Earwax Removal – Should You Do It at Home or See an ENT?

The ear is a complex structure that if treated improperly can cause a host of follow-on issues, infection, and hearing loss among them.  Not all hearing loss is due to age or loud noise exposure.  A build-up of earwax, known medically as cerumen, can also cause significant hearing-related symptoms. The ear consistently secretes an oily to waxy substance that when mixed with dead skin cells, hair, and foreign material, becomes what we commonly refer to as earwax (known medically as “cerumen”).  It is secreted by specialized sebaceous (oil) glands that shed with the superficial skin layer.  This slowly makes its way outward through the ear canal, where it either dries and flakes away, falls out or can be removed from the outer ear very quickly.

Earwax does have an important function. That sticky, gooey residue-like buildup in your ear traps dirt and bacteria, and maintains the proper pH for skin health and preventing fungal and bacterial growth.  It also contains enzymes which prevent infection.  As such, earwax plays a vital role in your overall ear health.

The Causes and Consequences of Impacted Earwax

The advent of cotton-tipped swabs and sometimes natural circumstances leading to bad ideas in home remedies can be a cause of both impacted wax and infections of the ear canal, and even perforation (holes) in the ear drum.  When earwax has built up deep in the ear it can become hardened and compressed and fail to move outward as usual. Impacted earwax can cause hearing loss, tinnitus, and cause pain, and itching among other problems. Water trapped behind the wax can lead to infections. While we know there may be some satisfaction in digging with a cotton-tipped swab after a shower or when you feel “stuffed up,” ultimately, it only pushes the earwax deeper into the ear canal and prevents natural migration. It also strips off the wax and can scratch the ear canal skin, leading to infection (otitis externa, or “swimmer’s ear”).  Eventually, this ear wax can block sounds or even push up against the eardrum to cause significant hearing loss.  The skin and wax also get dryer with age, making the wax less able to migrate outwards as it normally should.  Conditions like eczema can also contribute to a significant build-up.  Some people have very narrow ear canals or simply make A LOT of wax.

Home Remedies for Earwax Removal

Whether due to age, the structure of the ear, or natural buildup, sometimes our ears produce too much wax, or the wax is hard or dry, and there are several ways to remove it. There are some safe and effective home remedies that can be tried first. These include mineral oil, baby oil, hydrogen peroxide, or Debrox (a common brand of ear wax softener), and white vinegar drops (with or without alcohol).  These home remedies can be performed quickly and easily to attempt to remove any buildup and work by either dissolving the edges of the earwax or lubricating the ear to allow the movement of wax through the ear canal.

Other more sophisticated gadgets, like otoscopes (miniature cameras), are being sold as home remedies. These kits contain a high-definition camera, allowing patients to evaluate their ear canal. They can then use a small scooper to remove the earwax they see, not unlike what we do at the office.

We also discuss why we caution against ear candling

We can’t stress this enough – anything that requires inserting an object into the ear canal should be left to an Ear, Nose, and Throat specialist like Dr. Boger. No matter how novel or safe these devices may seem, there is a significant risk of damaging the structures of the ear. Removing earwax safely, particularly under magnification or using video for visualization, requires specialized training and experience.

Of course, moderate to severe impaction of earwax, ear pain, and any earwax pushing up against the eardrum should be evaluated and ultimately treated by a qualified medical specialist. You should also see your doctor if home remedies have not done much to improve your symptoms within a few days.