Blog

12 November 2023

What is ear wax?

A common question that I get asked is “what is earwax”? Ear wax is a combination of oily secretions from our ear, known as cerumen, together with skin cells. Skin cells regularly fall away from the wall of our ear canal and can sometimes build up in the ear rather than fall out naturally.

Why do we have earwax?

Although it may seem counterintuitive, it’s actually really important for some earwax to be present in our ears, as it helps protect them from ear infections and helps act as a barrier to insects, dust and small objects getting into our ears and causing damage.

Another purpose of ear wax is to keep the inside of the ear canal healthy and moisturised, which in turn prevents our ears from feeling dry, itchy or sore.

Ear wax is also an important factor in the ‘self-cleaning’ process of our ears. As our ears produce new ear wax, the older wax is slowly pushed towards the opening of the ear canal, allowing it to dry naturally and fall out.

How our ears should work:

Our ears have small cilia – a type of hair cell – which help the ear wax to migrate and move out of our ears naturally without needing any extra physical help or intervention. Our jaw movements too, will help the ear wax to move outwards.

Once the ear wax has naturally migrated to the outside of our ears, this will then fall out in small pieces, it’s not something we expect to see and the majority of the time happens without us realising. It might fall out on our pillow, whilst we’re walking around, or when we’re having a shower.

What can cause a buildup of earwax? Why are my ears blocked?

When our ears are operating efficiently, the production of ear wax is regulated and the wax works its way out of the ear naturally. However, there can be a number of reasons why this delicate balance is disrupted, which then leads to a build up of earwax within our ears.

For individuals using hearing aids, earwax can accumulate more rapidly. The earmould of the hearing aid can obstruct the natural flow of wax out of the ear canal, leading to increased buildup.

More recently, there has been noted an increased association between earwax buildup and people who are regularly using earphones and airpods, as well as those using ear plugs to help sleep, as these devices can push the older, drier wax, back down the ear canal.

Some people naturally have narrower or more curved ear canals, making it challenging for earwax to exit easily.

Ironically, the common practice of using cotton wool buds (also known as cotton swabs or ‘Q-tips’) to clean the ears can contribute to earwax buildup. Inserting these swabs into the ear can accidentally push wax further down the ear canal, impacting it against the eardrum, and again disrupting the natural cleaning mechanism of the ears.

In some cases, the body may produce more earwax than necessary, leading to an increased risk of buildup. Small objects or insects entering the ear canal can also obstruct the natural flow of earwax, causing it to accumulate. Additionally, certain medical conditions, such as a genetic predisposition to produce dry or sticky earwax, can also hinder the self-cleaning mechanism.

Some may find if they work in a dusty environment that ear wax builds up more frequently, this is due to the dust drying up the earwax faster than normal, and therefore not enough natural oil is helping the wax to move out.

When should I get professional help for a buildup of earwax?

Suffering from excess earwax buildup is generally harmless, but there are some instances when it can cause problems that require the attention of a medical professional. Some of the signs you may need to seek medical assistance include:

• Hearing Loss: A sudden or gradual decrease in hearing ability may indicate there is excess or impacted earwax present within the ear.

• Ear pain or discomfort: Persistent pain or discomfort within the ear could be an indicator there is a blockage within the ear arising from excess ear wax.

• Tinnitus (also known as ringing in the ears): A significant buildup of wax within the ear can sometimes lead to instances of tinnitus, whereby there is an ongoing and persistent ringing, buzzing or beeping sound in the ears.

Understanding the importance of earwax and how our ears naturally function is essential for maintaining ear health. While the temptation to clean our ears with cotton wool buds may be strong, it's important to let our ears do what they do best…self-clean.

Excess wax buildup means some people need extra help to professionally clean their ears more often than others. Please always seek professional advice when it comes to ear cleaning and ideally have your ear wax removed via microsuction or water irrigation (if safe to do so).

Written by Nicola Miller BSc MSHAA