The guidelines, which will appear as a supplement to the September 2008 issue of Otolaryngology–Head and Neck Surgery, are the first comprehensive clinical guidelines to help health care practitioners identify patients with cerumen impaction.
Who knew earwax could be so interesting? But it's still gross.
Cerumen, commonly called "earwax," is not really a "wax" but a water-soluble mixture of secretions (produced in the outer third of the ear canal), plus hair and dead skin, that serves a protective function for the ear.
People use everything from Q-Tips, to bobby pins, to 'ear candles' to get this stuff out of their ears. What do you use? By the way, they're all bad ideas.
Cerumen is a beneficial, self-cleaning agent, with protective and even antibacterial properties—and it shouldn't normally be removed.
Dr. Richard Rosenfeld, one of the authors of the new guidelines, and Chairman of Otolaryngology at the Long Island College Hospital in Brooklyn, New York, says “Injuries from well-intentioned use of cotton swabs to remove earwax are something I see almost every day in my practice, despite the admonition on every box that clearly says ‘do not stick this in your ear.”
The new guidelines suggest that cotton-tipped swabs, along with oral jet irrigators, and ear candling, are all inappropriate or even harmful interventions, and it is strongly advised not to insert cotton-tipped swabs (or any other objects) into the ear canal.
So how do we keep our ears clean?
Dr. Rosenfeld explains, “the best way to keep your ears clean is to leave them alone. We all have a self cleaning mechanism—like a little conveyor belt in our ear canals—that can bring wax out. Every time you chew and swallow it helps to move that process along. The best way to have it work is not to sabotage it by sticking items in your ear canal that may have a negative effect.”
Of course, in some cases there may be complications from cerumen impaction, including infections and hearing loss, in which case you need to see a doctor. And now that doctors have these guidelines, they can better deal with your earwax problem.
If you do think you have a problem, take out your earphones and listen up: Dr. Rosenfeld explains that this problem used to be very common in people with hearing aids, but now it is something that a lot of young people are facing; they’re walking around with their own hearing aids: MP3 player earphones.
“If you're constantly sticking earphones in your ear, you’re going to interfere with the normal removal of wax,” says Dr. Rosenfeld.
And then there are certain people, like that kid who sat next to you in fifth grade, who are more prone to getting funky earwax. Why?
“I don’t think anyone knows the exact mechanism of how it goes awry,” explains Dr. Rosenfeld. “Some of it is genetic. Different types of people have different types of earwax. The genetics in certain people is such that there is a very dry or flaky earwax produced which is often more prone to accumulation. Some have a more sticky earwax."
And sometimes, he says, "it just happens."
So don’t take it personally! A lot of people have the same problem, and talk it out on the earwax forum. It's a safe place where everyone's welcome.
But in all seriousness, if you do have a problem go see a doctor. You're not alone; approximately 12 million a year in the U.S. seek medical care for impacted or excessive cerumen.
