ASK THE DOCTOR: Ear wax not a sign of bad hygiene
By JIM MITTERANDO
The Patriot Ledger

Q. I am having problems with ear wax blocking my ears and affecting my hearing. What can I do? I read that Q-tips can make my problem worse.

A. Ear wax is part of the body's normal defenses. It traps dust and foreign objects, protects the ear canal and prevents growth of bacteria.

The ear canal is like a conveyor belt. If you leave it alone, it will push the wax out of the ear. Using cotton swabs (Q-tips) to remove the wax can actually push it in farther and pack it against the ear drum. Some people make excess wax while others make harder wax that may block the ear canal causing temporary hearing loss or ear pain. I find that as you age, your ear wax tends to get harder and you are more likely to get plugged up ears. If you wear a hearing aid, you are more likely to get wax plugs because the hearing aid blocks the ear canal.

People tend to pick at their ears with cotton swabs, paper clips or bobby pins. This makes the problem worse and also can puncture the ear drum or irritate the ear canal. The golden rule of ear care is ‘‘never place anything larger than your elbow in your ear.''

People tell me they want clean ears and feel embarrassed if they or their children have wax in their ears. Use a washcloth to clean the outer ear and leave the ear canal alone. Ear wax is not a sign of bad hygiene.

If you have recurrent problems with ear wax building up that blocks your hearing, there are several things to do to help soften and remove the wax. You can try applying 4 or 5 drops of olive oil, baby oil, mineral oil or glycerin with an eyedropper nightly for three or four days to soften the wax. Place a piece of cotton soaked with the drops in the ear to keep the liquid in place overnight. After three or four nights of applying drops, use an ear syringe (available at the pharmacy) to flush the ear with warm water until the wax comes out. Make sure not to use cold or hot water which can cause severe dizziness. Add a few drops of vinegar to the warm water which will suppress bacteria in the ear canal and prevent a swimmer's ear infection. Avoid peroxide which can irritate the ear canal.

If this does not work, follow up with your health care provider who can either flush the ear or use a special instrument to scoop out the wax or suction it out.

For people with real hard wax plugs that are difficult to remove, I recommend Colace - liquid drops which act as a pediatric stool softener. Do not use the syrup formulation. Colace liquid is over-the-counter, but your pharmacist may have to order the one ounce bottles which cost around $10. Apply Colace drops for several nights and then flush the ear with warm water.

Over-the-counter Debrox and Murine Ear contain peroxide which can be irritating. The prescription wax softener, Cerumenex, also can irritate the ear canals. Ear candles, which attempt to melt and soften the wax, do not work.

Some people have recurrent wax plugs that require regular prevention with once-weekly applications of olive or mineral oil ear drops to keep the ear wax soft.

Your ear canal and ear drum are very delicate and can be damaged easily. Follow up with your health care provider if these measures do not help or if you experience pain or your hearing gets worse.

Dr. Jim Mitterando is a family doctor at Health Care South/Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.

Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.

Copyright 2002 The Patriot Ledger
Transmitted April 23, 2002