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Earwax

An underrated secretion

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Earwax

Yes, earwax is a bit gross. But it actually has some surprising health benefits, and we generally don't want to remove it.

As humans, we produce a variety of bodily fluids and secretions, but we’ve evolved to have a natural aversion to them, especially if they belong to someone else. Earwax is one such secretion, prompting many of us to risk permanently damaging our hearing by using cotton swabs and other objects to remove the offending material—but we shouldn’t even have to do so. “We don’t. It’s there for a reason,” says Fred Kozak, MD, FRCSC, division head of Pediatric Otolaryngology (ear, nose, and throat) at BC Children’s Hospital.

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The reasons for earwax

In a healthy individual, earwax (also known as cerumen) serves multiple purposes, with the ultimate goal of protecting our inner ear from infection.

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Lubricating

By keeping the ear canal moist, earwax prevents the ear canal from cracking, which leaves the inner ear open to infection.

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Fighting infection

Earwax is shown to inhibit the growth of several types of bacteria such as e. Coli, Staphylococcus aureus, and Haemophilus influenzae, all of which can contribute to ear infections.

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Cleaning

Similar to mucus, earwax traps debris such as dust and dirt to keep it from reaching the ear drum. Under normal circumstances, the body naturally expels earwax from the body, taking the trapped debris with it.

A certain amount of earwax is beneficial to us, and given that our bodies usually expel it naturally anyway, we should probably leave it alone. However, too often we may aggressively clean it out with cotton swabs, which can lead to a host of other problems. Devices such as hearing aids, earphones, and earplugs also push earwax into our ears, but not nearly as much as cotton swab usage.

“People think they are fixing the problem and they are only making it worse,” Kozak says.

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Compacting the problem

At the very least, cotton swabs are highly ineffective at cleaning out earwax, as they don’t actually remove all of it and are more likely to push the material further in, making it harder for the body to expel the earwax naturally. The continuous buildup of earwax can lead to tinnitus (ringing of the ears) and hearing loss.

Worse yet, cleaning your ears with cotton swabs runs a high risk of damage and injuries, especially since you can’t actually see what you’re doing, accounting for the many patients that Kozak ends up seeing.

“I would say they cause the majority of injuries,” says Kozak. “Or other things people put in their ears, like toothpicks and paperclips. As they say, anything smaller than your elbow should not go into your ear.”

Kozak goes on to list some of the various objects that he’s removed from children’s ears, which he collected and had framed in his office, including rocks, beads, seeds, Lego, and Styrofoam.

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Avoiding injuries

Potential injuries from violating the “smaller than your elbow” rule include

  • perforated eardrums
  • dislodging of the bones of the ear
  • lacerations causing bleeding which may lead to ear infection
  • severe dizziness
  • cholesteatoma, an abnormal skin growth resulting from repeated ear infections and injuries

All of these can further result in permanent hearing loss. If it isn’t clear by now, it bears repeating: don’t stick anything smaller than your elbow in your ear.

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Wax on, wax off

For most of us, our ears are self-cleaning. The wax naturally migrates to the outer ear, where it dries up and can be wiped away with a washcloth. But ear canals come in a variety of shapes and sizes, so some individuals will be more prone to developing excess earwax, as will those who regularly use hearing aids, earplugs, and earphones.

Additionally, ethnicity plays a role, as people of European or African descent are more likely to have wet type earwax, whereas those of Asian descent are more likely to have dry and flaky earwax, which may be harder to expel naturally. Plus, the elderly are more likely to have impacted earwax.

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Natural relief

For affected individuals, Kozak has patients place a few drops of mineral or olive oil into the affected ears, which softens the earwax so that it may be expelled naturally. He also recommends families take their kids swimming, which frequently helps to remove the excess wax (assuming that their heads go underwater).

If that doesn’t get it out, Kozak recommends a visit to one’s family doctor, who can typically remove earwax using the proper tools and techniques. Failing that, an ear, nose, and throat specialist may be able to help.

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Ear syringing

A more controversial technique that may be effective is an ear syringe, similar to what a doctor uses. “Some doctors advocate self-syringing, but I don’t,” says Kozak. “If done wrong, it can cause injury to the eardrum, which I have seen, although this is rare.”

Similarly, the American Academy of Otolaryngology advises caution when ear syringing, especially if one has diabetes, an already perforated eardrum, or a weakened immune system.

Despite our natural aversion to it, earwax is important for healthy ears. Most of us should leave it alone and keep the cotton swabs far away. But, as always, consult with your health care practitioner before going above and beyond what nature intends.

What about ear candling?

Ear candling is an alternative remedy that involves inserting a hollow candle or cone, actually a wax-impregnated cloth, into the ear and lighting it, leaving it in for several minutes. This is intended to draw out excess earwax.

How does it work?

Two main theories seek to explain how ear candling works. One is that the burning candle creates a vacuum that draws wax, bacteria, and debris out of the ear. The second theory is that heating of earwax results in it being expelled by the ear within a few days of treatment. Few studies have been conducted on the effectiveness of ear candling. To date, no studies have offered scientific support for either theory or for ear candling’s purported benefits.

What are the risks?

Ear candling entails the risk of burns, obstruction of the ears due to melted candle wax, and punctured eardrums. The import or sale of ear candles for medical use is currently banned in Canada and the US.

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