Sunday, January 29, 2006

An ear wax rant

Time for a few anticipatory answers.

1. No, there's nothing wrong with having dark brown wax. Any shade of brown, all the way down to pale yellow, is fine. It should smell like ear wax, though. (Don't know the smell of your own ear wax? Stick finger in ear. Twirl. Smell it.) If you think you are going to lose your lunch from the aroma, you may have an infection. You need to see your doctor.

Green and pitch black are not acceptable colors, by the way. Green suggests a bacterial infection, black, a fungal infection.

2. No, you do not need to live with an itchy ear. This is soooo treatable it isn't funny. Scratching at them with Q-tips is not the solution (see my January 17 post).

3. No, I can't tell you how to clean your ears. Everyone's wax is different, and different types of wax respond to different cleaning techniques.

The Ear Wax Compendium

A. No wax. This is not abnormal. Most people's ears are self-cleaning. By the way, if your ears are itchy and you "have no wax," the "lack of wax" isn't causing the itchiness. Your incessant cleaning is causing the itchiness. See #2.

B. Dry, scaly wax. This isn't all wax, but flakes of skin combined with wax. This is nearly impossible for you to clean at home, and it's not too easy for me to clean, either. Interesting fact: I see this most often among people of Asian descent.

C. Hair impactions with variable amounts of wax mixed in. This is the absolute worst. It's irritating to the patient, impossible to clean with Q-tips or over-the-counter ear wax remedies, and it's a devil for me to clean, too. TRIM YOUR EAR HAIRS, puhlease.

D. Hard wax. Assuming you have an intact ear drum, it is safe to put oil in your ears to soften the wax: vegetable oil, baby oil, anything but motor oil. Don't waste money on "sweet oil," as this is just overpriced olive oil.

E. Soft wax. This will respond to the use of over-the-counter ear wax kits, assuming you haven't waited to long. Which brings me too . . .

4. Don't wait too long to seek a doctor's help. Once the wax gives you an unremitting hearing loss, it's too late to clean it with Q-tips or over-the-counter wax kits. You'll only make it worse.

It saddens me whenever I have to clean out wax that has been present since the Truman Administration. This is a patient who has had treatable hearing loss for decades. For heaven's sake, practitioners, look in your patient's ears.

5. Irrigation (the most common cleaning technique used by nurses and non-ENTs) probably works about 99% of the time (number pulled from where the sun doesn't shine) but it's that 1% that'll get ya. Yes, I have seen serious injuries due to over-forceful irrigation. For what it's worth, I've never seen any injuries from self-irrigation using a kit. When they're doing it to themselves, folks generally know not to use too much force.

Irrigation is not pleasant, though. If you're doing it to yourself, make sure the solution is at body temperature, or you may get very dizzy.

Important: If you think there is any chance you have a hole in your ear drum, STOP. Do not put anything in your ear canal. Do not irrigate. Do not let the doctor or the nurse irrigate. Repeat, STOP. This is a job for the ENT.

6. When you see your ENT, do not say any of the following things. We've heard each one of these 'jokes' so many times, it makes us want to scream when we hear it again.

A. "Can you see through to the other side?" (No, ma'am. There are two peas rolling around which are obstructing my view.")

B. "Huh?" (Unless you really mean it.)

C. "I was always told you shouldn't stick anything in your ear smaller than your elbow." (I see. You did a damn good job jamming the wax in with your elbow. Or did you use your foot?)

Which brings me to . . .

7. Yes, it is okay to use Q-tips, with several warnings:

A. Make sure you don't forget about the Q-tip and leave it dangling from your ear. This makes cell phone conversations quite hazardous. Yes, I have seen two ear drum perforations (separate patients) by this mechanism.

B. Make sure no one, but no one, is nearby who might bump into you while you are cleaning. This goes double for big dogs.

C. Don't go too deep. If you pinch the stem of the Q-tip behind the cotton, you'll prevent yourself from going too deep.

D. If you wait until you have a hearing loss to use a Q-tip, you have waited too long. You'll only pack it in deeper.

E. If you use Q-tips too frequently, you'll give yourself itchy ears.

F. Once a week is probably often enough. Do it after you shower, since that's when the wax is softest.

G. If you think you might have a hole in your ear drum, see #5 above.

8. Don't even dream of getting your ears candled. If you are a candling practitioner, or if you are a person who loves getting your ears candled, and if you would like to send me hate mail, please do so in the comments. I dearly love reprinting candle fanatics' letters. They are soooo special. And, no, I don't disparage candling "to keep all the money to myself." I disparage candling because it is quackery.

Betcha didn't know someone could wax on about wax, eh?



At 8:57 PM, Anonymous PBW said...

When we were kids my mom would clean our ears out once a week with a 50/50 solution of hydrogen peroxide and water. The cold temperature of the mix made me sick, and incessant bubbling sound about drove me nuts. We kids constantly had itchy ear canals, swimmers ear, and one infection after another. The minute I turned into an adult, I refused to irrigate my ears with anything ever again, which drove my mom crazy, of course.

I don't know if not irrigating makes any difference, but I don't have wax-plugged ears and I never get ear infections anymore. I've had only two in my adult life: one that came after a post wisdom teeth extraction site infection, and the other was more like dry ear from swimming in an overchlorinated pool. Both my doc treated with meds and drops and they cleared up quickly.

At 2:05 PM, Blogger Douglas Hoffman said...

I don't recommend routine use of peroxide. Doing nothing is always the best option, since ear wax has protective effects (reducing the risk of fungal and bacterial infection).

But . . . if someone really, really wants to use peroxide, I recommend 1 part white vinegar, 2 to 3 parts peroxide. The vinegar acidifies the solution, reducing the risk of swimmer's ear (swimmer's ear secondary to the use of peroxide, that is).

At 5:02 AM, Anonymous Anonymous said...

my family is living in Bavaria Germany for two years and since we've been here my 7 year old has had more problems with his ears and nose. He has had several colds that have gone into a bad cough that lasts a long time and in November had an ear infection that kept him awake. We went to an ENT in our small town and he perscribed antibiotics but mentioned if it didn't clear up he should have tubes put in or his adenoids removed. He usually only gets one ear infection at the most in a year back home so our doctors have never suggested this before. After a month we noticed his ears seemed plugged and he wasn't hearing as well so this time we went to a pediatrician and she told us there was just fluid behind the ear and we should just watch it and then maybe see the ENT again to do as he suggested- the tubes or adenoid removal. Well, today he woke up and said his left ear hurt and he had a headache. I took him in to the pediatrician again and she said there was no middle ear infection but he did have pain when you pushed on the outside of the ear. She also checked the right ear and said he didn't seem to be hearing much out of the ear. I thought this seemed to be better and there have been no complaints by his teacher. She then scraped some ear wax out of his left ear and then put in some drops to soften the wax. We waited and then she and her assistant proceeded to aggressively irrigate the ear with some tool I've never seen before. My son was shaking and in tears and it obviously hurt, but she insisted it was mainly the noise bothering him. He later told me the water was a hard spray and it hurt. I am very concerned she may have damaged his ear and I am afraid to take him back there. The medical care seems very different here and they are quick to suggest surgery. Something I am not interested in doing in another country. We are going back to the states for the summer. Is this something we can wait on to talk to our doctors there? Also what should we do next time if he still has fluid behind the ears?

At 11:18 AM, Blogger Douglas Hoffman said...

It would be irresponsible for me to answer such detailed questions when I haven't examined your son. Since he had a great deal of pain with irrigation, I recommend you take him to an ENT who will examine his ear under a binocular microscope to determine if any serious injury has occurred. As for the recommendation for adenoidectomy, if the only problem is your son's ears (and nothing, repeat NOTHING else), then adenoidectomy may be a premature recommendation, in my opinion.

I really can't tell you if it's safe to wait until summer, since I haven't examined your son. Given what happened with the irrigation, the top priority is to get his ears appropriately examined (and his hearing tested) ASAP.

At 12:21 PM, Blogger gigi the hun said...

My father used to have a lot of ear wax and regularly had to have it removed by a doctor. I inherited this lovely trait and about twice a year I pour hydrogen peroxide in my ear, wait a few minutes while it foams and bubbles (which, incidentally, I LOVE), then I take a q-tip and very gently swab the whole mess out. Usually, a very large plug of dark brown wax comes out and I am very gratified.

Only once did I give myself an ear infection from overdoing the peroxide routine. Now I'm very careful.

When I was in my twenties, I went to the doctor for a routine checkup and he told me that he'd never seen so much earwax. He used a water pic filled with water and peroxide* and worked it around the perimeters of the wax plug. I'm not exaggerating when I tell yout that two plugs fell into the sink with a "plink, plink" and they were about half an inch long. Filled me with pride, they did ... not!

* one of the most pleasurable sensations I've ever had. am i weird or was the doctor just very good?

At 11:34 AM, Blogger tlittle said...

The best way to relieve swimmers ear is to use camphorated oil. fill a teaspoon with the oil and heat the oil until body temperature. make sure it is not hot or it will burn the eardrum. then tilt the head and pour the oil into the ear. stick a cotton ball into your ear so that the oil does not drain out. This is the best remedy! It worked for me when I was a kid. Your swimmers ear will be gone in a couple days.

At 9:25 PM, Anonymous Anonymous said...

i was told during a recent check up that i have a lot of ear wax. i do not produce wet war wax at all. i have chunks randomly fall out of ear once a month. what is a good way to remove this. the ear wax softner kit my dr. recomended did not work. i have done research and it seems only people of asian decent have ear wax like this. my family has no asian descent that i know of. this confuses me.

At 11:51 AM, Anonymous Matthew said...

You're an awesome doctor; most are all professional and alost "sterile" with no personality and no sense of humor whatsoever. Not that professionalism is a bad thing, but overdoing it always made me feel like a lab specimen or someting.

Here online, outside of the doctor's office, the professionalism and knowledge stays, but there is some real personality, some humor (I get a kick out of how you despise candles) in it. Makes this fun to read. Thanks! -Matt
p.s. is it true that vinegar has antibacterial and antiviral properties?

At 5:11 PM, Blogger QueenIce said...

I have two questions. One is unrelated to wax (losing the voice) and the other is related (whiteish liquid wax).

Ok, so you mentioned several types of ear wax. I didn't see white, liquidy wax though. For the past few months I've been overusing q-tips. (Yeah, the itchy thing... I think I shall stop with the q-tips now). So, then this week I got a serious headache and fever etc. Many of the kids at my school have been having issues, too, and we have attributed it to allergies and the high levels of mold and pollen in the air this week. Mom thought I had a sinus headache. My nose was all clogged, there was tension behind my eyebrows, etc. The headache is gone but somehow I ended up losing my voice! We have a choir concert coming up in 3 days, so I NEED my voice! How did my headache end up with me losing my voice and what can I do to get it back?

I went to the doctor and she pulled out a huge chunk of wax from one of my ears. I guess I'd pushed all that wax down with my q-tips while I was itching inside. It smelled funky. There was normal, orange wax attatched to a portion of what looked like a film of skin (like a thin layer of onion skin?). There was also white wax in there. My ears have recently started to smell abnormally. I've nevern noticed them smelling BEFORE now. When I go to clean them with a bobby pin, I get liquid white wax. How do I get back to my normal chunky soft orange odorless wax?!

At 9:53 PM, Anonymous Anonymous said...

Just a very quick question that I thought you could help me with. I was cleaning my ears with a Q-tip and I think I accidently stuck the earwax farther. Now, my ear is clogged slightly, I can hear, but not very well. I have soft earwax and I was wondering what you suggest I should do and I have never used peroxide or other removal agents...

At 10:51 AM, Blogger KimSensitive said...

My son used to have an unusual amount of ear wax (needed cleaning every 3 hours) until we removed the foods that he was sensitive to (gluten and dairy).

I didn't expect that to affect his ear wax but it certainly did!

Now... geez... I don't think I've thought to clean them in months and months...

Nope, I just checked them and they look good and clean.

At 10:21 AM, Anonymous Anonymous said...

Am I eligible for a rhinoplasty procedure even though Im positive for Hepatitis b.? Although I had it for only two years and it's not severe.Does it it affect my eligibility.THANKS!!!

At 10:11 PM, Anonymous Anonymous said...

My problem is that I have ringing in my ears. My ears NEVER have any wax in them and I am wondering if the lack of having wax is causing my ears to ring.

At 7:55 AM, Anonymous Anonymous said...

Treatment for Ear Ache:
Mother used to run hot water over a bottle of Sweet Oil (available from Rx Pharmacist) She get it warm but not too hot by putting drop on underside of wrist to test it.
She then would our 2 or 3 drops onto cotton ball and have us rotate our head on a pillow (while lying down so the sweet oil would go into the ear canal; keeping the cotton ball in place for 24 hours.
By the next day you forgot you had an ear ache!

At 5:29 PM, Blogger candice said...

can loud noise= swimmer's ear?!!?

Ooooh I am happy to have found you! Occasionally I have the (not so much of a) pleasure of having a swimmer's ear-like dealio but without swimming or using peroxide...etc The most recent time it started up the day after a concert so I'm not sure if that's coincidental or just random data you didn't need to know! Last time it happened it took about a month before it subsided (this was about 2 months ago that it subsided last) but during that time I went CRAZY as I am beginning to again. I constantly push above the earlobe, as i would if i were draining water from my ear, but it does nothing. I use the evil q-tips and I even get so optimistic that if i lightly roll a tissue aqnd stick it in'll just suck that water outta my ear and make me all better....only no liquid is ever absorbed :( I went to the dr after about 2 weeks and he took a quick look in there, said I had no blockage, informed me i didn't want to take a risk having anything done with it and to leave it alone and just wait, wait, wait. BUT, regardless of how many times I verbally assure myself there is no water or foreign objects or Anything in there... I keep on going crazy trying to figure out how to get it out! I tried an irrigation kit last time and it caused IMMENSE pain, giant huge sweltering pain. I'm basically just interested in knowing what is going on in there and if this is something I'm going to have to deal with on a normal basis? I swear I'm ready to just shove a Q-tip in there til I rub up against my brain!

Any tips or suggestions or giant q-tips you wanna pass my way, I'd be much grateful! thank you

At 8:10 PM, Anonymous Jenna said...

Who knew that a blog about ear wax would be so popular?? I'm curious to know what causes ear wax to be a solid mass or ball?? My son is only 10 months old and his ears are always packed with solid balls of wax. I don't dare use q-tips or anything else for that matter to clean his ears, as I'm afraid the wax will just get pushed deeper into his ear canal. I have to wait until it is right at the outside edge and coax it out carefully. It is a round ball that completely fills his ear hole! He constantly plays with and pokes at his ears, so I assume that his ears may be itchy or sore. what should I be doing or how do I prevent this???

At 10:21 AM, Blogger Rob and Steph Puterbaugh said...

OKay, I have a question....I just went to the urgent care place because My ear hurt like crazy. Turned out I had/have swimmers ear. Well, Now my ear doesn't hurt anymore. It definatly itches though and i have some brownish crud/crusty stuff in the ear. Oh, and I can't hear still. This is all in my left ear. I think the brownish stuff is making me not able to hear still. The doctor did give me an ear wick, but it fell out the very next day, either he didn't put it in far enough or the swelling was done...not sure. Anyways, I go back to my normal doctor on Monday. I'm hoping that they will clean out my ear and then i'll be able to hear again. I am supposed to keep on using my antibiotic ear drops until wednesday and today is Saturday. What do you think?

At 11:09 AM, Blogger P.Baughman said...

I just got back from the "Minute Clinic". She said I have no wax in there, no irritation, no apparent infection. She could do anything there.

She told me to go see a specialist.


I hear a bubbling sound like carbonated soda in my ear.

I drive a shuttle bus and on my route, when I get to a certain place on the route, it acts up, bubbling and buzzing sound - always in the same ear.

This problem started in July, six months!

I got an mp3 player and the ear buds fit air tight. That's when I first noticed this problem.

At 1:50 PM, Anonymous Tinnitus Scams said...

This was an interesting blog post, thanks for the info. I enjoyed the rant and the stab at the "ear candles" that are often touted to supposedly work.

Outside of ear wax issues, tinnitus is also an unfortunate, common ailment that plagues many individuals...

At 1:37 PM, Anonymous Anonymous said...

I have a question - after bath last night, I noticed something in my 5 year old daughters ear. I used a wax softening kit which bubbled a little and was oily. (I did it on myself first). Out of her ear came a small flat ear wax colored thing. About 1/2 by 1/4 inch. It was all crumpled up in her ear. It seemed like a thin piece of kleenex or tissue - kind of transparent. She has told me she hasn't put anything in her ear, but it is wierd. I see something in her other ear too, but I wasn't going to do both ears in one evening. Do you have an idea?

At 4:28 AM, Anonymous Anonymous said...

Well, my earwax problem aside,this is one of the best sites I have found in ages, very informative and, more importantly, hugely entertaining. It took my mind off being totally deaf for a few minutes there - good enough for me!

At 3:35 AM, Blogger Kyutie Cakes said...

Seems like you know a lot about ear lol thought I would say a lil somthing with you. Bare with me im using my phone at like four in the morning. Well anyways went to the doctors for pain in my left ear had infection and recived drops and antibiotics. The doctor told me to also put the drops in my right ear as well. Lost hear in the right ear recently and it started itiching yesterday. I was rubbing and rubbing around the ear because it hurt to touch the actual ear. Then it started leaking on my finger and it was yellow. It felt like there was something on the verge of coming out so I took a cotton ball and whiped. Out came a chunk, a yellow odd smellling chunk. Smelled a little like poroxide but all I used were the drops the doctor gave me. In pain but havent used the drops for a day because I didnt know if my ear drum busted. I have a picture of what came out.

At 6:03 PM, Blogger Rachel said...

not sure how old this post is but I did have a question.. my ENT is a quick doctor. Walks in "yep. your ear drum exploaded" a month later "yep there is wax I'll try to remove it" but after 2 months of an ear infection from hell (wrong medicine first, wrong dosage second and right dosage of medicine but didn't work now on medicine no 3 which is working)

he said to put olive oil or sweet oil in my ear over night and eventually it will fall out.

He didn't say that I had to irrigate the ears. I just wanted to make sure I heard him right.

p.s. the post made me LOL. Are there people who ask "can you see through the other side?" lol

At 6:41 PM, Blogger SouthCityStacie said...

OK Here Goes !!!
I could clean both ears and put the q-tip back in the box and NO ONE would be able to determine which one was used.

I know it is nearly impossible to have NO WAX producing ears and have never had ear infection, ear tubes, ear aches or any of the other flaky itchy symptoms that go along with this.

I am consumed with the thought that there must be wax being produced somewhere and just not draining the typical way/external ear. I've been told it is not possible to NOT produce Wax & never have had ear issues.

Any ideas what's going on with me. I do have allergies, I make that sound with my throat (allmylife) that vibration/scratching thing i've met a few people in my life that do the same. We scratch our ear canals and throat by vibrating them from the very farthest part of our tongue(somehow. Again no tubes as a child, never any illness/fevers/colds just allergies. I JUST want 1 piece of wax or yellowish waxy q-tip 1 time before I die.

So, I said it. This is just about the best thing i've found on the internet ever. Thank you for Getting my innermost Weirdness Out.

p.s. i imagine a lifetime of buildup draining down inside my neck just waiting, and fear my autopsy will turn up with 2 5 lb. wax balls lodged in my head


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