Managing earwax

Question and Answer
#1

I’ve been having a problem with impacted earwax for several weeks, which is having a very significant effect on my hearing. It seems impossible to get my ears syringed with the current covid-19 restrictions in place. I went to my (NHS) hearing aid clinic 10 days ago and they said there was so much gunk in there I needed to stop the drops (which I’d been putting in for 10 days). A week later, no improvement. So I rang up the NHS 111 helpline and they sent me to a local pharmacist who said I needed to put olive oil in 3 times daily for up to 3 weeks! (I can only think she had an interest in an olive grove in Spain!)

Everyone professional seems to advise against anything but drops. Even syringing seems to be a last resort, and any form of DIY ear cleansing provokes a sharp intake of breath. Putting more and more drops in when nothing ever comes out seems to be like expecting your dinner plate to drain itself clean if you add some more gravy, instead of washing it up properly.

This leaves me with a couple of questions:

  1. I can’t see that self-cleansing using a bulb syringe or similar and saline or bicarbonate solution could do any harm, or simply letting the water from the shower or whilst hair washing run in then out again. What is other people’s experience?

  2. What preventative methods to people suggest? Regular olive oil? Weekly? Monthly? Shower water? In my experience, as soon as I start to notice a problem, olive oil only causes the wax to get onto to eardrum, making it 10 times worse.

#2

Syringing is used as a last resort as it can damage your ears ability to remove the wax itself. My nurse said they only do it for quite elderly people as once you start doing it you have to keep having it done. I find olive oil does work and as it softens gravity may take it to your eardrum first but give it more time and it should move the wax out of your ear, but be prepared to give it 4-6 weeks, drops aren’t a quick fix! Now I have hearing aids it’s actually easier for me to keep on top of the wax, I use drops when I notice wax coming out on my domes, maybe once a couple of weeks/a month or so. Not really kept track! The other thing to consider as you say your canals are completely full of wax is microsuction but I think you would have to get it done privately and as you mentioned there won’t be anyone performing it at the moment

#3

I got told by a nurse to put the shower on the hardest pressure and to aim the shower water in your ears. Works well for me but you shouldn’t put the shower head right next to your ear, slightly away from your ear.

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#4

This is what I do every day. Using my finger to soap the ear then repeatedly rinse out with the shower spray until the bubble sound stops.

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#5

Whatever you do, do not resort to “candling”, it is ineffective and potentially very dangerous. Over the years I have seen many people have success with hydrogen peroxide. Pour a half a cap full in and hold your head horizontal for 5 or 10 minutes and let it fizz and bubble. Then flush with warm water. If the ear canal is a full as you stated, it would take a number of sessions. As soon as physicians start seeing patients, get in to have it looked at. That may be more difficult than it seems. My wife has had a rash for the last week and it is spreading. Yesterday I called around for a Dermatologist and the ones that were even taking appointments were booked out until August at the earliest. Another option is that many audiologists and/or hearing aid specialists do cerumen removal.

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#6

There are scores of adverts for ear candles on Amazon, most with 4 or 5 stars! Draw your own conclusions about Amazon reviews.

I wonder how microsuction compares with syringing. Is it discouraged by professionals in the same way as syringing, on the grounds that the more you do it the more you need to do it?

#7

What kind of drops are you using? I think by this point you need more than softening–you need some bubbling action. Debrox can do this. Also hydrogen peroxide, although may be irritating. If something with bubbling action doesn’t do it, you likely need to see ENT or other medical person who is willing to pluck out wax

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#8

I started off with olive oil for 7 days then went to urea peroxide (similar to Debrox I think) for a further 3 days, thinking it might break up the wax better. What’s more, it’s miscible with water so might come out more easily if I’d managed to get them syringed.

#9

Here’s advice from the Mayo Clinic. Earwax blockage - Diagnosis and treatment - Mayo Clinic Sounds like they can scoop it out with a curette or suction.

#10

Every time I go for a mapping, my Aud checks my ears for was. If needed she uses a curette to gently remove any wax from my canal.

My L ear was blocked last week, because of Covid I couldn’t get into the clinic as it’s closed. I used waxsol drops for 5 days then I gently syringed it in the shower. I used a normal syringe, it’s not recommended I know but when needs be I do what I have to to hear again. This removed the bit of wax that I had in my ear.

#11

I second the peroxide recommendation as long as it doesn’t cause you discomfort. Oil will soften wax, but won’t really move it. Peroxide will break it down, although slowly. You can try to gently syringe it out yourself with luke-warm water after a week or so of treatment with whatever.

The DIY risk is that water will get trapped in the ear because of the wax build-up and increase probability of infection. If you feel like you’re having trouble with that, 50:50 white vinegar and rubbing alcohol with re-acidify the ear canal and dry it out, reducing infection risk. This is a pretty traditional treatment for swimmer’s ear that most people tolerate, although if used extensively it can by drying. If there’s a perforation in the eardrum it will hurt like hell.

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#12

Audiologist Cliff Olson makes a compelling argument for EarWax MD and flushing with something more than a bulb syringe.

#14

Interesting what he says about bicarbonate - I hadn’t heard elsewhere about it breaking down fatty molecules. But I couldn’t catch what the ingredent was at 2:24 - bicolic acid?

BUT - perhaps I’m just being cynical, but I can’t help wondering how much he’s being paid to promote this wonder solution. And it doesn’t seem to be available on this side of the pond.

#15

Ingredients

Water, Glycerin, Sodium Bicarbonate, Glycolic Acid, Potassium Bicarbonate, Benzyl Alcohol, Benzalkonium Chloride

#16

The captions caught it correctly as glycolic acid. I’m not sure if his videos use auto captions or actual captions; I haven’t watched enough of his stuff. Personally I think your cynicism is misplaced though.

#17

Yeah, he gets paid to promote these days. I don’t begrudge the guy supporting himself and his family, but I liked his earlier videos better.

EarWax MD works well. But yes, $$. Baby Colace actually works quite well, too, though it’s an off-brand use.

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#18

Baby Colace? So stool softener (basically liquid soap I think) in drop form? Perhaps Dawn Diswashing soap would work too? :>)

#19

:grinning: Not to my knowledge. Is docusate sodium a type of soap?
But yes, stool softener. Baby so that you can get it in liquid form with the little dropper.

#20

That was my basic memory from many years ago in nursing school. Looking it up, it does decrease surface tension as does soap. We used castille soap in enemas to accomplish something similar. In one reference it was called a detergent. I did see something suggesting using Dawn or other dishwashing soap mixed with water to clean out dog’s ears. I suspect it would work in humans if it’s not too irritating.

And to add. I think if somebody has managed to really occlude the ear with old, dry wax that all the softening agents in the world may not help. If the ear is really blocked, fluid may not be able to get to all the wax behind the occlusion. It’s worth a try, but I wouldn’t do this approach indefinitely. It may need some help.

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#21

Here in quebec canada nurses are allowed and do ear cleaning. No vertigo, no pain, no liquid coming out of ears is essential for us nurses to do this autonomously. Also we use syringes with water. It can be tap water. Needs to be warm or warm hot as tolerated by patient. Not more then 10 min per ear as it can be irritating to ear canal. If discomfort happens i stop. Most cases i see
with this problem is when they come to my office for sore throat. I otoscope their ears and realize they have impacted ear wax. I usually try to remove using a 30 ml syringe with water and either a small tube from a blood collector needle ( i cut off the needle) or a special ear rinse syringe tip. I try this for 10 min. Usually after 3 min its out. Some rare cases i have seen i needed to ask them to go home and place oil in ear before bed time for 7 nights to soften it up and come back and see me. No problems with oil use but the purpose of oil is to soften it to be able to remove it. Its usally very easy to remove with syringe after. Other then senior citizens, i have not seen that many ppl come back probably because i Usually find out what the cause of the impaction was. Usually they have been cleaning ears with qtips. Once they stop this ear wax impaction stops. I do have my regular customer sometimes but its usually elderly people. Hair cells are slower and ear wax is dryer so its harder to come to surface of ear canal.
As a nurse i am not allowed to curate ears. And i cant use peroxyde. Although at a dr appointment, my dr trying to see my daughter’s ear drums attempted to remove ear wax. It was solid. She proceeded to insert peroxyde filling ear canal to brim and we waited 10 min per ear in a laying down position. It came out right away with syringe after.

Normal care regimen i tell my patients to do is to let water from shower go in ear at lowest sprinkle pressure. I tell them to take a wash cloth with finger and remove ear wax as far as finger with washcloth would go. No soap in eat canal as removing too much eat wax contributes to more ear wax being secreted. I also say not to use qtip. Qtips irritates ear canal causing more ear wax to form and it pushes it in. More and more pushed in ear wax creates glob of ear wax impossible for hair cells to bring to surface. And it traps more ear wax… And then its just a matter of time before ear wax is building and its covering ear drum.

I think that if you do use a syringe and water finally gets behind the ear wax buildup but you stop, you may trap water causing external ear infection. I use an otoscope to see what is going on. If i see its starting to move i know its just a matter of 2 -3 syringes and its out. So maybe getting a friend to try to look in ears or getting a cheap set of otoscope on amazon.

Good luck

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