The Do’s and Don’ts of Earwax Management

Seth Schwartz, MD, MPH, and chair of the AAO-HNS guidelines update group said this update on earwax management, these guidelines are significant because it is a reminder to patients that ear health starts with them.

“There is an inclination for people to want to clean their ears because they believe earwax is an indication of uncleanliness,” Schwartz said. “This misinformation leads to unsafe ear health habits.”

The AAO-HNS also provided patient information on the “Do’s and don’ts” of earwax management and healthy ear care…

Earwax DO’S:

1. Leave your earwax alone
   • Unless your earwax is causing symptoms or blocking the ear canal, leave it alone!
2. Understand the symptoms of earwax impaction
   • These include decreased hearing, fullness, ringing, distortion/changes to hearing aid function
3. Seek medical attention
   • If you have symptoms of hearing loss, fullness in the ear or ear pain, seek medical attention
4. Ask your health care provider
   • If you have a history of wax buildup, ask your healthcare provider for at-home treatment options
5. Seek medical attention:
   • If you have ear pain, drainage or bleeding, seek medical attention

Earwax DON’TS:

• Over-clean your ears
  • Excessive cleaning can:
    • Irritate the ear canal
    • Cause infection
    • Increase the chances of wax blockage
• Put anything smaller than your elbow in your ear
  • No cotton swabs, hairpins, car keys, or toothpicks!
  • Small objects can cause cuts in ears, a hole in your eardrum, and dislocation of the hearing bones
  • This can lead to hearing loss, dizziness, ringing and other symptoms of ear injury
• Stick flaming candles into your ear –EAR CANDLES ARE A BIG NO!
  • Ear candles can cause damage
  • There is no evidence they work
• Ignore symptoms if home remedies are unsuccessful
  • Seek medical attention if at-home attempts have not resolved the problem
• Irrigate or try cerumen-removing/softening drops
  • If you have had previous ear surgery or a perforated eardrum, do not try earwax removal drops unless cleared to do so by your ENT
• Forget to clean your hearing aids
  • Make sure to clean your hearing aids as recommended
• For general at-home ear care, the AAO-HNS recommends:
  • Using a wash cloth to clean the external ear- but do not insert anything into the ear canal
  • Using a few drops of mineral oil, baby oil, glycerin or commercial drops in the ear to help soften the wax and aid the natural process of removal
  • Detergent drops such as hydrogen peroxide or carbamide peroxide may also help

   

• Or, you can take a do-it-yourself approach. The thing that many people do — but shouldn’t — is try to remove the wax with a cotton swab, which tends to push the earwax back into the ear. Instead, soak a cotton ball and drip a few drops of plain water, a simple saline solution, or hydrogen peroxide into the ear with your head tilted so the opening of the ear is pointing up. Keep it in that position for a minute to allow gravity to pull the fluid down through the wax. Then tilt the head the other way and let the fluid and wax drain out. You can also use a bulb syringe to swish out the ear.
• However, despite self-cleaning efforts, if wax does buildup and cause a blockage in your ear canal, see a medical professional.“There are no proven ways to prevent cerumen impaction, but not inserting cotton-tipped swabs or other objects in the ear canal is strongly advised,” AAO-HNS advises.