EAR WAX

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

I periodically go deaf. It is usually only in one ear. Fortunately, there is nothing seriously wrong with me. I usually end up at the walk-in clinic. The doctor looks in my ear and usually says, “It is right full of wax.” Then a nurse takes some warm water in a syringe and clears it out. Voila! I can hear again. So I did some reading about ear wax. Here is what I found.

The skin lining the outer two thirds of the external auditory canal (EAC) has little hairs on it. The EAC also has two types of glands, ceruminous and sebaceous. Secretions from these glands mixed with sloughed off dead skin is ear wax, or more properly called cerumen. Cerumen (ear wax) helps to lubricate and protect the ear. It water-proofs the EAC and protects it from bacteria. Cerumen (ear wax) is normally produced in small amounts and moves out of the ear by the action of the little hairs we talked about earlier and by the motions produced in the EAC during talking and chewing. The ear is usually self cleaning. I am to discourage anyone from “Sticking anything smaller than their elbow” into them. Cotton swabs, match stick, pins, etc may just jam the wax in there real good and cause impaction.

What might too much wax in my ears do? It can: make it harder for a doctor to see my ear drum which they need to do to diagnose certain ear problems; I could get the wax impacted; my hearing could be impaired; or my ears could get infected. Why are my ears having problems getting the wax out? As we age the cerumen we produce gets drier and harder to move out, my EAC might be narrow or misshapen, my EAC might have too much hair in it, my hearing aids can cause problems, or I might have bony growths in my EAC.

What shoud you do if you think your ear is plugged with wax? See your doctor. Syringing with body temperature water works great in many cases. You should NOT try to syringe your own ears at home. If you do, more than likely one of the following will occur: pain, dizziness, ear infection, or perforated ear drum. There are things you can try at home first to soften the wax before syringing.

The most gentle treatments for ear warx are softening agents. These include olive oil, light mineral oil, 3% hydrogen peroxide mixed half and half with water, glycerin, and commercially available products like Cerumol (contains Chlorbutol 5%), and Murine Ear Drops (contains Carbamide peroxide 6.5%). You put these products in the ear 4-6 drops at a time, twice a day for 3-7 days. They are generally not irritating, but their effects take a few days to be noticed. The feeling of hearing loss and fullness may initially get worse as the ear wax swells. The wax may flow out naturally, but if it doesn’t, see your doctor in 3-7 days to get it syringed.

The commercially available product Cerumenex (contains triethanolamine poly peptide) works much faster than the softening agents, but don’t use it unless you are immediately going to have your ear syringed. If Cerumenex says in your ear longer 10-15 minutes it can cause irritation and allergic reactions.

The best ear wax disintegrator apparently is docusate sodium. This surprised me because there is no commercially available docusate sodium ear drop. What happened is some doctors tried the docusate sodium liquid stool softener for children in ears to soften wax. Apparently it works better than Cerumenex. The problem with the stool softener liquid is it has red dye and other stuff I don’t want in my ear. So I’m going to try to compound a docusate sodium ear drop, for the next time I go deaf. I’ll let you know how it goes.

As always if you have any questions or concerns about these or other products, ask your pharmacist.