The Purpose of the Ear Canal
The ear canal protects the eardrum, migrates dust and dirt out of the canal, funnels sound to the eardrum and, finally, modifies sound. The eardrum is the end point of the ear canal. The canal is shaped like a test tube and houses hair follicles and wax producing glands. The actual shape of the ear canal is unique on all people and can even be an oval shape at the opening and then change into a round shape closer to the eardrum. Some people have ear canals that are collapsed shut and open if you pick up on the outside of the ear. The shape of the canal may contribute to the difficulty in managing the wax. Every time I look into an ear canal, it is an adventure to find the eardrum!
Types of Wax
People produce ear wax at different rates and some people only have wax build-up in one ear. There are no rules when it comes to wax production. There are different types of earwax: sticky wax (I call it honey wax), flaky wax and oily wax. If wax stays in the ear canal long enough, it dries out and can stick to the canal wall similar to a scab. Wax will collect dead skin and old hairs and can eventually begin to look like a birds nest! (After getting your hair cut, ask the barber/hairdresser to clean all the hair out of the bowl of your ear so the tiny cut hairs do not go into your ear canal.) Wax is only an issue if it builds up enough to block sound from going to the eardrum or if you wear hearing aids and the wax blocks the receiver of the aid.
To Clean or Not to Clean
First, ask your health care provider if you have a hole in the eardrum. If you have a hole in the eardrum, it is important NOT to clean your own ear canal. You do not want to introduce germs through the eardrum with oils or water. If your ear canal has an odor, tell your health care provider.
Wax tends to make your ear feel itchy if it dries out or collects in one area. The canal may become itchy if you remove all the natural oils by cleaning out the canal too much. If you are prone to dry skin on other areas of your body, your ear canals may produce flakey dry skin with minimal wax in it. If you are under the care of a dermatologist ask if you can put a tiny amount of the skin medicine in your canal once every few months.
The difficulty people have is trying to maintain a balance of moisture to keep the skin happy but not have significant wax build-up. Some people are able to clean their ear canals with cotton swabs after every shower and not have any problem. However, it is generally recommended that people with small, twisting or collapsing ear canals not clean with a cotton swab. Never clean deep into children’s ear canals with a cotton swab.
Cleaning Ears with No History of Perforation
Normal canals with normal eardrums are relatively easy to take care of but it is wise to have at least one otoscopic exam every year to make certain that your chosen wax management strategy is successful. I recommend that you drip one or two drops of mineral oil into your ear canals two times a month to keep the wax moist and keep it from sticking to the canal wall. Moist wax will naturally migrate out of the ear toward the opening.
Most people do not need to wash out the oil because it is absorbed by the wax. If you want to wash out your ear, use a solution of 1/3 white vinegar to 2/3 body temperature water or 1/3 hydrogen peroxide to 2/3 body temperature water. Please do not use an ear candle or coning; simply do a good old-fashioned rinse every other month. Keep a routine schedule rather than waiting until your hearing has diminished. Clean them monthly because the more wax you have the more difficult it is to get out. QCBN
By Karon Lynn, Au.D.