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Cerumen; we all have it, and it serves a vital purpose to keep our ears healthy

What are we talking about? Earwax.

Small glands in the outer ear canal make earwax (or cerumen), which works to protect your ears against infections. So, what is earwax? It is 20-50% fat, and keeps your ears protected against excessive moisture, dust and dirt, and regulates the inner acidic barrier that protects against infections.
For most people, earwax causes no problems. When it has done its job it moves down the canal and falls out of your ears. Generally, cleaning earwax is as simple as a light wipe with a wet tissue or cloth. That is all that is needed to keep your ears clean and healthy and you often won’t need to undergo any further earwax removal.

What can cause things to go wrong?

Some people just make a lot of earwax — it’s genetic — and too much earwax can affect your hearing. If your ears are blocked, sound waves can’t get to your eardrums. It is estimated that hearing can be improved by 10% when a build-up of earwax is removed.

Blocked ears also increase the chance of getting an infection because moisture can build up behind the wax and disrupt the protective acidic balance, producing ideal conditions for bacteria and fungi to thrive. Over-active earwax glands are not the only cause of wax building up in the ears.

Here are some others:

Skin or bone infections, or unusual ear anatomy can cause narrow ear canals.
As we age, our glands produce a drier earwax which doesnt discharge as readily
Things we put in our ears (swabs, hairpins, cotton buds), as a form of DIY earwax removal, only work to compact and push the wax further into the canal.

Hearing aid moulds and earphones/ear buds inside the ear prevent wax from discharging.

How can you tell if things are not okay?

First of all, if you have sore, sticky, weepy ears get to a doctor as soon as possible. You may have an infection and may need to have your ears suctioned so that antifungal or antibacterial drops can work.

In the absence of an infection, the signs of wax build up or impaction may include:
• Earache, itching or irritation
• A sense of fullness in the ear
• Loss of hearing
• Vertigo (dizziness)
• Tinnitus (ringing in the ears)
• A cough
• Discharge from the ear
• Jaw or face pain, or ear pain when flying.

So, if your ears are itchy and you are not hearing well, they probably need unblocking.

Water in the ears

Water sport enthusiasts deserve a special mention here as they risk damage to their ears. Cold, wet, windy conditions can cause abnormal bone growth
in the ear canal. Wax and water can gather around these growths and cause blockages and infections. This condition, known as ‘surfer’s ear’, is progressive so it is important to make sure you have ear protection when you’re out on the water.

What are the safe options for earwax removal?

Wait a short while and see. Many blockages will clear on their own accord. If you’d like to give the process a bit of help you can use softening eardrops available from a chemist. After a few days, if your ears still feel blocked, call your audiologist for an examination.

Syringing or suctioning to get rid of earwax

Syringing, where a stream of warm water is washed into the ear canal, is
a safe form of ear wax removal. However, it is not suitable for people who have frequent ear infections, perforated eardrums, or surgically inserted grommets.
Suctioning is another method for clearing earwax. It is performed with a microscope so the ear canal can be seen while it is being cleaned. It should only be done by your hearing care professional or a doctor. Children with grommets who are prone to middle ear infections should have wax removed regularly.

Another method is manual extraction. An experienced professional (nurse, ENT specialist, audiologist or doctor) will use a curette or other fine specialised tool for clearing earwax. This technique is safe and perhaps the quickest of all methods. It works best when earwax is soft and sitting in the first portion of the ear canal.

A special word about cleaning or clearing earwax with cotton buds (and hairpins…) Dont do it. Cotton buds interrupt and damage the normal self-cleansing process of the ear. Most attempts to clean with cotton buds only push wax further into your ear canal — they act as ramrods. They can also puncture your eardrum. Your ear canal and eardrum have thin, fragile skin that is easily damaged by sticking cotton buds into them. You are also risking serious ear infections by “cleaning” out the good, protective earwax. So, just dont stick things in your ears.

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