Earwax is often regarded as dirty, or gross—something to be removed with a Q-tip.
But that’s just wrong. Over the decades, countless doctors—and friends and family in the know—have reminded us why it is a bad idea to clean out our ear canals. Still, many of us aren’t hearing the message.
Earwax—also known as cerumen—is made up of secretions from both sebaceous glands and sweat glands mixed with sloughed-off cells from the outer part of the ear canal. Sometimes it gathers hair or dirt. Cerumen is the body’s way of keeping the ear canal clean and lubricated. Its acidic nature also seems to give it some antibacterial properties, says Seth Schwartz, an otolaryngologist and director for the Listen for Life Center at the Virginia Mason Health System in Seattle.
Earwax production and migration—facilitated by talking or chewing or otherwise moving the jaw—is a constant cycle. Where we get into trouble is when we push that mix back into the ear—whether it’s with a Q-tip, a paper clip, a finger or a pen.
Some 12 million Americans visit their doctor each year with complaints about earwax. The most common reason is for impaction, a buildup of wax that’s often due to our own fussing. The wax mass can block the ear canal and press up against the eardrum, which can cause pain, dizziness and hearing loss. The elderly are particularly vulnerable, mainly because their skin is dryer, and muscles have atrophied, which means the wax can’t move out of the ear as easily, says Schwartz. Eight million people a year have medical procedures to remove wax blockage.
Accumulation of cerumen is such a common problem that Schwartz and a group of colleagues are updating a 2008 guideline on diagnosis and treatment that the American Academy of Otolaryngology—Head and Neck Surgery will release in early in 2017.
Why are people so obsessed with removing earwax? Maybe because of the feeling of obstruction, says Schwartz, but “probably part of it is the meticulousness of humans.” He often sees abrasions in his patients’ ears—sometimes even caused by Q-tips, since the ear skin is so delicate.
Everyone produces earwax, and some are prone to produce more. Just like some people perspire profusely while others merely glisten, it is not clear why. Some people are prone to obstruction, especially those with very dry skin or lots of hair in the outer ear, Schwartz says. Those who wear hearing aids tend to have more wax accumulation because the devices block cerumen’s natural migration. People who wear noise-blocking ear muffs on the job or who use phone headsets or earbuds for lengthy periods are also at risk for impaction—not because they produce more wax but because, as with hearing aids, the devices can block cerumen’s exit, Schwartz says.
Earwax comes in either a “wet” form that’s greasy and yellow, or a “dry,” white, flaky form. Race can influence the type of wax produced. Caucasians and African Americans have wet wax, while Asians tend more towards the dry type.
The dry wax also lends itself to obstruction, says Schwartz. That has made for some interesting cultural differences, he says, noting that it’s common in China for restaurant employees to offer to clean your ears while you dine.
Another method of wax clearing—using a lit, hollow candle shoved into the ear—has unclear origins, but both otolaryngologists and the Food and Drug Administration warn against the method, saying that it is neither safe nor effective.
Far from a nuisance, earwax holds the potential to be an indicator of health, according to a 2014 report by researchers at the Monell Chemical Senses Center. Testing the earwax of healthy Asians and Caucasians yielded some interesting findings, including that Caucasians had higher concentrations of the chemicals detected by odor testing. The scientists said they aim to dig deeper, pointing out that it’s already been shown that at least two odor-producing diseases (maple syrup urine disease and alkaptonuria) can be identified in earwax before they can be detected in blood or urine.
Schwartz says he’s not familiar with the Monell studies, but says he does know that one way to harm your health is to stick something in your ear.