Earwax, also known as cerumen, is a naturally occurring substance secreted by glands in the ear canal. Its role is to protect the ear by trapping dust, debris, and harmful bacteria, preventing them from reaching the delicate structures of the inner ear. Normally, excess earwax gradually moves out, carrying away any trapped particles.
However, in some cases, the production of earwax can be more than normal, or the wax can become impacted, causing a build-up or blockage known as cerumen impaction.
Symptoms
Earwax build-up or blockage can cause various symptoms and discomfort. Some common signs listed by Dr Girish Anand M S, consultant, ENT surgery, Aster CMI Bengaluru:
- Earache: The person experiences a feeling of pain or discomfort in the ear.
- Decreased hearing: The build-up of earwax obstructs the ear canal, leading to a temporary reduction in hearing ability.
- Tinnitus: The person experiences ringing, buzzing, or other noises in the ear.
- Feeling of fullness: There is a sensation of the ear being clogged or blocked.
- Itching: Excess earwax can cause itching in the ear canal.
- Dizziness: In some cases, earwax build-up affects the balance mechanism in the inner ear, resulting in dizziness or vertigo.
Additionally, Dr Anand says that earwax accumulation can cause decreased hearing, while using buds and exposing the wax to water can result in swelling of the wax. This swelling exerts pressure on the ear canal, leading to severe ear pain and increasing the risk of ear infections.
Causes
According to Dr Sanjay Bhatia, ENT surgeon, Fortis Hospital Mumbai, the common causes of earwax build-up or blockage include:
- Excessive production of earwax, which occurs naturally in some individuals, increasing the likelihood of build-up or blockage.
- Having a narrow ear canal, which can make it difficult for earwax to naturally work its way out of the ear.
- Inserting cotton swabs, bobby pins, or other objects into the ear canal, which can push the wax deeper and cause it to become impacted.
- Regular use of hearing aids, earplugs, or earbuds, which can interfere with the natural removal of earwax and contribute to its accumulation.
- A history of previous episodes of earwax impaction, which can make an individual more prone to experiencing it again in the future.
Treatment
According to Dr Anand, an examination of the ear canal would reveal a blackish hard material that could be ear wax. It is then checked whether it is hard or soft. “If it is soft, it can be evacuated by employing a method of suctioning and if hard it is always advisable to use wax softening drops to soften the wax and then remove it,” he says.
A few treatment procedures for ear blockage listed by Dr Bhatia are:
Ear irrigation: Irrigation or syringing involves use of normal saline in room temperature to flush the wax with a gentle force with the help of a syringe. However, the preferred method is to evacuate the wax with gentle controlled suctioning.
Earwax removal: An expert may remove the excess wax using specialised tools, such as suction or curettes.
Ear drops: In some cases, ear drops may be prescribed to soften the wax, making it easier to remove.
Dr Anand adds, if there is no hole in the eardrum, wax softening drops like mineral oil, baby oil, or commercial ear wax removal drops can be used. However, if there is an ear infection, this remedy is not safe, and ear irrigation should also be avoided.
Prevention
A few preventive ways suggested by Dr Bhatia and Dr Anand are:
Avoid using cotton buds, earbuds, safety pins, hairpins, or other objects that push the wax deeper into the ear canal. Such actions can lead to ear canal injury or abrasion and complications. Injury to the ear canal can cause swelling and introduce bacteria and fungi, increasing the risk of infection.
Earwax is produced only in the outer part of the ear canal, and using cotton buds can push the wax deeper, leading to impacted earwax. This can result in laceration, perforation of the eardrum, or other complications.
Gently cleaning the ear with a rolled handkerchief over the little finger and using wax softening drops for three days a month, can help wipe away accumulated wax.
It is important to consult an ENT specialist if an individual is experiencing warning signs such as decreased hearing, ear pain, ear blockage or a sensation of fullness in the ear, ringing in the ear, severe dizziness, loss of balance, inability to walk, or sudden hearing loss.
