Ear wax, or cerumen, is a yellowish, waxy, natural substance produced by glands in the skin of the outer ear canal of humans and other mammals to protect the ear canals from damage and infection. Ear wax consists mainly of shed skin cells, hair, and the secretions of the ceruminous and sebaceous glands of the outer ear canal.
Ear wax serves several important functions in the ear canal so removing it is not required. Ear wax protects the skin of the ear canal; assists in the cleaning and lubrication of the ear canal; and provides a form of protection against bacteria, fungi, insects and water build-up in the ear canal.

Types of ear wax
Interestingly, earwax varies in form, color, and appearance from person to person. There are two genetically distinct types of earwax -- the wet type, which is dominant, and the dry type, which is recessive. The color and texture of the ear wax is dependent upon its composition. Asians and Native American populations usually have the dry, gray, flaky type of cerumen, while African and European populations are more likely to have the wet, honey-brown to dark-brown, soft type of cerumen.

Excessive wax build-up
The ear canals are self-cleaning. This means that ear wax and old sloughed off skin cells are automatically transported from within the ear canal to the outer opening of the ear by chewing and the other movements of the jaw. At this point, the ear wax usually dries up and falls out of the ear canal. Any noticeable wax deposit left at the edge of the outer ear can be gently wiped away using a towel.
Ear wax is only formed in the outer one-third of the ear canal, hence, when a person has a wax blockage deep inside the ear canal that rests against the eardrum, it is often because they have inserted a foreign object into their ear canals, pushing the wax deep into the canal.
Common causes of excessive wax build-up and wax blockage include placing small objects into your ears, like Q-tips, hair pins, earbuds, rolled cotton balls and paper, etc. A narrowing of the ear canal due to infections or diseases of the skin, bones, or connective tissue of the ear. Less production of the fluid form of cerumen due to aging of the glands that produce it as we get older. An overproduction of cerumen related to trauma of, or a blockage within, the ear canal.

Signs and symptoms of excessive wax
o Ear pain
o Itching
o Irritation
o Full feeling in the ear
o Hearing loss
o Dizziness
o Ringing in the ears (tinnitus)
o Reflex cough
o Odor
o Discharge

Guidelines to removing wax at home
Home treatments can be used to soften and remove excessive ear wax.
o Place a few drops of mineral oil, baby oil, sweet oil, hydrogen peroxide or commercial ear drops (available in most pharmacies) into the ear. Use finger to gently massage the oil into the ear canal. Wait 15 to 30 minutes. Use an ear syringe (available at the pharmacy) filled with warm water or saline to flush the ear. Water or saline should be at least body temperature warm to prevent dizziness. Gently squirt the solution into the ear canal to flush the wax out. This may need to be repeated several times to ensure all the wax is removed. Repeat the entire procedure once to twice per year.
Do not clean your ears at home if you have a perforation or hole in your eardrum, you have an ear infection, you have diabetes, you have tubes in the eardrum, you have skin problems such as eczema in the ear canal, or you have a weakened immune system.
Ear candling can result in serious injuries and is therefore not a safe method to remove ear wax.

Wax removal by medical professional
If you are unable to remove the wax at home, or if one of the above special conditions apply, please seek medical help to have the wax professionally removed. Your ENT or physician will be able to remove the wax safely in one of two ways -- by syringing; or by using suction or special miniature instruments. A microscope will be used to magnify the ear canal. This method is usually used on patients with narrow ear canals, perforations, tubes, skin problems affecting the ear canal, diabetes or a weakened immune system.
Putting things in your ear only pushes the wax further down the ear canal and may also result in damage to the delicate ear system. Therefore, never stick anything in your ear, including Q-tips. Remember, the ear is self-cleaning. In the rare case you are a person who has excessive wax buildup or blockage and are unable to have the wax safely removed at home, seek help to have the wax softened and removed by a medical professional. If you are a person with constant wax impaction, or if you use hearing aids, have a routine ear check every six to 12 months to have any wax taken care of before it builds up.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive at 356-2276 or 677-6627 or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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