How to Properly Clean Your Ears

Ear wax has both cleaning and protective purposes. However, your ears can become infected if you don’t clean them properly, and hearing loss can also occur. The build-up of ear wax is genetically-linked; some people experience more ear wax accumulation in the ear canal than others. Consequently, some people may find themselves unable to successfully remove that ear wax. According to medical research findings published in 2017, 62 percent of research participants who self-cleaned their ear canals with a cotton-tipped swab experienced itchiness (and 57 percent experienced an earache) after self-cleaning. The following describes the proper (and safe) way to self-clean your ears, how physicians clean ears when self-cleaning is not possible and why hearing loss can result from improperly cleaning your ears.

Purpose and Consequences of Ear Wax Build-Up in the Ear Canal

Our ear canals produce an oily substance called ear wax (medically-termed cerumen). The foremost function of cerumen is to trap and prevent dust, bacteria and other irritants from entering – and then damaging – the tympanic membrane, middle ear and inner ear. 

Another function is to prevent skin irritation when water gets into the ear canal. Therefore, preserving some ear wax in the ear canal is protective. In aging, the accumulation of ear wax tends to increase (a primary reason is that the glands that produce cerumen become increasingly less functional in senior-aged adults). An article in Scientific American suggested that 30 percent of elderly and developmentally-disabled people in the US experience a problematic blockage of the ear canal due to excessive ear wax resulting in substantially-impaired hearing.

Damage to the ear canal can occur due to daily self-cleaning of ear wax from the ear canal and/or improper/unsafe self-cleaning. Since ear wax keeps the ear canal moisturized, having no ear wax in the canal can lead to irritation, causing bleeding. However, even more senior-aged people cope with an inability to safely remove excessive ear wax, leading often to the development of a hard cerumen “plug” pressing against the eardrum. In fact, it’s estimated that two thirds of nursing home residents encounter this sort of ear problem as a result of improper ear cleaning routines.

How Ear Wax (Cerumen) Contributes to Hearing Loss

One in every three people between the ages of 65 and 74 suffers from hearing loss (per the National Institute on Aging [NIA]). The NIA also notes that ear wax impactions are linked to hearing loss in senior-aged adults, and especially in those who require hearing aids. This is because ear wax “plugs” can prevent sound waves from traveling through the eardrum to the middle and then inner ear. In contrast to sensorineural hearing loss (caused by damage to the inner ear and/or auditory nerve) that is typically irreversible, conductive hearing loss is most often caused by ear wax build-up, fluid (such as pus) or a punctured eardrum.

Meanwhile, age-related hearing loss (presbycusis) is naturally-caused by the gradual damage to  the hair cells in the inner ear. These hair cells enable a transmittal of sound via an electrical signal carried by the auditory nerve to the brain and/or by reduced function of the tiny bones in the middle ear that carry sound waves (as described by the National Institute on Deafness and Other Communication Disorders [NIDOCD]).

While wearing hearing aids is common among adults aged 65 and older, an ear wax impaction can muffle sound even when utilizing a hearing aid. Furthermore, ear wax build-up on hearing aid earbuds can damage them (so keeping the earbuds clean is vital to optimal functioning of a hearing aid with earbuds). According to a Harvard Health, around 60-70 percent of hearing aids returned for repair annually due to reduced functioning were actually damaged by cerumen build-up in parts of the hearing aid, such as the vent!

Bacterial Infections and Ear Wax Self-Cleaning

Improper (and unsafe) self-cleaning to remove ear wax can lead to an infection of the middle ear,  or otitis media. A bacterial infection typically requires an antibiotic treatment, and with an antibiotic drug that specifically targets the organism causing the infection. Three of the most common bacteria associated with middle ear infections in adults (including senior-aged adults) are:

  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Staphylococcus aureus

Improper and Unsafe Ear Wax Removal Methods

Use of a paper clip or match-stick (or self-irrigation with a water pick), as well as the use of any other non-sterile and/or potentially dangerous object to remove ear wax, can lead to permanent injury of the ear canal. Even the use of a cotton-tipped swab – if not inserted gently and with minimal twisting inside the ear canal – can harm the canal or eardrum. Likewise, using anything to remove ear wax that causes a skin abrasion in the ear canal can result in a skin infection that can potentially progress to the inner ear.

If you’re unable to easily remove ear wax with a cotton-tipped swab, the Mayo Clinic website suggests utilizing an eye-dropper to apply a drop of mineral oil to soften the ear wax. However, always remember to use a sterilized eye-dropper so that you do not inadvertently introduce bacteria into your ear! After waiting 3-4 days, the ear wax may have softened enough for you to safely remove it.

Physician-Assisted Ear Wax Removal

Tinnitus and a sensation of fullness in the ear are two other common symptoms of extensive ear wax in the ear canal (besides hearing reduction). Diagnosing an ear wax over-abundance is accomplished by physicians through the use of an instrument called an otoscope. According to an article in the Journal of Primary Care and Community Health, physicians typically remove impacted ear wax by the following methods:

1. Use of cerumenolytics (cerumen softening agents)

2. Ear canal irrigation

3. Manual cerumen removal (using a specialized tool designed for cerumen removal)

This above-cited article also specifies that removal of impacted ear wax is contraindicated in people deemed “high-risk” for complications, such as people with perforated eardrums or ear canal lacerations. As described by the American Academy of Otolaryngology (AAO) in their clinical practice guidelines, an increased complication risk linked to ear wax removal exists in patients with:

  • Neoplasms (cancers) of the ear canal
  • Prior radiation therapy affecting the ear
  • Dermatologic diseases of the ear canal
  • Prior ear surgery such as a tympanoplasty or myringoplasty

Mental Health Impact of Hearing Loss on Senior-Aged People

Hearing loss is linked to increased depression, social isolation and dementia in senior-aged adults. Findings of a Johns Hopkins Medicine research study revealed that mild hearing loss doubled the risk of developing dementia, and moderate hearing loss tripled the dementia risk. Dementia (whether Alzheimer’s disease, Lewy Body dementia, or some other form) drastically diminishes overall quality-of-life. Since depression and social isolation are also linked to developing dementia in later life, taking action to preserve hearing is recommended.

Today, there are a wide variety of nearly invisible hearing aids available. If your family members and friends have been encouraging you to get  a hearing aid, you have more options than ever to find one that will be comfortable for all-day wear and suit both your lifestyle and budget.

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