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What is earwax buildup?

Earwax, or cerumen, is a brownish-yellow substance made up of secretions from sweat glands and sebaceous

glands in the ears. In some people, this waxy substance — which contains particles of sloughed off skin and is also rich in body oils — accumulates in the outer portion of the ear canal. The wax buildup is a persisting problem for some people, while others may never experience it.

Scientists think that cerumen serves several useful purposes. It protects the auditory canal from moisture, injury, and infection. Swimmers, divers, and water polo players, whose ears are frequently flushed out with water, have little residual wax in their ears. This may be why they suffer an itchy condition called swimmer's ear, and why they also are susceptible to ear infections.

Many misconceptions about earwax persist. For example:

• It does not cause deafness, although it may temporarily block hearing until it is removed.
• Earwax buildup is not a sign of poor hygiene.
• The wax does not cause the normal and gradual loss of hearing acuity that occurs with age.
• Most important, it does not need to be removed daily.

What causes earwax buildup?

No one knows the cause. Earwax buildup may be an inherited trait, since the problem tends to run in families.

How is earwax buildup diagnosed and treated?

The buildup usually can be seen simply by looking into the ear. A parent or care­giver may notice it first in a youngster. The child may be annoyed by the wax, and try to pick it out with the tip of a finger or pointed object. Self-care methods are available for removing accumulated wax. When they fail, topical drugs may be used to remove it. In unusually severe cases, an ear doctor should be consulted.

What can I do myself?
Most people can keep earwax under control by wiping out the auditory canals occasionally with a washcloth. A word of caution, however — very frequent (e.g., daily) removal is not recommended, since too much fiddling with the ears and auditory canals can lead to hearing loss or infection.

If you are not satisfied with an occasional cleansing, use the tip of a finger to gently pull out the wax. Ear specialists (otologists) warn against using a hairpin, paper clip, or other sharp object to clean out the ears. They can injure or puncture the eardrum. Doctors also frown on cotton-tipped sticks that push the wax down into the ear rather than remove it.

Several over-the-counter preparations are available for self-care of earwax. One that is approved by the Food and Drug Administration is carbamide peroxide in glycerin. This compound also may be called urea hydrogen peroxide.

The carbamide peroxide fizzes when it comes into contact with body tissues. The oxygen bubbles loosen the wax, which can be flushed out with an ear syringe. Note, however, that when you use an ear syringe you must squeeze it gently, so the water does not damage the eardrum.

Glycerin alone has long been used to soften earwax. After inserting it into the ear, tilt your head for 15 minutes or so, to keep it in place while it acts on the wax.

When should I see my doctor?
If self-care is unsatisfactory, and the wax has crusted up so that you can't remove it then make an appointment with the doctor. If the sense of fullness persists after self-care, or if you feel dizzy, or pain in the ear, you also should seek medical care; you may have a foreign object in your ear.

What will the doctor do?
The doctor will examine your ears, and remove the wax. He or she may prescribe an earwax solvent, or a cerumolytic agent, which, as its name implies, dissolves the wax so that it can be removed more easily. Or special implements may be used to carefully remove the wax. Follow-up visits may be needed to keep the wax buildup under control.

The course of earwax buildup

The buildup usually recurs, but it can be removed with ease when it becomes a problem.

Is earwax buildup dangerous?
No — it may be annoying, but it is not a threat to health.