Glands in the skin of the outer part of the ear canal make
earwax (also called cerumen).
The wax traps dust and small particles to keep the ear
clean.
It also helps keep water out of the ears.
How can I clean my ears?
The ears clean themselves of wax. You should not have to clean
them.
The wax builds up a little, then dries out and falls, or is
wiped, out of the ear.
Without wax, the ears become dry and itchy. A normal amount of
earwax is healthy.
Cotton swabs (such as Q-tips) are not recommended for
cleaning.
If you feel you must use cotton swabs, use them no more than
once or twice a week.
Use them gently. Do not push them into the ear. Use on the
outer part of the ear. (See picture below.)
What is earwax impaction?
Impaction means that several layers of earwax have been pushed
together and may be stuck in the ear.
What causes it?
Normal wax builds up in the outer part of the ear canal, not
near the eardrum.
If a patient has build-up near the eardrum, it is usually
because the wax has been pushed there.
Patients who are trying to clean their ears with a cotton swab
(Q-tip) or twisted tissue sometimes actually push the wax deeper
into the ear.
This not only can cause wax build-up, but it can injure the
thin skin of the ear canal.
Who can get it?
Anyone can get impaction, but it tends to be more common in
certain ethnic groups.
People with narrow ear canals are more likely to get it.
People who use cotton swabs in their ears are more likely to
get it.
What are the signs and symptoms of it?
Ears feel plugged.
Partial loss of hearing.
How is it treated?
You may try ear drops at home before calling a doctor.
Eardrops soften the wax so it comes more easily out of the
ear.
Some drops can be found over-the-counter, such as Debrox or
Murine Ear Drops. A mixture of 1 part hydrogen peroxide and 1 part
water (or equal amounts) can also be used.
You can use several drops twice a day.
Tilt your head to one side and fill the ear canal using an
eyedropper.
Let soak in for a minute or two.
Do this to the other ear if needed.
Do this up to two times a day for 3 to 4 days.
After 3 to 4 days, follow the same steps once a day.
If impaction is a frequent problem, put 2 or 3 drops into each
ear once a week.
Stop using the drops if it causes any discomfort, dizziness,
or drainage.
If home treatment doesn't work, call the doctor.
To clean out the wax, the doctor might wash it out, vacuum it
out, or use special tools to get it out.
How long does it last?
If the impaction does not improve with home treatment after 7
days, call the doctor.
When should I call the doctor?
If you or your child have tubes in the ears, call your doctor
before using drops, oil, or peroxide to clean them out.
If impaction is a frequent problem, ask the doctor to suggest
ways you can prevent it.
Call the doctor if impaction does not improve after 7 days of
home treatment.
Call the doctor if you have questions or concerns.
Quick Answers
Earwax (or cerumen) traps dust and small particles to keep
them clean.
The ears clean themselves of wax. You should not have to clean
them. If you feel you must use cotton swabs, use them no more than
once or twice a week.
Impaction means that several layers of earwax have been pushed
together.
If a patient has build-up near the eardrum, it is usually
because the wax has been pushed there with a cotton swab or
twisted tissue.
People who use cotton swabs in their ears are more likely to
get it.
If your ears feel plugged or if your hearing is muffled, it
could be a sign of impaction.
Eardrops soften the wax so it comes more easily out of the
ear.
If the impaction does not improve with home treatment after 7
days, call the doctor.
If impaction is a frequent problem, ask the doctor to suggest
ways you can prevent it.
References
American Academy of Otolaryngology. Earwax... and what to do
about it. 1995 (cited 2002 January 23). Available from: URL:
http://www.sinuscarecenter.com/waxaao.html
Davidson TM. Ambulatory Healthcare pathways for Ear, nose, and
Throat Disorders. University of California San Diego. 2000
February 4 (cited 2002 January 23). Available from: URL:
http://www-surgery.ucsd.edu/ent/davidson/pathway/earWax.htm
American Medical Association. Atlas of the Body: The Ear.
Medem. 1999 (cited 2002 January 23). Available from: URL:
http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZYXNW46JC&sub_cat=198
University of Florida. Cerumen Impaction. (cited 2002 January
23). Available from: URL:
http://www.ent.health.ufl.edu/Patient%20Info/cerumen.htm
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