By: Dr. Lindsey
I would say at least 70% of the time I look into someone’s ear during their appointment they (or their parents) say, “Ew, I’m so sorry if it’s gross”. That is a made up statistic but seems about right.
First of all, earwax is normally occurring in the ear canal and our bodies produce it for a purpose! You do not need to apologize or feel dirty if you have earwax! Let me say that again, you do not need to say sorry for having earwax!
Here’s what you should know if you have some – or a lot – of earwax when an audiologist is looking in your ear.
Earwax is NOT:
- Uncommon. Especially if you wear hearing aids or earbuds a lot, have small ear canals, or are an average human being.
- Gross. Well, it seems gross to some people. But the large majority of audiologists are not at all grossed out by it because we see it EVERY DAY.
- Something you should feel bad about.
- A correlation of your hygiene practices (usually). It does not usually correlate AT ALL to your hygiene. In fact, if you’ve been using Q-tips and have a large amount of wax production, your hygiene practices could be making the problem worse.
- Something your audiologist will judge you for. I promise!
Earwax IS:
- Something most audiologists enjoy helping you with. I actually love cleaning ears and find it extremely satisfying.
- Different in texture and oiliness in different people. Some people (like my husband) have flaky earwax that randomly falls out. He hates it, I think it is funny. However, for lucky individuals like myself and my dad, we have to have ours cleaned out by a professional because it is sticky and things like Q-tips only makes matters worse.
Earwax impaction CAN:
- Cause tinnitus
- Cause dizziness
- Cause a temporary hearing loss
- Cause pain in the ear
- Cause itching
- Cause feedback (whistling) in hearing aids if you wear them
There is definitely a huge increase in people being both grossed out and fascinated with earwax videos right now. My adult nieces and nephews beg me to clean out their ears and are disappointed when there is nothing there to pull out. However, it really is amazing what can come out of the ear with a wax impaction! Here are some do’s and don’ts regarding earwax:
- If you are prone to wax impaction DO use a solution like Debrox (sold over the counter) but ONLY if you use it regularly and consistently. If you only use it on occasion or after you already have a significant amount of wax—it can make it worse and harder for a professional to remove the wax.
- DON’T use ear candling to remove wax. I know, I know. Your mom’s friend swears by it and maybe you do too. If you are doing it for spiritual or emotional reasons or because it helps you on a mental-emotional level then proceed with caution. However, the wax you see coming out is mostly or all wax from the candle itself and it can be a dangerous procedure. If you have an occlusion, it won’t take care of it. If you’d like to prove me wrong, feel free. Take a picture of your occluded ear canal before and after candling. If I’m wrong, I’ll admit it. Scientific Research* however says otherwise. However, TikTok and YouTube may have you convinced, and I get it. But if you use an ear candle and turns out I’m right—go to a professional that has the right tools to ACTUALLY clean your ears out safely. If you are like, “what is ear candling?” I’m going to be doing a YouTube video all about it, so stay tuned!
- If your audiologist recommends you get your ears cleaned out DO IT! Things function better when the ear canal isn’t compacted with wax.
- DON’T stress if there is a little wax in your ear. It helps your ear canal stay healthy and is completely normal. It is also a natural bug deterrent.
So what are options for getting earwax out if you’re told you have an impaction or enough wax to cause concern for an impaction? There are a few different methods your practitioner may use, all of which have advantages and disadvantages.
- Irrigation Method: This is common in audiology offices and non-ENT physician clinics. A lot of people utilize this technique. Personally, it isn’t my favorite method but Dr. JJ prefers this method for his patients. The advantages: It’s fast, easy, and it works. The disadvantages: It can make you a little dizzy if the water hits your eardrum with too much force. Also, if there is any kind of perforation in the eardrum, even microscopic, it can create problems. If you or your child has tubes in the eardrum or a known perforation – this method is not the one to use!
- Curette Method. This is my preferred method. Despite a lot of devices coming out on the market for at home use I DO NOT RECOMMEND DOING THIS AT HOME YOURSELF. The benefit of this method is that more time and care can be taken to do less damage to the ear canal. It needs to be done by someone who has experience and training. It is extremely effective. The disadvantage is it takes a little longer since it takes care and a steady hand.
- Suction. This can be done in an audiologist’s office if they have the equipment or an ENTs office. This is relatively quick and painless and is a great way to get that wax impaction out. The disadvantage—it will likely cost more money if you are having it done in a medical clinic by an ENT. If the audiologist isn’t able to get the earwax out (e.g. the wax is too close to the eardrum and there is concern for damage) they will likely recommend this.
If you are someone, like myself, who tends to get wax impaction, know that this is pretty common and the safest way to take care of it is have someone who knows what they are doing help you with it. If you have a child that gets frequent wax impaction due to small ear canals and especially if they are wearing hearing aids in addition, go see a professional regularly to be sure everything is cleaned out appropriately.
And remember—wax is normal!
*Rafferty J, Tsikoudas A, Davis BC. Ear candling: should general practitioners recommend it?. Can Fam Physician. 2007;53(12):2121-2122.
*McCarter DF, Courtney AU, Pollart SM. Cerumen impaction. Am Fam Physician. 2007 May 15;75(10):1523-8. PMID: 17555144.