No, no, I never stick anything into my ears

ouch

Damn it. That was too deep.

I’m going to discuss sticking cotton buds into your ears (and giving your brain a good tickle). I’m not condoning it – I’m discussing it because, well, we get a lot of dogma about it. Dogma can work for many people but it rubs others like me the wrong way.

Lets understand this urge. Cerumen – that yellowish mix of oil, skin and dead bacteria coming out of your ear is how the ear canal cleans and defends itself. Similar to your nostrils, dirt and nasty stuff enters and is dragged out along with dead skin particles. There’s a constant cycle of the skin renewing itself and exiting.

SO, the extroverted among us will now declare: ‘Well I blow my nose out all the time and I’m constantly picking it, so what’s the big deal with cleaning my ears?’  Thanks for that but maybe a bit TMI… Yeah there are similarities, in fact both canals are called meatuses.  But the similarity ends at their respective ends; the back of your throat in the case of your nostrils and the ear drum for your ear canals. Herein is what gives rise to the fears and anxieties which make health professionals jump in shock-horror and declare ‘Oh no! Don’t stick anything smaller than your elbow down there!’ It’s the fear of either damaging your ear drum or pushing the cerumen onto it and stopping it from moving.

When everything is working well

Ceruminous glands produce secretions which keep the ear canal lubricated and acidic – something bacteria and fungi don’t tend to enjoy. Earwax, the combination of this stuff, makes its way out into the concha (the bowl of your ear). This is because the ear is self-cleaning. The stuff makes its way out because of the direction of skin growth and the chewing of our jaws; which jiggles it in an outwards direction (isn’t evolution smart!)

So you might get a bit of a tickle now and again but most people will be fine without needing to do much. It’s tickling you because there’s magical protective gunk inside and it’s meant to be there. You can remove normal amounts of earwax in and around the outer ear by giving them a good soaping in the shower and then using a washcloth or a tissue to dry them out. This is fine unless you have a perforated ear drum or are prone to fungal infections.

When it all breaks down

Tragically, in a show of just how unfair mother nature is, those people who probably feel the greatest urges to clean their ears are probably the ones at greatest risk of causing more harm than good by poking them. Now this excludes the obsessed people who have been doing it all their lives and feel discomfort because the behaviour is a part of their daily routine (I’m looking at you my dear parents), but I’ll deal with you in a second.

The amount and type of earwax produced varies from person to person and has nothing to do with personal hygiene. My sympathy goes out to the (mostly) Asians and Indians who get dry ear wax. This is actually a genetic thing and the only bright side to this is that your sweat is also less smelly than people with a different form of the gene who get wet ear wax. If there’s too much of it, dry wax just needs to be picked out (by a professional).  And now you know why there’s a street trade of ear picking in India. I’ll spell it out for you in case it isn’t obvious: dry wax won’t stick to a cotton bud so chances are you’ll just be pushing it towards your ear drum if you try.

The shape of your ear canal can also cause problems. People with narrow ear canals, such as people with Down’s Syndrome (but not exclusively), experience a kind of bottle neck effect for the ear wax. In this case there could be a nice lump of wax hiding out of sight, behind a bend, screaming for you to pull it out.

Age is another factor, as the ceruminous glands I was talking about start to shrink, causing the earwax to dry out. Dead skin particles continue to build up, and because the earwax is so dry, it doesn’t travel out as easily.

Blocked ears tend to have more wax because it doesn’t have anywhere to go. So if you’re not listening to music but your ear plugs are in, maybe take them out and give your ears some breathing space. Unfortunately, the same can be said for hearing aids, especially ‘hidden’ completely in the canal ones. If you produce a lot of wax and need a hearing aid, it’s really about getting into a good wax-removal routine.

A couple of these factors and the situation is ripe for impacted wax, also known as an earwax plug.  This is really annoying, can cause a hearing loss because it blocks sound and stops the ear drum from moving, can be painful, and can even make some people dizzy.

What can I do?

We’ve talked about how smaller amounts of wax don’t need removing and how a good concha scrub helps, so you don’t really need cotton buds. There are ways to remove larger amounts of earwax or earwax plugs too.

If it’s not too bad

First things first: apocrine (sweat) glands contribute to how soft your ear wax is, so if you’re dehydrated, well, so’s your wax. Hydration is important for practically any bodily function I can think of. Here’s some evidence in case you’re from another planet.

There are loads of commercially available ear drops or sprays (cerumenolytics) that can soften earwax.  The goal here is to try to dissolve the fatty blockage in your ears. Use it as the product instructions state. In general it’s something along the line of ‘lie on your side and drop in 3-5 drops. Use for a week.’ If you get the wax soft enough, it can then make it’s way out.

I rarely get to say this, so I say with with pleasure: home remedies like warmed olive oil could also work just as well. Just please don’t end up frying your ear canal. If you’re in doubt, cold oil is fine. It’s a principle of Chemistry, that like dissolves like so anything fatty like olive oil, almond oil, special ear drops, or sprays soften the earwax so that it can resume it’s journey out of your head. Even simple water will help. Just make sure the solvent you are using is clean and don’t squirt it forcefully.

Hydrogen Peroxide drops work differently by creating a mechanical force, bubbles, which further aids to soften the wax. Commercially available peroxide drops are at the right concentration and pH so as not to be too harsh on the ear, so stick to them. Even so, if you’re not getting any relief after a week of peroxide, it’s time to let the professionals have a go.

If you’re a waxy overachiever

Microsuction is the gold-standard of wax removal. A trained professional vacuums wax out of the ear using a suction device and a microscope. It’s usually done lying down and sounds very noisy for the person getting suctioned. (I’ll give you a penny if you can guess why). 5 minutes later you’re skipping (or running) out of the clinic. You’ll hurt less if you soften up the earwax, like I described earlier, before going to a microsuction session. The good news is that it’s a free service on the NHS, available in many trusts.

The only not-disgusting picture of microsuction on the internet

Irrigation is when a stream of water is used to rinse out the ear. This isn’t suitable for people who have a middle ear infection, or ear drum injuries.

A final note: if someone suggests ear candles, please ignore them.

 

 

 

If you’re stubborn

As I’ve indicated, there are people who have been poking ears for years and aren’t going to listen to reason. But I appreciate that you’ve made it so far through the post, and I guess there are ways to make this risky procedure less stupid. Let me just dramatically drive the point home here with a simile: these considerations are like giving clean needles to people. OK maybe a bit too much, like giving helmets to rally drivers. Yeah I like that.

  • There are situations when to NOT EVEN THINK ABOUT IT: if you’ve been told you have a lot of wax in your ears, if you have an infection, if you’ve had recent surgery, if you’re drunk, if it’s not your ear.
  • Also, definitely don’t try this if you’ve never tried it before or if none’s ever had a good look down your ears before.
  • Keys, needles, ear wax picks in untrained hands, tweezers, shards of glass and the backs of cutlery are possibly all worse than cotton buds.
  • Not all cotton buds are equal and it’s no use lying to me and telling me that you never stick stuff in your ear when there’s the left-over cotton wool from a cheapo cotton bud still down there.
  • If you’re going to stick one in, make sure you’re standing still, in front of a mirror and keep in mind that your ear canal is not much longer than 2 cm, so don’t stick it in deeper than the white bit.
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