Ear wax is also called cerumen . It is a normal substance of the external auditory canal. It protects us from the damage that can be caused by objects and substances that enter the ear.
It is made up of secretions from the glands in the skin of the ear canal, which drag hairs, cells that flake off, and substances that enter the ear. The wax is produced in the outermost part of the ear canal and, little by little, it comes out.
It is normal for the appearance of the wax to vary a lot from one person to another, and even in the same person. It can be from almost liquid to very hard; and almost white to almost black, or reddish or amber. This does not say there is a problem.
And wax plugs, why are they formed?
It is not uncommon for wax to accumulate in the ear, completely or only partially plugging it. This happens to one in 10 children.
Some people are more likely than others to form wax plugs. It may be due to the shape of your ear canal, with some narrowness that makes it difficult for the wax to come out. It may also be because more wax is produced than usual. This “overproduction” can occur in healthy people and also in response to injury or water retention in the duct.
Sometimes the plug forms because there is a foreign body in the ear, such as cotton. And also because of the habit of cleaning the ears with cotton swabs. With the stick the wax is pushed inwards and it becomes more difficult for it to come out.
What problems can they give?
Wax plugs do not usually give symptoms , although sometimes they can cause discomfort such as:
- seems to hear less
- pain in the ear
- it seems that the ear is full
- dizziness or vertigo
How can I tell if I have impacted earwax ?
Just have your pediatrician look at your ears with the otoscope. It is something simple and without risk.
In what cases should it be removed ear wax ?
When you have discomfort: you hear less, there is pain… And sometimes, when you have to examine the ear and the wax prevents it.
So there is no need to remove the wax when there are no symptoms . Because you usually leave without doing anything and it serves to protect your hearing.
Only in young children or children with disabilities is it better to remove the plugs even if there are no symptoms.
How are they removed?
When the wax plug needs to be removed, a doctor should be consulted . If it’s not done right, it can hurt.
There are 3 methods: earwax softening drops, ear canal irrigation, and manual removal.
1) Drops to soften the wax : can be used if there is no perforation of the eardrum. They should not be used if you have or have had any symptoms, illness or injury suggestive of perforation: such as ear discharge or pain, or have had otitis. They should also not be used if there is an ear canal infection.
There are many substances that soften wax. Oil-based and hydrogen peroxide-based preparations are the most widely used. Drops of olive or almond oil also work.
They are placed at home: make sure they are at the same body temperature, lay the child on his side, put a few drops in his ear and keep him in that position for 5 to 10 minutes. It is repeated 2 or 3 times a day, for a maximum of 3 to 5 days.
It is rare that putting these drops gives problems. Although sometimes they can give allergic reactions, external otitis or ear pain.
2) Irrigation or washing of the ear. It is used a lot. It is safe and effective when done by a healthcare professional. It consists of introducing abundant liquid into the ear, generally warm water or warm saline solution, with a large syringe.
Extraction is easier if drops are placed beforehand to soften the wax.
It doesn’t usually cause problems. Although rarely, liquid can be retained behind the earwax and cause an infection. Or it may cause a perforation of the eardrum , or decreased hearing, pain, or vertigo after irrigation.
3) The ENT performs manual extraction with appropriate instruments when neither the drops nor the lavage have gone well, or if there is a problem such as a tympanic perforation.
Ear candles should not be used. They are useless and dangerous. They can burn the ear or face, block the ear canal, cause infections and perforate the eardrum.
Can we prevent them from forming?
It is important not to insert cotton swabs or any other object into the ear canal to clean the ears . To clean the ear it is enough to wet and clean the ear in the shower.
Your healthcare professional may advise people with a tendency to have wax plugs to put on some preparation from time to time. Or have them have their earwax removed every 6 to 12 months. Earwax softening drops should not be used daily.