Ear wax
The seemingly benign ear wax may feel like an unusual topic for discussion, but years of working as an ENT consultant has made me realise that there are a lot of misconceptions about it out there. It is time to debunk some of them.
Let us start with what ear wax is. It is a mixture of secretions from the ceruminous and pilo-sebaceous glands present in the front part of the skin of the ear canal, mixed with dust and dead skin.
The formation of wax is a very normal phenomenon in all people, irrespective of age. The consistency of wax is determined by the proportion of secretions from the glands which is a watery fluid and fatty acids. Depending on the secretions, the consistency can be dry or wet.
The function of wax is to protect the ear by its anti-bacterial action, and it also helps to trap and remove dust and other foreign particles that may enter the ear canal. Also, it keeps the skin of the ear canal moist and prevents dryness.
The colour of wax, when it’s secreted, is yellowish, but when it comes in contact with oxygen, it becomes brownish. Sometimes, patients come to us complaining of having blood in their ear, but it is only wax.
There is a misconception that the ears need to be cleaned so that this wax does not accumulate. But this is false, as there is no need to clean the ears. Our ears have a natural self-cleansing mechanism, by which, the wax is automatically extruded outwards. It works like a ‘conveyor belt,’ where the wax with dead cells and debris moves outwards by the movement of the jaw and very small hair follicles present in the ear canal.
This is happening all the time, wax, as well as water, which enters our ear during bathing, is being cleared naturally. We do not need to put things like cotton buds, towel ends or clips to clean, clear, or dry our ears. When we do, we are actually hampering the natural cleaning process of our ears and pushing the wax deeper into the canal, where there is no movement and so the wax stays there.
By repeatedly putting cotton buds in the canal, we are pushing more and more wax in the deeper part, where it accumulates and becomes hard and impacted. It blocks the passage of sound to the ear drum, so our hearing suffers. Also, if there is entry of water, it makes the wax swell and cause earache. Sometimes, patients complain of earache after swimming, and this may be due to impacted wax.
By introducing cotton buds, clips or other material into our ears, not only are we pushing the wax backwards, but also destroying the normal epithelial lining and its functions in the ear canal. If this is done for a long time, it can cause problems with the amount of secretions of the ceruminous glands as well as other structures leading to dysfunction. There will be itching and feeling of dryness and irritation in the ears. Repeatedly scratching the ears results in a bad habit which is almost like an addiction, where proper evaluation and treatment by a consultant becomes necessary.
If there is impaction of wax, please do not go to ear cleaners sitting on park benches or street corners. They will use sharp unclean objects inside your ear which may cause infection and permanent damage to your ear drum. It is best to visit an ENT consultant who will give you de-waxing drops and clean your ears with proper and clean instruments.
You can use olive oil once a week, poured in your ears with droppers, to keep the ears moist and the wax loose. Please don’t use cotton buds on a regular basis as they destroy the ear lining and its function. If you have any ear problems, consult an ENT specialist for advice on how to take care of your ears.
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