Dr. Kreutzer’s Favorite Topics

Dr. Kreutzer addresses topics relevant to his clients’ medical issues.

View previous articles in Dr. K’s Favorites Topics list on the right.

Earwax (Cerumen)

It is a misconception that earwax (cerumen) is “dirty” or abnormal. It is a necessary product of glands of the outer ear canal that performs the following functions:

  1. Protects against bacteria, viruses and fungus infection
  2. “Waterproofs” the delicate skin of the ear canal
  3. Provides a protective layer between environmental irritants and chemicals and the fragile ear structures.

For some people, excess or “impacted” earwax can become a nuisance and impair hearing. Risk factors for problem earwax include:

  1. Heredity: excessive production can be inherited
  2. Q-tip use: pushes wax that might otherwise fall out inward toward eardrum
  3. Use of earplugs, earbuds, certain headsets: again, pushes wax inward
  4. Unusually narrow ear canals from surgery, trauma or inheritance

For the vast majority of people, THERE IS NO GOOD REASON TO “CLEAN” THE EAR CANALS! The ear canal is a part of the human body that stays much healthier if left alone.

For a minority of people, excess earwax becomes an issue. The following are methods, some simple, others more involved, that people can safely do without a doctor’s supervision. NOTE: Patients should NEVER attempt any of these methods if they have a history of ear surgery, ear tubes or a known hole (perforation) of the eardrum.

  1. NEVER use Q-tips down the ear canal, that is, never lose sight of the head of Q-tip used to clean external ear. In general, Q-tips are dangerous and perform no useful tasks.
  2. Allow lukewarm shower water (mild soap or detergent can also safely enter the canal) to fill up the ear canal, and turn head to get it out; repeat several times.
  3. A few drops of hydrogen peroxide or mineral oil can be placed in the ear canal, allowed to dissolve and loosen wax for 10 minutes, then rinsed out over the sink using a bulb syringe or small turkey baster. Never block the canal when rinsing – always allow room for the liquid to escape. This should not be done too frequently (every 1-2 weeks maximum).
  4. Wax removal kits (Debrox, NeilMed, etc) can be used infrequently.
  5. For more difficult chronic wax blockages, use a Water-Pik. Fill the reservoir with 1/3 peroxide to 2/3 body temperature tap water. Cut the plastic probe meant for dental use with a heavy scissors, creating a larger diameter water stream, and use this to pulsate out ear wax. This method can be used as in #3 after 10 minutes of peroxide or oil in the canal to loosen wax. Always leave room for the water to easily escape the ear canal over the sink.
  6. Manual removal: Obviously, do not try this at home. Many primary physicians and all ENT specialists should be able to remove wax safely with specialized instruments or irrigators.

NOTE ON EAR CANDLES:   They are useless and dangerous! The “stuff” that appears inside the candle is not extracted wax, but the combustion product of the candle itself. Ear candles can burn the eardrum, canal, external ear and hair. Save the candles for romantic dinners and birthdays!