Do You have “dirty” ears?

Ear Wax/cerumen is a natural product. It is supposed to be in the ear canal. It contains useful antibiotic properties to protect against infection. It acts in the ear canal like oil on your skin.

Why do we have ear problems of the ear canal? It is because we are not designed for modern living including:
• Shampoo
• Hair Spray
• Hot Tub
• Shower
• Swimming

These activities remove the good wax. The soap from the shampoo can get into the ear canal and dries out the canal. This dryness leads to itching. In your sleep you scratch the ear and get it infected, you get external otitis. Prevention is to place a few drops of baby oil or olive oil in your ear canal before you shampoo.

Those who are in the water for long periods get outer ear infection. This is because cerumen is eventually washed out. If there is no wax, its like having dishpan hands, the dry skin itches causing you to scratch in your sleep. Aquatic mammals such as Beavers and Whales produce thick heavy cerumen at a frequent rate. If you swim daily, I recommend daily applications of baby oil.

If you have a hearing loss is it cerumen or something else? Don’t assume its cerumen. If you have a severe hearing loss and the doctor says you don’t have a cerumen blockage, you MUST see an ear nose throat specialist right away for treatment of the middle or inner ear in order to restore the hearing.

I frequently see patients who complain of Tinnitus, a ringing in the ear. When it is cermen impaction that is causing it, the cure is easy.

Soap in the ear is bad for the ear. Soap breaks up the oils and dries the skin of its natural oil. The ear canal is like a long tube closed at one end. Once the soap gets into that canal it is very difficult to remove it.

No No No of ear health:
Dig in your ear with a pencil. The point breaks off or punctures the ear drum.
Dig in your ear with the end of an eraser. It will break off and then the doctor will have to remove it.
Do not put alcohol in your ear canal, this dries the ear and leads to itching.
If you have a perforated ear drum you must not put anything except a doctor’s prescription in the ear.

Be careful what you put in your ear canal. When I was just starting my residency training, my first patient was someone who had poured sealing wax into her ear canal because the neighbors were making too much noise. This was transparent, and I couldn’t tell which was the ear canal and which was the wax! Now that the sealing wax had hardened and was irritating the canal, there was no way to remove it except under general anesthesia by surgery.

Some of the objects I have removed from ears:
• Erasers
• Cotton from cotton swabs
• Beetles
• Wasp
• Small roach
• All kinds of pieces of paper.
• Beads and tiny plastic toys.
• Screws
• A hearing aid battery.

If you are sure you have cerumen blocking your ear, it is OK to use one of the OTC ear wax preparations that come with a plastic syringe for irrigation. The wax softener should soften the wax and then with warm water – should be about the temperature of your body- you are supposed to rinse it out. However, because it may not work, before you start the drops on Friday, be sure to make an appointment for wax removal next Tuesday. Then if the home kit doesn’t work, you can see the doctor. If it works you can cancel the appointment.

The most common wax remover are:
]Carbamide peroxide (6.5%) and glycerine Carbamide peroxide is a source of hydrogen peroxide and nascent oxygen; the effervescence caused by the release of oxygen mechanically removes debris from inaccessible regions. Physician’s Choice Ear Wax Kit contains softener, plastic ear syringe and ear basin.

Ducosate or Colace Docusate sodium allows water and fats to get into the wax. This helps soften wax material and makes removal easier.

Its not wax if there is a bloody or yellow or green discharge from the ear canal. A dirty grey smelly discharge is usually due to a fungus infection of the ear canal. Do not irrigate these unless asked to do so by your doctor.

It’s not cerumen if the ears are quite itchy.
If you remove too much cerumen you end up with dry ears and one step before an ear infection. What happens is that the ear canal is too dry, in your sleep it itches and you scratch it and then the scratch becomes infected. Prevention is to place olive oil or baby oil into your canal whenever there is any itching or after all cerumen is removed.

Never use an old rubber syringe to irrigate your ears. (or your nose). They are always contaminated and rubber particles can dislodge to end in your ear. Only use a fresh plastic irrigator.

Ear Candling. The theory is that the heat of the candle will soften the wax and draw it out. It can drip candle wax into the canal and it can burn the canal. In my office I have seen three patients with burns of the ear from ear candling. There is no evidence that it is effective.

Patients ask, “Doctor why do I have so much wax? My answer: “Wax is the end product of thinking. “
No, that’s not true. Certain people are congenitally heavy wax formers. Anything that irritates the ear canal will stimulate more wax production. For example regular use of ear plugs, ear buds or hearing aids. Heavy cerumen production, although a nuisance, can not cause permanent hearing loss.

The healthy person makes cerumen which protects the ear canal. There is no need to remove cerumen unless it is blocking your hearing.