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7 questions about earwax answered

What is earwax made from?

Earwax or cerumen contains keratin, which is shed from the ear canal wall during skin regeneration. It also contains lipids and peptides that are secreted by the ceruminous and sebaceous glands in the ear canal. The balance of these substances varies between individuals and different ethnic groups, but generally the drier type of wax contains more keratin and less of the other secretions, and wetter wax contains less keratin and more of the other secretions.

Why do we have earwax?

Earwax helps to trap dirt and repel water from the ear canal. It also helps in the process or desquamation, or the shedding of dead skin cells from the ear canal.

Does earwax need to be removed?

Normally as the skin of the ear canal regenerates, earwax travels towards the opening of the ear canal where it should come out by itself. However, sometimes earwax can become impacted, blocking the ear canal and requiring manual removal.

How does earwax impaction happen?

The use of hearing aids, earplugs and cotton buds are well known to promote wax impaction, as all these things can push wax back into the ear canal, causing a blockage. Ear canals that are narrow or have tight bends can be more prone to becoming impacted.

What are the signs of impacted earwax?

One of the most obvious signs of wax impaction is a decline in hearing because a wax blockage can act like an earplug. Wax impaction can lead to outer ear infections, especially if water from showering or swimming becomes trapped in the ear. This can cause pain or itchiness. Tinnitus and dizziness can also occur as a result of impacted wax.

What is the best way to remove earwax?

The most common techniques used by health professionals for earwax removal are irrigation, curettage, and microsuction. All these techniques carry their own risks, but the disadvantage of irrigation is that the practitioner does not have good visualisation of the ear while performing the procedure and the use of water can promote infection. Lindfield Audiology has a dedicated earwax removal service called #earwaxsydney. We use the microsuction technique, which is one of the safest and most comfortable earwax removal methods.

Should I attempt to remove my own earwax?

Despite the widespread use of cotton buds for cleaning the ear canal, this practice should be avoided because it tends to impact wax rather than remove it, and it also carries the risk of injury to the eardrum or ear canal. Similarly, ear candles, which are marketed as a method for removing earwax, do not have much evidence to support their use. There is also documented evidence that they can cause burns to the ear or further impaction due to candle wax entering the ear.

Reference

Guest, J. F., Greener, M. J., Robinson, A. C., & Smith, A. F. (2004). Impacted cerumen: composition, production, epidemiology and management. QJM, 97(8), 477–488.

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