How to clean your ears properly

Although earwax, also known by the medical term cerumen, has a bad reputation, it actually plays an important role in keeping our ears clean and healthy. The yellowish-brown film in our ears keeps them moist, clean and protected.

It keeps the ear canal supple, catches dust and dirt and even has an antibacterial effect. The belief that earwax has to be removed regularly has more to do with cultural habits than medical necessity.

“The production of earwax is a natural bodily function that varies greatly from person to person,” says Professor Marcus Maassen, ENT specialist in Lucerne.

Around one in 20 adults are affected by excess earwax, which can lead to blockages in the ear canal. However, too little earwax can cause symptoms such as dryness and itching.

In most cases, doctors say you shouldn’t clean your ears at all. The ear is a self-cleaning system.

However, you should consider seeking medical advice for the following symptoms:

• Sudden one-sided hearing loss
• Itching or feeling of pressure
• Feel like one ear is closed
• Pain or increased production of earwax

“We often carry out treatments to remove impacted earwax after beach holidays or air travel,” says Maassen. If water gets into the ear and combines with earwax that is already there, it can liquefy and completely block the ear canal, creating a viscous, almost honey-like substance that builds up directly in front of the eardrum, causing a sudden loss of hearing.

The earwax can be removed quickly and easily by a doctor in a routine procedure.

There are three methods for removing earwax:

• Rinse the ear canal with warm water. The drawback with this approach is that any defect in the tympanic membrane may go unnoticed.
• Cerumenolytic agents: Water, salt-water solutions or alcohol solutions can help soften the earwax so it can be rinsed away.
• Manual removal: Ear curettes, probes or hooks, ideally in combination with micro tweezers and micro suction devices, can be used to remove earwax.
   Using an ear microscope can help the doctor remove the wax safely.
  

With minor blockages, cerumenolytics – oil or glycerine-based ear drops that soften the cerumen – can help. Maassen recommends:

1. Tilt your head to one side and apply the drops
2. Leave to work for 5 minutes
3. Repeat for 2–3 days

If you still experience symptoms after a week, you should see an ENT specialist.

Syringing with fluids at home is not recommended as it can lead to complications in case of undetected eardrum injuries or solid cerumen plugs.

Serious cases of impacted earwax, especially cerumen obturans, cannot be removed with home remedies. “These plugs are often deep-seated, wedged and can only be removed with the help of a microscope – by suction or using special micro forceps,” says Maassen.

Attempting to remove them yourself with knitting needles, hairpins or self-made tools is dangerous. “If you puncture the eardrum or injure the inner ear, it can cause permanent hearing loss.”

Despite decades of warnings, many people still use cotton buds as part of their daily hygiene routine. But it often does more harm than good, especially when it comes to ear cleaning.

“What many people don’t know is that cotton buds don’t remove the earwax – they often push it in even deeper,” says Maassen. This not only speeds up blockage of the ear canal, but also significantly increases the risk of its inflammation.

“It’s like a snowplough that pushes the snow along in front, with the difference that this plug sometimes sits directly in front of the eardrum,” explains Maassen.

The result: inflammation, irritation and, in the worst case, even injury. That’s why it’s all the more important to be careful and to seek medical advice in case of doubt.

If hearing loss persists after successful cleaning – especially if it occurs suddenly and on one side – this may indicate acute hearing loss or another medical cause. Time is critical here: if you seek medical help within 48 hours, you have the best chance of a full recovery. It could also be hearing loss, tinnitus or a chronic middle ear infection.

Many people swear by tried-and-tested home remedies, but not all of them are useful.

You have to be particularly careful with children, because their ear canals are narrower and more sensitive – and they are more likely to get things stuck in their ears. “For example, if a child gets a bead or part of their toy stuck in their ear while playing, you should never try and remove it yourself,” says Maassen.

Any kind of manipulation will increase the swelling, and a general anaesthetic will then be required to remove the foreign body.

Impacted earwax is rare in children. A specialist should only be consulted to assess whether cleaning is necessary in the event of complaints or suspected hearing loss. In the vast majority of cases, simple manual removal by a specialist is sufficient.

Our ears are great at cleaning themselves. They do their job fine, as long as we let them! Cotton buds, rinsing or mechanical intervention often do more harm than good. “If you think there’s a problem with your ears – don’t try and solve it yourself. It’s better to let a specialist take a look using a microscope,” says Professor Maassen.