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Volume CXXXIII, Number 7 |
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Cotton swabs may be harmful to your health, says Dr. Jeff
JEFF BENSON, M.D.
DUDLEY COE HEALTH CENTER
Dear Dr. Jeff: I know I've been told not to use Q-tips to clean my ears, but I have a real problem with wax build-up. What do you recommend?-D.H.B.
Dear D.H.B.: Wax is a normal product in all of our ears. Our ear canals are shaped like hourglasses and are narrow part way down. Our eardrums lie at the very end of the canals. Apocrine glands in the outermost part of the ear canal form earwax, and it serves a number of protective functions
Earwax traps dust and dirt particles that might otherwise collect in the ear canal. Earwax causes water to bead up and run back out of the canal. Ear wax also prevents infection. It is acidic, and as a result noxious to most bacteria and fungi. Finally, earwax coats and protects the delicate skin that lines the ear canal and eardrum.
Most of the time, our ears are self-cleaning. There is a slow and orderly migration of ear canal skin cells from the eardrum to the outer ear opening. Earwax adheres to these cells and so is continuously transported out from the deeper parts of the ear canal. At the same time, it dries out, flaking and falling off on its own.
Different individuals vary considerably in the amount and consistency of their earwax. The lipid (fat) content of earwax can vary from 20 percent to 50 percent. Dryer wax is common in Asian populations, while wetter wax is more common in those of African and European descent. Japanese researchers have even identified the specific gene, chromosome16, that codes for the richer or leaner fat content of earwax!
Excessive earwax can block the canal, resulting in decreased hearing, discomfort, and tinnitus (ringing). Far more often, however, impacted earwax is the result of cleaning with Q-tips.
Ear, nose, and throat specialists are famous for their advice never to clean your ears with anything smaller than your elbow. Cotton swabs just pack down the wax, pushing it deeper into the canal. They can also perforate the eardrum, if pushed in too far or with too much force.
Water jet devices are more effective, but may be unpleasant. They can also cause perforations if not used with care. "Candling" is not felt to be a particularly effective method of ear wax removal.
So, if you feel like you need to clean out your earwax, what are your best options?
One method is to put a few drops of mineral oil or olive oil into your ears every few days. Let it sit in there for a few minutes, to soften and dissolve some of the wax, and then let it drip out onto a washcloth or towel.
You can also use OTC Murine or Debrox drops or the prescription preparation Cerumenex (which is enzyme based).
Earwax can be easily and safely flushed out in the shower with a gentle stream of warm water. If your wax tends to be dry and hard, try the softening drops first.
You should never attempt to clean out an ear that is painful or presumed to be infected. And you should never clean out an ear that has tubes or a perforated eardrum.
Of course, you can always come into the Health Center for us to take a look and lend a hand!
Be well!
Jeff Benson, M.D.
Dudley Coe Health Center
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