain due to the dry ear wax pressing on sensitive skin in the ear canal.





Is it safe to use cotton buds to clean my ears?

Nop. I'd say never use cotton buds to clean the ear wax in your ear. Most of the ear canals are a bit like a funnel. You may get a satisfying sense of cleaning and progress as you see some of the ear wax coming out, however, you are pushing the rest of it deeper in the ear canal and worse, you are compacting it too.


I came out of the swimming pool and my ears have been blocked since, is this ear wax buildup?

Often the ear wax expands when exposed to moisture and water. If you travel to humid locations or use a swimming pool or steam room and notice that your hearing is muffled suddenly, it could be an expansion of the ear wax, or it could be the scenario that water has gone deep in your ear canal and cannot come out because there is a blockage of ear wax.


I use cotton buds and never have a problem with ear wax, is this all right?

Yes, that can be the case. Some people have a habit of cleaning their ear canals with cotton buds daily. The ear wax does not get a chance to build up. but the side effect of such a habit is that you are not allowing the natural skin oil and ear wax to form the protection layer on the skin in your ear canal. Such a person might be vulnerable to ear infections and eczema.

Last month I had a patient who complained about very itchy ears. She thought it must be due to ear wax buildup. Otoscopy showed a super-dry ear canal, but inflamed and agitated. She confirmed that she has been using cotton buds to clean her ears all her life.


What is the most natural removal technique for cleaning my ear wax?

Ear wax microsuction is the safest way to remove excess ear wax buildup. If you suffer from frequent ear wax buildup (sooner than 6-12 months), you may want to use almond or olive oil in your ear canals once a month. The frequency can be shortened to once every 2 weeks if needed.



natural olive oil drops for ear wax removal


Why are my ears so itchy?

In my experience, you may feel your ears are itchy for reasons such as:

  • Excessive ear wax buildup

  • Dry ear wax irritates the sensitive skin in your ear canal

  • Dry skin

  • Frequent cleaning of the ear with earbuds


Why do my ears create so much ear wax?

Often it is not the amount of the ear wax produced in the ear canal, but why they are not transported out. There are several factors which can contribute to ear wax buildup, including:

  • Narrow ear canal

  • Bendy ear canal

  • Hairy ear canal

  • Dry ear canal (that could be a mix of reasons including genetics, dehydration e.g. too much coffee, and cleaning frequently with cotton buds)

  • Genetically your body creates more ear wax than others

  • Using sleeping earplugs or hearing aids





How often should I clean my ear wax?

most of my patients got into the habit of cleaning their ears once a year, pretty much the same routine you scale your teeth once a year. The prevention of ear wax buildup is important to avoid problems with the migration of the ear wax deep inside the ear, and water trapping in the ear and creating infection.


How best to clean my ear wax?

When we talk and when we chew food the upper jaw muscle shakes our ear canals. This in conjunction with a gentle downward slope of the ear canal is good enough for a soft ear wax to slide out of the ear canal. I strongly advise against using cotton buds for cleaning your ears.


I never had any problem with excessive ear wax build-up until a few years ago, why?

Simply put, there are two factors contributing to ear wax buildup, a. the volume of the ear wax build-up and b. the speed it can be transported out of your ear canal naturally. You may have started drinking coffee or drinking coffee more than before hence your body is dehydrating can simply slow down the transportation mechanism as your ear canal will be dryer than before. You may be aging and more hair is now growing in your ears than before. You may be going through a tough period of your life hence your body creates more ear wax (ear wax is a defence mechanism of our body). Best to consult with your audiologist.


My child is only 7 years old and needs regular ear wax microsuction, is this normal?

I see young patients every week in our clinics in London, Yes, this issue is normal for kids as young as 2 or 3 years old to start having excess ear wax. The hormones may signal more ear wax than their narrow ear canal can handle to transport out.


My ears block with ear wax as soon as I get a cold, why?

Often the sound of one side being muffled is not ear wax blockage, but Eustachian tube dysfunction (ETD). Please read more about ETD in this article. A sense of blockage in the ear can also be an infection in the ear canal or the middle ear. The latter can happen while or after a severe cold, sinus infection, soar throat, or chest infection. Best to consult with your GP or your audiologist.





How do I know if the sound of muffled hearing is ear wax buildup or blockage of the Eustachian tube?

One is to check with your GP or your audiologist. Please see my response to the previous question.


How can I manage blockage or a clogging Eustachian tube?

My best advice is to use the gargling technique 3 or 4 times a day, mix half a teaspoon of salt in half a glass of warm water, and gargle. By gargling you will be disinfecting the top of your throat where your Eustachian tubes are located. The washing and cleaning process of the tubes usually takes more than a day. Please see this article about Eustachian tube dysfunction (ETD).



Should I use drops to soften the ear wax before a microsuction?

Yes, I do recommend using ear drops about 2 to 3 days twice a day before your ear wax microsuction appointment. The drop helps soften the ear wax and make the procedure less disturbing for the patient. The old glands in the ear canal are usually still active in children and young adults. As we age the oil glands in our skin start fading out and that is why we might experience dryer skin as we age. Using olive oil drops before ear wax microsuction for 5-7 days before the procedure is highly recommended for seniors.


Does NHS provide ear wax microsuction?

In the United Kingdom, the water syringing has been removed from the list of the services provided for free in a local surgery. On special occasions, the GP may refer the patient to a local ENT hospital for ear wax removal with microsuction but usually, the waiting list is in order of months.


When is the best time to clean my ear wax?

Most of my patients do ear wax removal and ear cleaning once a year. It is nice to do it this way, the same as descaling your teeth with your dentist which is usually scheduled once every year. Some patients do ear wax removal before they travel, mainly a. to avoid problems with the flight and b. they learned from the last holiday that ear wax buildup led to infection and ruined the holiday. Some came to my clinic after the holidays when being in the water and swimming pool resulted in some water trapped in their ears and only then they realised they must have ear wax buildup.


What drops should I use to soften my ear wax?

Olive oil is quite popular and recommended for people with excess ear wax buildup. If the ear wax is dated more than 6 to 12 months it becomes dry and hard. In such cases, I might advise the patient to use drops which have active agents such as sodium bicarbonate. One of the popular ear drops with active agents in the UK market is called OteX Express. You can use drops twice a day for 3-5 days before the appointment.








Do you have a question about ear wax buildup and ear wax microsuction? Please use the following box to share your concerns on this page or contact us for a free consultation.



References

  • Wright, T., 2015. Ear wax. BMJ, 351.

  • Sharp, J.F., Wilson, J.A., Ross, L. and Barr-Hamilton, R.M., 1990. Ear wax removal: a survey of current practice. British Medical Journal, 301(6763), pp.1251-1253.

  • Poulton, S., Yau, S., Anderson, D. and Bennett, D., 2015. Ear wax management. Australian family physician, 44(10), pp.731-734.

  • Hand, C. and Harvey, I., 2004. The effectiveness of topical preparations for the treatment of earwax: a systematic review. British journal of general practice, 54(508), pp.862-867.





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