Monday, July 19, 2010

Ear Wax

Medical Meanderings 15 October 2008

Waxing Eloquent ©

If your head is wax, don’t walk in the sun.
Benjamin Franklin (1706-1790)

Ear wax is beautiful stuff. Medical types call ear wax “cerumen,” from the Latin word “cera,” meaning wax. Cerumen is a complicated mixture of secretions and debris produced by the outside third of our ear canals. The secretions include sebum, the same oily chemical that, when eaten by bacteria in our armpits, gives us the distinctive odor of locker rooms. Also, specific glands called ceruminous glands secrete the long chains of fat molecules that make ear wax so…waxy.

The sebum and wax mix with whatever passes by in the ear canal, including dead skin cells, bacteria living on our skin, water and occasional hairs. This mixture can range in texture from liquid to a rock-hard, and in color from a reddish-black to white. The characteristics of our cerumen depend on its specific composition and on how long it’s been sitting in the ear canal. The texture and color of our ear wax, however, doesn’t necessarily tell us much about how the ear canal is working.

The wax is moved outward from the ear canal by a lining of hair cells, by the movement of the tissues around our jaw joint, and by the normal growth of skin in the canal. The point of knowing this is: we do NOT need cotton-tipped swabs! The ear canal comes with standard equipment that moves the wax out, unless we do something (like sticking in a swab) that destroys the lining cells or packs the wax in more deeply or tightly. All we do with those swabs, toothpicks, paper clips or whatever else we stick in our ears is damage the system that would clean our ears out all on its own.

Cerumen has several important roles in keeping the ears healthy. First, it traps dust, skin, hair and insects that would otherwise plug up our ear canals in a few months, and moves that garbage out. Second, it absorbs water that would, if allowed to stay in the canal, form a home for bacteria to grow and infect us. Third, it is thought to have acted as an insect repellant back when our ancestors slept on the ground.

Getting rid of impacted ear wax is not something to try at home. Serious, sometimes permanent damage can be done to the ears during botched attempts to dig ear wax out. Leave it to the professionals, who have several methods of attacking this difficult problem. Drops that soften ear wax (e.g., mineral oil) are helpful. We will use cerumen spoons or curettes to carefully pull wax out. Water irrigation often works, and if all else fails, suction devices may work. There is no scientific evidence that “ear candling” is useful in removing ear wax, and it cannot be recommended.

The easiest way to maintain the health of your ear canals is to leave them alone. If it’s too late for that, then simply placing two drops of mineral oil in each ear once a week, occasional irrigation of the ear in the shower, and avoiding cotton swabs is all you need to do.

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