Get the Wax Out, and Hear!

When I did a short stint as a family practitioner in UK, the most rewarding thing I could do was remove wax from a patient’s ears. The simple procedure was greeted by: “It’s a miracle, doctor! I can hear again!” in those days we used to syringe the ear canal with warm water until the wax was removed. More recently, there have appeared ear drops that soften the wax to an extent that the syringing procedure can be shortened considerably. Now ear specialists (otorhinologists) are warning about too precipitous attempts to remove ear wax. Writing in their specialist journal, they’ve issued guidelines on the subject.

They point out that ear wax, or cerumen, isn’t really wax at all; it’s a mixture of ear secretions, hair, and dead skin. Excess cerumen normally travels out of the ear together with any dirt, dust, or particulate matter that shouldn’t be there. As cerumen is a useful substance, one shouldn’t rush to remove it, unnecessarily. Especially, one shouldn’t try to ‘clean’ the ear canal with cotton swabs or ‘ear candling’.

If the cerumen is blocking the ear canal (‘impacted’) and causing symptoms or preventing visualization of the ear drum, it should be removed by a physician. Wax-dissolving agent, such as water or saline, or cerumenolytic agents, should be used to dislodge it by irrigation, or, if necessary, manual removal with special instruments or ear syringes.