All About Earwax – Facts, Safe Removal, Management at Home

Funny chihuahua with big ears managing ear wax

By Martine Schlagintweit, M.Sc., AUD, Aud(C), RHIP

Everything you need to know about earwax, how to remove it safely (never use Q-Tips or cotton buds!), and pointers for managing build-up at home.

What is cerumen?

Earwax, or cerumen (pronounced seh-ROO-men) as it is called clinically, is an orange, reddish-brown, or light-yellow substance in the ear canals. Cerumen protects the ear from dust, germs, and foreign particles, and keeps the skin in the ear from being irritated by water. However, the unique cul-de-sac shape at the end of the ear canals can trap earwax. In some cases, earwax builds up to a point where it needs managing.
 
Believe it or not, there’s more to earwax than just simply ‘wax’. Earwax is made up of skin cells shed from the ear canal walls, mixed with secretions from glands that are in the skin in the outer two-thirds of the ear canals. Two types of glands make the main parts of earwax: sebaceous glands and ceruminous glands. Sebaceous glands contribute lipids, or fats, as well as alcohols, wax esters, and cholesterol. Ceruminous glands add peptides, or amino acids. How much each gland contributes affects how the earwax holds together; for example, more lipids will mean a more ‘wet’ or soft consistency (Guest et al., 2004). 

The ear expels wax naturally

If left alone, ear wax is expelled from the ear canal in a six to twelve-week cycle. Because chewing and talking move the ear canal, these actions can speed up the process (Guest et al., 2004). However, placing items in the ear canals can stop the process by pushing the wax back in. For example, the use of Q-Tips or cotton buds notoriously leads to earwax buildup, as it pushes wax further in and dries the wax out in the process. Hearing aids can also lead to a buildup of wax just past the point where they sit in the ear canal. 

Removing earwax safely 

Twirling cotton buds in your ear canal is not a successful method of removing earwax, so what is? The best thing someone can do to manage their earwax is to ask an Audiologist or family physician about the status of their ear canals. 
 
The clinician will be able to advise if there is a lot of earwax in the canal and whether it has reached a point where it should be removed. If so, they may extract the wax by:
  • Using vacuum suction
  • Flushing with water
  • Manual removal with a curette

Creating a management plan

Once the wax has been removed, a wax management plan can be put in place; this may include recommendations for the use of Cerumol, an at-home earwax removal kit, or an earwax softening substance.
 
Common recommendations for at-home wax management:
 
Soften the wax
Placing one to three drops of olive oil in the ear canals at night to keep the wax soft so it will come out on its own. 
 
Flush with warm water
Rinsing your ears in the shower, or submerging your ears in the bathtub can soften the wax and help it move out of the ear canal.
 
Rinse the ear canals
The Mayo Clinic recommends gently rinsing the ear canals with a solution of ½ part white vinegar and ½ part rubbing alcohol periodically, in addition to the softening and flushing regimen.
 
Before you try removing earwax, you should talk to your Audiologist to make sure your ear canal and eardrum will tolerate an at-home remedy. If you have questions about cerumen management, call the Broadmead Hearing Clinic at 250-479-2969 or the Oak Bay Hearing Clinic at 250-479-2921.
 
 
References:
Guest, J.F., Greener, M.J., Robinson, A.C., Smith, A.C. (2004). Impacted Cerumen: composition, production, epidemiology and management. Quarterly Journal of Medicine, 97: 477-488. Doi:10.1093/djmed/hch082