This is a very “popular” health issue amongst our clients and we generally have to reassure them that excess earwax is not as a result of poor hygiene!!!
Also known as cerumen, it is a yellowish waxy material 60% of which is keratin, a protein from shed layers of cells from the skin lining. The rest of it is made up of 12 – 20% saturated and unsaturated fatty acids, 6 – 9 % of cholesterol and other trace elements, such as alcohol, all of which are produced in the outer third of the cartilaginous portion of the ear canal by both sebaceous and sweat glands.
This “mixture” has various functions:
– Cleaning – this occurs trough a “conveyer belt” process, aided by jaw movement, where the keratin from shed cells, formed in the tympanic membrane (the ear drum), mixes with the other elements of the cerumen travelling down the walls of the ear towards the entrance at a rate compatible with fingernail growth. As this blend ages, it loses water and oxidizes, thereby taking on a darkened appearance. Jaw movement also dislodges any debris, such as dirt or small foreign objects, that are attached to the ear canal wall and this is carried out by the earwax as well as preventing water accumulating in the ear canal.
– Lubrication of the ear canal, is carried out by the sebum in cerumen produced by the sebaceous glands.
– Antimicrobial effects – studies have found that cerumen, which is slightly acidic, has an effect on some strains of bacteria and also some fungi inhibiting their production and spreading to the ear drum.
So if we did not have earwax the ear canal would become extremely dry or waterlogged and infected!
Some people are prone to produce too much earwax but this does not necessarily lead to blockage. Other factors include:
– Production of naturally hard/dry wax.
– Narrow, oddly shaped or hairy ear canals.
– Being elderly, as earwax becomes drier.
– Bony growths in the outer part of the ear canal.
– Frequently putting foreign objects, such as cotton buds, hearing aids, ear plugs and Bobbie pins into the ear canal. These stimulate the glands to produce more wax to protect the ear canal, stop the wax from coming out of the ear or push wax to the back of the ear canal causing impaction.
This build-up of wax can cause various problems such as:
– Sudden or partial hearing loss.
– Tinnitus – a ringing or buzzing in the ear.
– A feeling of fullness.
– Vertigo – a spinning sensation.
– Ear infection and inflammation.
Do no try to get the earwax out with your fingers or cotton buds as this could cause further wax impaction or damage the ear. As our doctors are fond of saying “the only thing you should put in your ear is your elbow!!”
If the wax is only causing a slight problem you can get topical wax softener drops, aiding the movement of the wax but generally these drops are not enough if there is a blockage.
Methods of wax extraction are carried out by your family doctor or an ENT specialist through:
– Ear irrigation – where warm water is gently syringed into the ear, flushing the wax out.
– Microsuction – where a small device is used to suck the wax out.
– Aural toilet – where a thin instrument with a small loop at one end is used to clear the ear by scraping out the wax.
By Nurse Niki Medlock