In Praise of Earwax

A Q-Tipsheet

By Rod Moser, PA-C, PhD

Granted, cleaning your ears feels kind of nice. Right? Like scratching an itch. Getting out that nasty looking orange/brown/yellow wax gives one a sense of accomplishment. We look at the stain on the Q-Tip with a certain element of personal pride.

We clean out our noses. No one readily admits to picking his nose, but we all do it ... some of use more blatantly than others. What else are we to do at red lights?

The big difference between taking some nasal crusts (that's boogers -- now there is a good medical term) and removing earwax is that one is important and the other is not. Both have a bad reputation.

We wax our tables and we wax our cars in order to protect the surface. That is exactly one of the functions of earwax (cerumen). A waxy surface repels water -- it will bead up and the water will not adhere. Another protective function of earwax is preventing infection. Earwax is acidic, and bacteria does not thrive in an acid environment. If you take out the wax, you change the acidity of the ear canal lining and you are asking for an infection. If you take out earwax every few days, or even after every shower, your body will just make more and more. Why? Because it is supposed to be there. You should no more remove all of the saliva from your mouth, or the tears from your eyes, than remove the wax from your ears.

Ears are self-cleaning (just like the eyes or nose). By gravity and body heat, the wax will gradually make it to the opening where you can wipe if off with a washcloth or rinse it away in the shower. That is all you really need to do with earwax.

You can have too much of a good thing, however. We can't be like the movie character Shrek, who made a nice candle from earwax. If we have a wax impaction, it will cause a significant conductive hearing loss. It will also trap water behind it and cause all kind of annoying "sloshing" sounds. It is only when you have a wax impaction that you can clean out your ears.

A few rules:

1. Never attempt to clean out an ear that is painful and/or presumed to be infected. To do so could cause additional pain and/or ear damage.
2. Second, you don't use Q-tips in the ears. Q-tips do not fit very well and will gradually pack the wax back against your eardrum (just like loading a cannon by tamping down the powder). If you want to use them to clean the ear opening, that's OK, but don't dig around deep in the ear canal.
3. Never clean out an ear that has "tubes" or if the eardrum is known to be perforated. This is a big no-no.
4. The safest way to clean out a wax impaction is with warm water -- either from your shower (just let a gentle stream hit your ears) or the gentle stream of an ear syringe (you can buy them at the pharmacy). If you use the syringe, remember -- just the warm water goes in the ear. Don't put the syringe in your ear, or you will surely have trouble.
5. If you have a history of very dry and hard wax, you may need to use some wax-softening agents prior to the warm-water wash. You can by various brands at the pharmacy.
6. Think about getting a home otoscope. Although you can't look in your own ears, you can train someone else to look in yours. Then you will know if the ear is "clean."

So remember: Earwax = Good; Boogers = Bad.

And if you find yourself overloaded with Q-Tips, here are some uses you might not have thought of:

1. Little barbells for those who do not want to overexert themselves.
2. Cannon plungers for your miniature cannon.
3. Paint brushes (actually, a very good use). Martha Stewart would be proud.
4. Use them for cleaning the gunk between the keys of your computer keyboard or that stuff in your comb.
5. Use them as substitute birthday candles for people afraid of fire. (Do not light them!)
6. Can be used as toothpicks for people who have wide gaps between their teeth.
7. Can become substitute cigarettes for those trying to stop but who still need some oral gratification. (Do not light them!)
8. Use them to clean the quills of your pet porcupine.
9. Let your kids use them instead of Popsicle sticks when making those attractive picture frames and jewelry boxes for Mother's Day.
10. Shoot them out of soda straws at flies and mosquitoes.

Rod Moser, PA-C, PhD, is a primary care physician assistant with more than 30 years of clinical experience in adult and pediatric health.

Originally published May 6, 2002.

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