Doctors speak out about earwax

Well, it's about time that earwax got the respect those white coats at the American Academy of Otolaryngology believe it so richly deserves.

For years – nay, centuries – people have done everything imaginable to rid themselves of the viscous and vaguely disgusting buildup in their ear canals. From the 16th century earwax spoon to the trusty Q-tip to new-agey ear candling, the quest to shed wax has yet to wane.

And patients often have done more harm than good, packing in the cerumen (the scientific name for the water-soluble secretions we call wax) rather than releasing it.

So the latest word from the ear experts: Leave the wax alone.

"We've learned in medicine that the body was built in a magnificent way and the more we try to do, invasively, the more problems we have," says Dr. Shoab Siddique, an otolaryngologist for the Mercy Medical Group. "Earwax was designed for a purpose, to basically lubricate the canal skin and also fight infection. It's a good thing."

Nationwide, more than 12 million people a year seek medical treatment for impacted wax or the pain, pressure, itching and tinnitus that serve as its manifestations.

To educate patients – and primary-care physicians – the otolaryngology group this month released its first-ever guidelines regarding earwax.

It warns against using cotton swabs such as Q-tips and dental water jets. Reason: They could push the wax deeper into the ear canal. The guidelines also recommend that doctors employ wax-dissolving agents and ear syringing with prudence.

The hope is that this will stop people from trying to dig out wax with objects such as a paper clip and doing potentially permanent damage to the drum.

"There's not a day that goes by when I don't have to deal with a problem of wax impaction," Siddique says. "With Q-tips, I guess there must be some good use for them, but it's not for cleaning out your ears. They really work as a plunger. It pushes the wax deeper and once it gets packed, it dries out and is like a rock.

"It often won't come out (with irrigation) because people have packed it in too far. The moisture just sits in there and causes a fungal infection."

Cleaning out wax for hygienic purposes also leads patients to complain of excessive itching in the canal.

"I see that every day, too," Siddique says. "They say, 'Doc, the itching is driving me crazy. Makes me want to stick a bobby pin in it.' That's because they have absolutely no wax from swabbing it out every day. The wax is meant to lubricate."

Even those who resist the temptation to perform self-removal of wax can sometimes suffer from impaction.

Siddique said the elderly and those who wear certain types of invasive hearing aids are most at risk. The good news is, however, that people who wear ear buds with their MP3 players all days are probably not risking earwax impaction.

"As people get older, all of their secretions dry up," he says. "As the wax dries, it's harder for the body to naturally soften it up and clear it out. The only problems I've seen with hearing aids are with the kind where the aid is molded to fit deeply in the canal."

Should a person suffer impaction, whatever the cause, Siddique says, see a doctor if over-the-counter ear drops don't soften the wax.

"Use the drops for a few days and then a bulb syringe to flush it out with water," he says.

But the guidelines strongly suggest that people stay away from the alternative therapy offered at many spas – ear candling.

(A therapist inserts a hollow tube made of beeswax, lights the outer end and lets it burn for 15 minutes. Proponents say the treatment draws the wax out of the ears via heat and suction.)

"It's just not a good idea to put a flame right next to your ears," Siddique says.

By Sam McManis  www.sacbee.com