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female earIf your ears are itchy, feel full, or if your hearing has changed, don’t reach for the cotton swab, ear candle or new tool on the market for self-management. And please do not use a pen cap, bobby pin or paper clip!  You may be making the problem worse! These previously mentioned complaints are just a few people may experience if they have cerumen, or wax build-up in the ear canals.

Cerumen is the medical term for earwax that develops in the outer 2/3rds region of the ear canals. Cerumen is created by sloughed epithelium, sweat, and sebum, secreted by the sebaceous glands. Cerumen mixes with other substances from the environment as it rests and makes its way out of the ear canal like hair, dirt, debris, or even its original duty, insect repellent. Our bodies are so complex to create a self-cleaning mechanism: jaw movement! Cerumen should naturally escape the ear canals over time by naturally occurring jaw movement from chewing or talking.

Cerumen is harmless, but can over time for some people, accumulate in the ear canal and cause temporary hearing loss, ringing in the ears (tinnitus), itching, fullness, discomfort, or odor. Excess accumulation of cerumen can occur based off ear anatomy, use of hearing devices, or most commonly due to “routine ear cleaning.”

When I refer to routine ear cleaning, are you imagining a cotton swab? Reach for the cotton swab box and turn it over to the instructions; you should find no mention of ear canal cleaning recommendations! You’ll notice, it doesn’t mention ear canal cleaning as one of the uses, mostly makeup and manicures! In fact, the major cotton swab manufacturer warns users on its web page to not insert the swabs into the ear canal due to possible accident or injury! In my years of clinical practice, there have been several instances where I removed foreign bodies from the ear canal, and guess what that foreign body was? The head of a cotton swab surrounded by ear wax! You may have also heard of ear candling to remove cerumen where hot candle wax is dropped into the ear canal to capture wax and debris. This is a dangerous practice and can do damage to the eardrum and delicate structures with burns. Damage to the ear canal from candling can result in subsequent hearing loss that may be temporary or permanent. There are several other instruments on the market for cerumen removal that should not be completed by untrained professionals. My simple advice is let the professional remove any cerumen necessary, but let your ears do the work naturally on a day-to-day basis!

Ever wonder why your ears are itchy? Try taking a break or better yet, discontinuing use of cotton swabs, and the itchiness should subside. By cleaning your ears with cotton swabs often or every day, you remove any of the natural oils in your ear that keep it lubricated, creating a constant, “my ears itch, let me scratch it with a cotton swab to relieve the itch” cycle, and the process begins all over again!

If you are one of the “I-must-clean-my-ears-every-time-I-get-out-of-the-shower” people, try this. Take a warm damp wash cloth around your pinky finger, and just clean the bowl of your ear to the entrance of the ear canal. This way, you’ll ensure the edge of the canal that is visible to others is nice and clean while preventing injury to the delicate structures for our hearing.

If you are interested in evaluating your hearing and are curious about the health of your ear canals, schedule an appointment with audiology to have one of our doctoral-level practitioners evaluate the status of your hearing health. You may also seek advice from your general physician or an ear, nose, and throat doctor.

Types of ear wax (cerumen) your doctor may see on examination:

  1. Asymptomatic or incidental cerumen: there may be a small or slight build-up of cerumen in the ear canal that does not obstruct in the provider’s visual assessment of the ear drum. This type of wax doesn’t need medical intervention.
  2. Cerumen obstruction: there is an excess build-up of wax to prevent a complete visual ear drum assessment and may cause minor symptoms.  Some people may seek treatment at this time or begin to notice symptoms.
  3. Cerumen impaction: the ear canalis completely occluded with cerumen that causes disruption in hearing or middle ear (ear drum and middle ear bones) assessment; the eardrum cannot be visually identified by ear examination.

Dr. Rutledge is a clinical audiologist and professor with University of Louisville Physicians. She has office hours Monday through Thursday at three convenient office locations.

  • Children’s Foundation Building, 601. S. Floyd Street, Suite 600
  • 401 E. Chestnut Street, Suite 710
  • 9931 Forrest Green Boulevard (New location!)

Appointment line: 502-588-0760

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Article by:

Casey Rutledge Roof, Au.D.

Dr. Casey Rutledge Roof received her bachelor's is communication disorders and subsequent doctorate in audiology from Auburn University in 2010. She holds interests in several areas of audiology to include diagnostic hearing tests, partnership with Otorhinolargnology (Ear, Nose, and Throat), hearing device selection and fittings, vestibular diagnostic and treatments, cochlear implants, and osseointegrated hearing devices. She holds her certificate of Clinical Competency from the American Speech Hearing Association and her fellow from the American Academy of Audiology. She serves as clinical faculty for audiology graduate students for the University of Louisville School of Medicine, Audiology Division.

All posts by Casey Rutledge Roof, Au.D.
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