What's the deal with ear wax?

Q: I've been getting lots of ear wax lately. Please tell me this has nothing to do with getting older.

A: I wish I could. Ear wax problems are just one more indignity seniors have to deal with. I sympathize with your annoyance.

As you age, your eardrums often thicken and the bones of the middle ear and other structures are affected. Hearing sharpness may decline because of changes in the auditory nerve. Impacted ear wax is another cause of trouble hearing and is more common with increasing age.

Ear wax (“cerumen”) is made by glands in the external ear canal.

This wax protects the skin of the ear from water and infection. The amount and consistency of ear wax varies.

Most of the time the ear canals are self-cleaning. There is a slow migration of ear wax from the eardrum to the ear opening. Old ear wax is constantly being transported, assisted by chewing and jaw motion, from the ear canal to the ear opening where it usually dries, flakes, and falls out.

There are two basic types of inherited ear wax--wet and dry. Dry wax is common in Asia, while wet wax is common in Western Europe. There's more fat in wet wax.

A moderate amount of ear wax is desirable. Both too little and too much ear wax increase the risk of infection.

If you have impacted ear wax, it can be eliminated with drops, water irrigation, and instruments used by doctors, audiologists, or trained technicians. Removal by a professional is the best method of getting troublesome wax out.

Over-the-counter drops work well for small amounts of wax.  These drops are solutions of oil and peroxide. However, there are a couple of studies that found water to be as effective as OTC products.

Syringing with water is a standard method of wax removal. Water jet devices, such as those used for dental care, have also been used for ear wax removal. Do-it-yourself ear wax vacuum kits are available over the counter.

A study comparing these vacuums to syringing found that the ear vacs did not remove wax.

When syringing, use body-temperature water. Cooler or warmer water may cause brief dizziness or vertigo. With your head upright, straighten the ear canal by holding the outside ear and gently pulling upward. Use a syringe to gently direct a small stream of water against the ear canal wall next to the wax plug. Tip your head to allow the water to drain. You may need to repeat irrigation several times.

Never irrigate the ear if the eardrum may not be intact. Go to a healthcare provider if your ears are blocked with wax and you are unable to remove it.

Don't use cotton-tipped swabs such as Q-tips. These swabs can push wax deeper into your ear. They also can break an ear drum and increase the risk of bacterial infection of the external canal, commonly called “swimmer’s ear.”

Never use ear candles to remove wax because they can cause serious injury. These are hollow, cone-shaped candles typically made of wax-impregnated cloth. These are inserted into the ear canal.

The exposed end is lighted. Common injuries are burns and obstruction of the ear canal with candle wax.

To maintain the proper amount of ear wax, you can put baby oil or olive oil into each ear. It doesn’t hurt to put a few drops of clean oil into each ear every day. Swimmers often do this. This should not be done if you have an eardrum perforation. Another method is to have your ears cleaned out by your doctor on a regular basis.