Most individuals do not need to clean their earwax, as it serves a protective purpose in the ear canal, acting as a waterproofing agent with antimicrobial properties that help prevent outer ear infections. Earwax also lubricates the ears, preventing dryness and itchiness.
Medical experts describe the ear as a self-cleaning organ. "Earwax is a combination of skin and oil," said Dr. Lawrence R. Lustig, chair of Otolaryngology-Head & Neck Surgery at Columbia University Vagelos College of Physicians and Surgeons. "Skin migrates out from the eardrum to the outside of the ear canal, and as those migrating dead skin cells mix with the oil glands of the ear canal on the way out, that’s where you get earwax." This natural process, akin to a "conveyer belt of skin," typically clears wax as people talk and chew, which moves the ear canal skin outward.
However, some individuals may produce excessive wax, have abnormal wax consistency, or experience migration issues, potentially leading to blockages that impair hearing and require medical intervention. For the majority, the natural self-cleaning mechanism is sufficient.
Experts strongly caution against common ear-cleaning methods, particularly the use of cotton swabs like Q-tips. "The packaging for Q-tip products today even contains a clear warning: ‘Do not insert inside the ear canal.’" Cotton swabs can scratch the ear canal, cause bleeding, or damage the eardrum. "Half the time it’s because they used Q-tips," said Dr. Erich P. Voigt, an associate professor at NYU Grossman School of Medicine, referring to patients presenting with earwax impaction. Q-tips can push wax deeper into the ear canal, creating a blockage, and stripping away natural wax can lead to dry, itchy skin, creating a cycle of irritation and further cleaning attempts.
Ear candling is also advised against. Studies have shown it to be ineffective, and it carries the risk of burns.
For those who wish to clean their ears, experts recommend focusing only on the external area. "My general recommendation for people is let the body do its job," Dr. Lustig advised. "Let that skin migration with the wax come out on its own. Take a wet washrag onto your finger and clean out whatever comes to the entry point." Both Dr. Voigt and Dr. Bradley B. Block, an otolaryngologist, suggest that the natural cleaning during showering and hair washing is usually adequate.
Over-the-counter ear drops containing carbamide peroxide, such as Debrox, can be used to soften and dissolve hardened earwax. The process typically involves lying on one's side, administering a few drops, waiting, then sitting up and blotting. Flushing with warm water during a shower can follow. However, these should be used with caution and are not recommended if one has a perforated eardrum.
Individuals experiencing symptoms of earwax blockage, such as a feeling of fullness, difficulty hearing, or an echoic voice, should consult a medical professional. In some cases, symptoms that appear to be wax buildup could indicate more serious conditions, including sudden hearing loss, which requires prompt medical attention due to potential time-sensitive treatments.
"The ear canal is sensitive and has a lot of nerve endings," Dr. Lustig emphasized. "A light touch that might feel like a tickle elsewhere can really hurt in the ear. So I wouldn’t go putting things in there."