Dr. Jacqueline Gerhart: Ease Up On Ear Wax

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that usually appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: I've heard I shouldn't clean my children's ears out with Q-tips. But doesn’t that help get the water out of their ears and prevent wax buildup?


Dear Reader: I'm asked this question quite a bit. It seems that using Q-tips inside ones' ears is quite common, even a ritual. For some people, the first thing they do when they come out of the shower is root around in their ears with Q-tips. It's almost as though the more yellowish goo that comes out, the more satisfying it is to people.


But earwax actually has several important jobs for which you might want to keep it around. It protects and moisturizes the skin of the canal, preventing itchy/flaky/dandruff-like ears. Additionally, it contains special chemicals that help fight infections. And, when dust and dirt enter your ear, earwax serves as a sticky shield, preventing debris from traveling further.


So, considering earwax usually can't be seen by an outside observer and that it is "healthy" for us, why do we always want to remove it?


Well, this actually may be steeped in our culture. The idea of the "cotton swab" was first developed by Leo Gerstenzang in Germany - he called them "Baby Gays." The name later was changed to Q-tips, with the "Q" standing for quality. Q-tips have been manufactured in the U.S. for more than 80 years, and although the box says they are a "beauty tool," they are most commonly used for ear cleaning.


But even before Q-tips, we cleaned our ears. Medical museums display metal, ivory and wooden spoons that date back hundreds of years and were used to scoop out earwax. It seems the use of Q-tips permeates most cultures and is often passed from generation to generation.


Interestingly, on most packages of Q-tips or other "cotton-tipped applicators," it actually warns against using them inside of the ear, stating that this is not an intended use. Why is this?


A 2001 Time magazine article titled "Something Evil in the Ear Canal," does a great job of outlining the problem with Q-tips: It's us. We are the problem. We can't see inside our ears, so instead, we blindly probe around, rolling the Q-tip this way and that, hoping to mine out the gold.


If it weren't for pain and sometimes blood, I suspect some people would excavate until they hit their skull. In fact, every five years doctors see more than 100 people with serious eardrum injuries requiring medical care or a procedure as a result of cleaning their ears with Q-tips.


Another negative: While you are trying to get the wax out, you may actually be packing more in (like plunging a cannon ball into a cannon). This can cause a wall of impacted wax, which can decrease hearing and cause pain. Routinely I see impacted wax in the ears of my patients, and it is very difficult to remove. Sometimes we need to shoot pressurized water into the ear to get it out. Not fun.


One huge disclaimer: I use "cotton-tipped applicators" on the little crevices on the outside of my ears, and just slightly into my ear canal. I agree with you – it makes me feel like I get the water out. But, keep in mind, I never get close to the eardrum, and never feel tickling or discomfort. I don't dig for gold.


In the office, I only treat earwax with the use of an otoscope, a device that allows me to see into a patient's ears. I don't dig around blindly, and I advise you to not dig around blindly on your children, because you can’t feel how far you are going.


This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 04/24/2013

News tag(s):  jacqueline l gerhart

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