Tips from an ENT on Safe In-home Earwax Removal

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Tips from an ENT on Safe In-home Earwax removal

Excessive earwax production can cause many uncomfortable symptoms in addition to decreased hearing. Going to the doctor can be expensive and time consuming but earwax (cerumen) can be removed safely and quickly at home.

What is earwax?

Approximately one half of earwax is made up of secretions from the sebaceous and ceruminous glands in the outer part of the ear canal and the other half from ear canal skin that is shed and mixed with the secretions. The more sloughed skin that makes up that clump of wax, the harder the mass and the more difficult is the removal.

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Clinical studies

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Several large well-designed clinical studies however have produced some interesting information about earwax and earwax removal. Many of the popular products that you see advertised did not fare any better than the recommendations we will make in this blog. One preparation selling for $20 a bottle can be made at home for a fraction of that cost.

So, what did we learn from these studies?

• Cerumenolytics (earwax softeners) work by hydrating and softening the exfoliated or shed outer layers of skin, which make up the major constituent of cerumen or wax plugs.
• Immediate ear irrigation alone without any pretreatment with ear drops was found to be effective in 70-75% cases. Use of a cerumenolytic agent 15-30 minutes before irrigation can increase that percentage to as high as 97%.
• Earwax is affected by dermatologic conditions such as eczema and seborrheic dermatitis (dandruff).
• In two large studies, docusate sodium (Colace) and sodium bicarbonate appeared to work better in children.
• One study demonstrated the effectiveness of cerumenolytic drops but did not find any significant difference among the agents. In fact, none were superior to water.
• Wax becomes harder and more prevalent with age.
• Earwax buildup is greater in hearing aid wearers and earbud users.

Eardrop Preparations

1. Water or Saline SolutionAt least 2 studies showed that overall, no cerumenolytic appeared to be superior to water or saline, making it an inexpensive first-line agent. The simplest and least expensive technique is using a soft rubber bulb ear syringe to flush the ear after 15-30 minutes of pretreatment with plain warm tap water or saline. Studies have shown that water alone can effectively soften the sloughed skin component of hard earwax. To make a saline solution, mix 1 teaspoon of table salt in 1/2 cup of warm water until it is completely dissolved. Using an eyedropper, instill 1 dropperful into the ear canal. Allow the saltwater to soak for 15-30 minutes before letting it drain out or flushing.
2. Hydrogen Peroxide 3% SolutionThe aqueous base and foaming action of the peroxide is what makes it effective as an ear wax removal solution. Mix equal parts Hydrogen Peroxide and warm water and instill this solution into the ear canal. After 15-30 minutes allow to drain from the ear and flush.
3. Sodium BicarbonateBecause of its alkaline properties, it reacts to help dissolve the acidic earwax. Studies found this solution to be twice as effective as Debrox. Sodium bicarbonate is the same active ingredient found in an ear drop costing $20.00 a bottle. You can make your own solution by using the same sodium bicarbonate that you purchase in the grocery store, dissolve 1 teaspoon in 1 cup of warm water. Fill the ear canal with the solution for 15-30 minutes before draining from the ear and flushing.
4. Docusate sodium or ColaceThis popular stool softener has been found to be a highly effective means of removing earwax. In fact, several clinical studies consider it to be the most effective cerumenolytic on the market. Though not available in the USA at this time, it is being sold as Waxsol and Molcer in Europe and is the No. 1 selling earwax softener drop in Australia.A significant number of studies have found it to be the best preparation for use in children under the age of 6.Liquid docusate sodium is difficult to find. An Amazon search found several companies selling pint size bottles for about $15. Liquid docusate sodium can be instilled directly into the ear canal without dilution. Let it drain from the ear after 15-30 minutes of soaking.
5. Baby Oil/Olive Oil/Almond OilCertain oils can be safely used as ear drops to soften impacted earwax and ease its expulsion out of the ear canal. Actually, the British National Formulary recommends olive or almond oil as an earwax softening agent.

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Earwax Removal Kits

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In some cases, ear drops will soften or dissolve the wax and allow it to fall out of the ear on its own. However, in most cases, wax removal will require a little help. For in-home treatment there is no safer method then to flush the ear canal with warm water to dislodge and expel the earwax.Several types of kits are available which make flushing easier, some safe but many not. Most consist of a spray bottle with a flexible hose and irrigation tip to help direct the water stream into the ear. Almost all use a single high-pressure jet stream that can injure the delicate eardrum so one must be careful with its use. The waxBgone kit uses the patent-pending SoftSpray irrigation tip that provides a 7-stream gentle shower-like spray that safely flushes wax from the ear.

WaxBgone also has a hand-held rechargeable electronic ear irrigator which is safer and medically preferred option. This device comes with the SoftSpray tip and has a variable pressure control, which helps ensure that irrigation can be initiated at the minimum pressure to avoid any possible damage to the delicate eardrum.

Avoid the following

None of the following should ever be used on children

• Invasive ear cleaning tools such as curettes, ear picks, hairpins or any similar objects can easily injure the thin delicate skin lining the ear canal causing infection or worse yet damage to the eardrum. They should only be used by a skilled medical professional and have no place in in-home wax removal. With the use of a binocular microscope, this is the most common method used in an ear doctor’s office to remove earwax.
• Ear Candling is dangerous and should be avoided. It is a practice in which a hollow candle is inserted into the ear canal and lit. Several well documented studies have shown that it neither created suction nor removed wax and was associated with many complications such as serious damage to the ear canal and eardrum.
• Suction or vacuum devices sold on the internet lack the suctioning power to effectively remove ear wax. The equipment used by ear doctors is expensive and 10X more powerful.Spiral electronic earwax removal tools are ineffective and dangerous.
• Cotton swabs only push wax further into the ear, not out.
• Waterpik dental flossing units using a single stream dental wand. Even at the lowest setting, the single high-pressure jet stream can easily damage the delicate eardrum.

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