Ear wax removal and tinnitus

Ear wax removal and tinnitus

Linda Mills, Head of Service, Primary Ear Care and Audiology Services, Rotherham

This information has been written to help you understand more about what causes ear wax build up, how to deal with it and whether it has any effect on tinnitus.
Written March 2012. Revised August 2012. Version 1.3. To be reviewed November 2014
This information has been produced in compliance with the BTA’s Information Production Protocol and no conflicts of interests have been declared. For more information on this and the Information Standard, please see our website.

What is ear wax?
Wax is an important and natural secretion found in the ear. It protects the ear against dust, dirt and bacteria, so it helps to prevent infection. Wax, or cerumen as it is also known, is composed of epithelium (skin cells), dust and oily secretions from the sebaceous and ceruminous glands in the ear canal. These secretions lubricate the ear canal and prevent it becoming too dry. The composition of wax varies from individual to individual depending on diet, age and environment.

What should you do about ear wax build up?

If wax is not causing any problems, it is best left alone. The ear is self-cleaning and the wax should clear naturally, so it is unnecessary to try to remove the wax yourself. If wax is noticed on the outer ear, a wipe with a clean flannel may be all that is needed. Sometimes, however, wax may build up, particularly if it is very dry or if the person has a narrow or hairy ear canal. Wax may also build up if it has been pushed down the canal by cotton buds, hearing aids, hair clips or other implements. Cotton buds can also irritate the ear canal, stripping it of its natural oils and causing it to feel itchy. When water gets into the ear during swimming or showering this may cause the wax to expand, giving a sensation of ‘blockage’ in the ear and increasing the perception of tinnitus.
If wax build up is causing deafness, problems with hearing aids, or is uncomfortable, it may need to be removed. Some people with tinnitus feel that their tinnitus is more troublesome when their ears are full of wax.

How can you treat ear wax at home?

If you have any pain in your ears, or any discharge from them, do not attempt any treatment at home, but see your GP. Most people tend to use ear wax softening drops as the first option for wax removal. These may soften the wax enough to aid the natural expulsion from the ear. There are many ear drops on the market. Some proprietary drops may be harsh to use, particularly if the person has a sensitive skin or any skin conditions such as eczema or psoriasis. Sodium bicarbonate ear drops can also be effective but again some people find them very drying.
Rather than use such ear drops, many people find that olive oil is easily available, comfortable to use and does not need to be warmed before use. Three or four drops, two or three times a day for one to two weeks is usually sufficient, and the wax will often then come out by itself. When introducing drops into the ear, it is best to use a dropper and lay with your head on one side for a couple of minutes to allow the drops to move along the ear canal. After this period, cotton wool may be used to soak up any excess from the outside of the ear.
If you often get a build-up of ear wax, using a couple of drops of olive oil once a week may help prevent the build-up.

Hopi ear candling

Practitioners of Hopi ear candling often claim that it is effective for removing ear wax but we remain concerned about this form of therapy. There is no good evidence that it helps the majority of people with tinnitus. There is, however, good evidence that the use of ear candles has damaged some people’s ears. In America, the Food and Drug administration have grave reservations about ear candles and have produced some guidance which can be accessed at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm200277.htm

What clinical methods are used to remove ear wax?

One of the most frequent ways to remove wax in general practice is by ear irrigation, or syringing as it is commonly known. This procedure cannot be carried out if the person has had any ear surgery, recent infections or a perforation of the ear drum. It is also not advisable to carry out the procedure if the patient has any dizziness problems or very troublesome tinnitus.
During this procedure, the person sits in a chair and the ear is rinsed with warm water from an electronic irrigator. The wax and water is collected in a basin or cup-shaped device which the patient holds under their ear. In the past clinicians used a large metal syringe; however the new electronic irrigators, which have controlled pressures, are gentler and safer. Ear syringing does make some noise but this is not excessive or uncomfortable. Most people who have irrigation find it to be a fairly pleasant procedure.
Wax can also be removed by micro-suction. This procedure is most commonly carried out in hospitals although some primary care clinics can also now offer this. During this procedure the clinician looks through a microscope and suctions the ear with a small instrument. It is a noisy procedure and although some patients may find the procedure slightly uncomfortable it should not be painful.
Wax may also be removed by a clinician using a headlight and instruments. Never try to remove the wax yourself with an instrument or device as you will most probably push it further down the ear canal or cause damage.
If any method being used is uncomfortable, tell the clinician at once.

Can ear syringing affect your tinnitus?

Very occasionally people with tinnitus have reported that ear syringing made their tinnitus more troublesome. This may be when the procedure has been an uncomfortable or unpleasant experience. Some people have reported that ear syringing actually caused their tinnitus. However, considering that wax removal - particularly ear syringing - is the most common ear procedure carried out in primary care, complications are few and far between.
If the wax has been blocking the ear and reducing the sound getting in, the increased loudness of the sound after wax removal can increase awareness of tinnitus temporarily.

To summarise:

• Wax is a natural secretion and if it is not a problem it is best left alone
• Do not use cotton buds, hair grips, a pencil or other items to try to remove the wax
• Consider ear wax softening drops or olive oil as the first option unless you are experiencing pain or discharge
• Visit a clinician who will advise whether wax removal is necessary and what type of procedure is most appropriate for you depending on your medical history

References:

Full references for this article can be obtained from the BTA.



Fuente: British Tinnitus Association 
http://www.tinnitus.org.uk/ear-wax-removal-and-tinnitus