Ear Cleaning: Understanding How Ear Wax Functions

Ear wax and how it helps us

Ear wax has an important cleaning function for our ear canals. Our skin is constantly regenerating, as new skin cells are made, the old skin cells on most of our body are brushed or washed away. This works well for most of our body, but because the skin in the ear canal is not exposed to the outside there is a specialised system to export the old skin cells and other debris out of the ear.

Ear wax is designed for ear cleaning. It works by migrating in a spiral motion from the ear drum to the entrance of the ear canal. Dust, debris and dead skin cells stick to wax as it moves along. Once it moves out into our ear, we can then use a tissue to wipe it away. Our ear wax has more than an ear cleaning role; it also lubricates our ear canals and has an antibacterial function. It protects the delicate skin in our ear canal from infections. For most people this process keeps the ear canals clear, and they never need to have their ear wax removed. It the migration down the canal is interrupted (more details below) a build up can occur and wax cleared suction is needed.

Our ear canals are about 2.5 cm in length. They are deep inside our head to protect the delicate hearing structures. At the end of our ear canal is the ear drum (or tympanic membrane), the ear drum vibrates in response to sound. The three small bones in the middle ear (ossicles) increase the vibration effect and transfer the vibrations into the fluids of the cochlear Inner ear). Within the cochlear there are tiny hair cells that convert the sound into electrical energy that is transported to the brain by the cochlear nerve.

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Why do some people need ear wax removed?

Ear wax production is unique to each person. It can vary in the amount of ear wax produced, consistency and colour.

• Just like some people perspire more than others, some people make more ear wax than others.
• People with narrow ear canals or a canal with a greater bend, find the ear wax may not be able to move out smoothly.
• Blocking the ear with earphones, earplugs, and hearing aids may stop the ear wax exiting out of the ear and cause build up.
• Consistency of ear wax or the natural ear wax migration system that does not work effectively may mean some people need to have ear wax removed regularly.

When should I make an appointment for ear cleaning?

• The wax is affecting your hearing. This can happen slowly over time which may not be so obvious, or it may happen suddenly. If the wax has been in building up over time, there is often a little gap through the wax. You may notice your hearing may block then unblock. If the gap is closed like after going for a swim or pushing a cotton bud into your ear, it will block. Please do not put anything into your ear canal as it is likely to push the wax deeper making it more difficult to remove and you may damage your eardrum.
• Your ear feels uncomfortable. Your ear may feel blocked, itchy, full or generally uncomfortable. An infection in your ear canal may also cause discomfort. If we discover an ear infection, we will suction out any debris in the ear canal and recommend you see your GP for management.
• You are having a hearing test. Your ears must be free of wax for an accurate hearing assessment. Even if there is only a partial blockage, the wax may need to be removed prior to the test. This is because “insert earphones” are used to assess hearing, and we want to avoid pushing wax deeper into your ear canal towards your eardrum. The wax can also block the sound coming from the earphones, creating a false hearing measurement.

Ear wax and Hearing aids

When you wear hearing aids a wax build up can have the following affects:

• Hearing aid function – Wax may affect the way your hearing aids work by blocking the receiver (sound port) of hearing aids, so the hearing aids do not produce sound.
• Using a lot of wax protection systems – You may find you have to change the wax protection systems often as they repeatedly block up.
• Blockage of your ear canal – Wax may block or distort the sound reaching your ear drum, so you notice you are not hearing clearly.
• Acoustic Feedback– Occurs if sound bounces off a wall of wax in your ear canal and bounces out of your ear rather than into your ear. If it reaches your hearing aid microphones it causes the hearing aids to make a whistling sound. Some people cannot hear the feedback, but it is an unpleasant sound for others and the feedback distorts the sound quality for the person wearing the hearing aids.
• Discomfort – wax in your ear canal can stop your hearing aids from sitting correctly in your ear canal. It can cause itchiness and discomfort.

Before your ear cleaning appointment

It’s completely understandable to want to clear your ears when they feel blocked and it can be tempting to reach for cotton buds or other items. We see this often! However, we gently advise against inserting anything into your ear canal, especially when it feels completely blocked. Doing so can sometimes push the earwax further in, making it more compacted and potentially uncomfortable against your eardrum. There’s also a small risk of irritating the delicate eardrum.

Please don’t worry if you’ve already used cotton buds or if your ear feels sore or blocked – that’s absolutely fine, and we’re here to help! Our kind and experienced team is ready to gently remove the wax and ensure you feel much more comfortable. We’re looking forward to making your ears happy again!

• Please do not poke a cotton bud or anything else into your ear canal as it may push it towards your eardrum.
• Please do not use Cerumol drops. These drops often melt the wax down onto your eardrum which can affect your hearing and make the wax more challenging to remove.

Please do:

Use Olive oil drops. To help make your earwax removal appointment as gentle and comfortable as possible, we suggest using a little olive oil in your ear canal beforehand. The oil works beautifully by gently easing its way between the earwax and the delicate skin of your ear canal. This lubrication not only makes the removal process much more comfortable for you but also significantly improves our ability to clear all the earwax during your very first visit, helping you hear clearly sooner!

Instructions for Oil Use

1. Place a few drops of olive oil into your ear and lie on your side for 7-10 minutes.
2. Hold a tissue over your ear and massage it a bit to help the oil reach deeper down your ear canal.
3. Repeat on the other ear.
4. Do this morning and night for two to three days before your ear cleaning appointment.