Saturday, July 13, 2024

Ear wax - 5 tips to combat it

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Q: Which ear drops remove ear wax best?

Some people (like yours truly) are enthusiastic earwax producers and ask themselves this question frequently.

The medical name for earwax is cerumen, which comes from the Latin word "cera," which means wax. But cerumen isn’t really a “wax” at all. It’s a sticky liquid secreted by the cells of the skin lining your ear canal.

Cerumen has an important job: protecting your eardrum by trapping dirt and dust. Ear wax is supposed to move along your ear canal and out of your ear. Along the way, earwax has an antimicrobial effect, which helps prevent infection of your ear canal.

Some people’s earwax just flakes away and never causes any trouble. But for the rest of us, it can be an ongoing source of discomfort. In fact, problems with earwax are one of the most common reasons people make appointments to see their doctor.

Wearing hearing aids or earbuds increases the production of ear wax and can block the normal movement of it out of your ear.

Cerumen trapped inside your ear canal can cause pressure, discomfort, and hearing loss. Attempting to remove ear wax by sticking cotton-tipped swabs or bobby pins into your ear canal doesn't work very well. The friction stimulates cerumen production and creates a wax plug inside your ear, leading to pressure, pain, and impaction.

The best way to remove ear wax is to soften the wad to help it come out on its own or be flushed out.

There are two main types of cerumen removal drops: oil-based and water-based. Oil-based “drops” include olive oil, coconut oil, and almond oil. At the same time, saline, hydrogen peroxide, glycerin, and docusate are water-based earwax softeners.

There isn’t any one best ear drop for ear wax removal. A recent systematic review of products used to remove ear wax showed no apparent differences between oil-based and water-based products.

The 3 top earwax removal drops in the United States are 6.5% solutions of carbamide peroxide, available as Debrox®, Murine®, and ClearCanal® from NeilMed.

According to a 2018 US News and World Report and Pharmacy Times survey, 96% of American pharmacists recommend carbamide peroxide drops to soften ear wax, while the other 4% recommend glycerin drops.

Carbamide peroxide reacts with earwax to release oxygen, creating foam that liquefies the cerumen and helps it rinse away. I stopped using Debrox® because of the annoying crackling and popping sounds and unbearable tickling sensation inside my ear canal.

Docusate sodium (Waxsol®) ear drops are used to soften earwax in the UK. Docusate is a stool softener or lubricant laxative. It pulls liquid into hard stool or feces, making it softer and easier to eliminate. It’s believed to do the same thing to impacted cerumen. In our clinic, we add docusate liquid in the ear for 1-3 days, then flush the ear canal with warm water.

I use docusate 250mg capsules. After snipping a hole in the end, I squeeze the contents into my ear canal, repeating this twice a day for a couple of days.  I flush my ears gently with warm water in a bulb syringe or during a warm shower.

To help ear wax escape, place the nose of the bulb syringe along the top of your ear canal rather than in the middle. Avoid “power washing," which can damage your eardrum with too much pressure.

Remove leftover water from your ears by tipping your head and blotting with a towel or using a hair dryer on a low setting. You can also use an ear drop designed to dry up the water in your ear, like Swim-Ear®, which contains isopropyl alcohol and anhydrous glycerin.

Here Are 5 Tips to Combat Earwax:

1. Don’t push cotton-tipped swabs, bobby pins, or rolled napkins into your ear.

These can create plugs of ear wax inside your ear canal, leading to impaction and pressure, pain, and muffled hearing.

2. Both oil-based and water-based drops work to soften cerumen.

Finding something that works for you is often a process of trial-and-error.

3. Avoid using eardrops if you have ear pain, bleeding, or any discharge from your ear.

Call your doctor instead. You could have an external ear infection, which needs a different approach.

4. Don't use a Water Pik® or high-powered device to flush out your ears.

Too much pressure can damage your eardrum or force fluid past it, triggering an inner ear infection.

5. Use warm water when flushing.

Cold water is uncomfortable and can cause problems with your balance.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog TheMedicationInsider.com. ©2022 Louise Achey

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