Earwax (CERUMEN) is the single most frequent cause of hearing aid failure. As a result, it is a matter of concern to most hearing aid users. However, it is also a frequent subject of questions from those who do not use hearing devices.
Cerumen is a normally produced substance in the ear canal. It is made up of the secretions of two tiny, specialized sets of glands located in the skin of the outer one-third of the ear canal. Sebaceous glands secrete sebum. Sebum is mostly a combination of fatty acids. Modified apocrine sweat glands produce a secretion that combines with the sebum to form cerumen. This cerumen also picks up discarded skin cells and hair follicles. It may contain dust or other debris that finds its way into the ear canal from the outside. The resulting compound forms the material we refer to as earwax.
Individuals vary in how much wax their ears produce-some producing very little and others producing relatively large amounts. We do not fully understand all of the reasons for these differences. However, stress and emotional states such as fear, pain or anxiety tend to increase production, as do certain drugs.
Many people regard earwax as nothing more than a dirty nuisance. However, it serves several important functions in the ear canal. First, it creates a slightly acidic environment that is unfriendly to bacteria and fungi. This is important, since the ear canal is a dark, warm, moist area that would otherwise support the growth of such microbes that would cause significant problems. Secondly, it lubricates the skin of the ear canal and keeps it from drying out to become itchy or crack and form hiding places for microbes to establish a foothold. Thirdly, cerumen-along with the hair follicles-helps to discourage small insects from entering the ear canal to set up housekeeping. Lastly, the cerumen traps the dead skin and hair cells and any foreign matter and helps carry them out of the ear canal, keeping the canal free of these substances.
As a rule people create more problems than they solve when they improperly try to remove cerumen. Common attempts, using cotton swabs, may result in partial removal, while a larger amount of the material is pushed far back into the canal where it often cannot work its way out. Eventually, the canal becomes blocked and that produces hearing loss that generally results in a visit to a health practitioner. Other attempts at cerumen removal using paper clips, keys, hairpins, wooden matchsticks, etc. may result in direct injury to the ear canal or eardrum. Such implements should never be used.
Use of hearing instruments or earplugs may interfere with the natural exit of cerumen from the ear canal by pushing it inward with each insertion. Thus, the ears should be periodically checked for cerumen buildup that can be professionally removed.
It is possible to clean the ear canals too frequently, eliminating the positive benefits provided by the cerumen. For example, you may have experienced or known someone who has "swimmer's ear." When a person spends a great deal of time in the water, the ear canals can be flushed of all the protective earwax and become susceptible to bacterial or fungal infections. These are painful and sometimes difficult to eradicate. Such individuals are often advised to put a few drops of a slightly acidic fluid into the ear canal after swimming to help re-establish the normal acidic environment to help prevent re-infection. A similar condition may develop if a person flushes their ears out too frequently.
If you experience rapid buildup of earwax that requires more frequent cleaning, it would be wise to ask your audiologist to teach you how to best manage your earwax. Specific, individual advice is dependent on your situation and must be addressed individually.