Ear wax- the sticky substance all of our ears produce- has a bit of a bad reputation. As audiologists, we often get asked about it- is it normal, why is it there, and how should one remove it? While ear wax serves an important purpose, there are cases where it can become blocked or impacted, and this can have long term effects if not managed appropriately.

Our ears produce wax for protection. In a normal ear, wax is produced at a standard rate, and slowly works it’s way towards the outside of the ear, catching any dust or dirt (or foreign bodies such as insects!) and effectively removing them from the ear. This keeps the ear clean and healthy. Once the wax reaches the outer part of the ear, it is normally washed away in the shower. The ears are designed to be self cleaning- and wax is the key player in the cleaning process.

Unfortunately, wax isn’t often recognized for the good it does, and instead people do what they can to remove it. Inserting cotton buds (often called the misleading ‘ear buds’) or other objects into the ear to try to remove wax is risky and counter-intuitive. By pushing even a cotton bud into the ear, you will inevitably push some of the wax deeper into the ear, risking a build up over time. In addition, cotton buds irritate the walls of the ear canal, causing your ears to produce more wax than they should, which may cause a blockage. Cotton buds also run the risk of physical trauma to the ear drum or ear canal wall.

So, what should you do? As mentioned above, the ears are self cleaning, so for many people just allowing the ears to rinse off, or drying the outer part of the ear with a towel should be enough. However, there are some people who naturally produce more wax than others, or who have ear canals that do not allow for the natural removal of wax. For these people, or those who have caused their wax to build up by inserting cotton buds, ear plugs or even hearing aids, it’s important that this plug of wax be removed. There may be a wax plug if your hearing appears reduced, or if you have a blocked sensation or discomfort in the ear- but it’s best to have your doctor or audiologist take a look to confirm whether there is a wax blockage. If you are a hearing aid user, increased feedback (whistling) from the hearing aid can be a sign of a build up of wax in your ear.

Of course, an untreated wax plug will reduce your hearing on that side. For most people, having the plug removed causes the hearing to be restored. However, the longer the plug stays in the ear, the higher the chance of long term damage. Infection can begin behind the plug, and go untreated for a long time because it can’t be seen. A build up of wax or infection can lead to damage to the ear drum or delicate structures of the middle ear, and permanent hearing loss. This is why it is so important to have impacted or built up wax removed sooner rather than later.

Removal of wax from the ears should always only be done by a trained medical professional. If the wax has been there for a long time, it may need to be softened before removal, but inserting drops or creams into the ear should only be done under medical advisement. Many people experience a significant improvement in hearing thresholds after wax removal, but it can be helpful to have your hearing tested after a plug removal anyway, to ensure that no permanent damage has occurred, or to identify any additional hearing loss.

For more information about wax and it’s removal, contact us or comment below.