All You Need to Know About Earwax

Earwax management guidelines updated by expert panel

(RxWiki News) Listen up — the guidelines on how to treat earwax problems have been updated. Here's what you need to know.

These guidelines provide recommendations on diagnosing and treating earwax impaction and provide patients with information to keep their ears healthy. The recent update comes from the American Academy of Otolaryngology — Head and Neck Surgery Foundation (AAO-HNSF) and replaces guidelines published in 2008. 

Why is this update important?

This update provides information for patients and serves as a reminder that ear health begins at home, as noted by the chair of the guidelines update group, Seth R. Schwartz, MD, MPH. 

According to Dr. Schwartz, many people tie earwax buildup to the idea that their ears are unclean. However, he noted that this misconception can result in unsafe habits. 

“Patients often think that they are preventing earwax from building up by cleaning out their ears with cotton swabs, paper clips, ear candles or any number of unimaginable things that people put in their ears," Dr. Schwartz said in a press release. "The problem is that this effort to eliminate earwax is only creating further issues because the earwax is just getting pushed down and impacted further into the ear canal."

When practicing healthy ear care, what shouldn't you do?

Based on the updated guidelines, experts recommend against the following:

  • Overcleaning your ears. That's because excessive cleaning may irritate your ear canal and may actually cause an infection and lead to earwax impaction (wax blocking the ear). 
  • Placing anything smaller than your elbow in your ear. This may include cotton swabs and hair pins, which can actually cause injury. Injuries may include cuts, a hole in your eardrum and even dislocation of the hearing bones. 
  • Using ear candles. There is no evidence to show that ear candles remove wax that has blocked the ear. Using ear candles can actually lead to serious injury to your ear canal and eardrum.
  • Ignoring symptoms. If your attempts to remove wax that has blocked your ear do not work, contact your health care provider. 
  • Irrigating or instilling wax-removing or softening drops if you have undergone ear surgery or if you have a perforated eardrum, unless your ear, nose and throat surgeon has said you can. 
  • Forgetting to clean hearing aids according to the manufacturer and your hearing health professional.

When practicing healthy ear care, what should you do?

Now that you know what not to do, the experts recommend doing the following instead:

  • Know that earwax is normal. In fact, earwax is a self-cleaning substance that keeps your ears healthy. It is not blocking the ear canal and should be left alone. 
  • Know the symptoms of wax blocking the ear. These symptoms include ear fullness, decreased hearing and ringing in the ear. If you wear a hearing aid, you may notice a change in the aid’s function. 
  • Contact a health care professional if you notice ear fullness, hearing loss or ear pain if you are not sure whether these symptoms are related to ear wax. Another condition like infection or fluid buildup may be causing these symptoms. 
  • If you experience ear pain, draining or bleeding, seek medical care. These are not symptoms of earwax problems. 

Ask your health care provider about safe ways to treat earwax impaction at home.

The update to these earwax guidelines was published recently in the journal Otolaryngology–Head and Neck Surgery.  

Funding came from the AAO-HNSF. Several guidelines authors said they were consultants for or had financial ties to companies, including some pharmaceutical companies.