Dear Doctor,

I’ve noticed that my 18-year-old sister always has dirty ears. They seem to be clogged with ear wax and any attempt to get her to wash them is ignored. Recently, she told me that wax is good for the ears and that it shouldn’t be cleaned but to be honest, I’ve never heard of such a thing.

Is this true? It really looks awful and I’m afraid people will think she’s unhygienic. Esther

Dear Esther

Cerumen or ear wax as it is commonly known is normally produced in the ear as a protective mechanism. It is produced by glands in ear canal and its purpose is to trap dust particles and other foreign body particles so they do not move ahead and damage the ear drum. It also prevents ears from becoming dry and itchy. It may be dry and flaky or almost liquid or firm and solid. The texture and amount of wax produced varies from person to person depending on genetic factors as well.

Normally, the wax produced is also expelled out with dust particles. It does not need any cleaning. Any wax visible outside can be removed by wiping externally with a soft damp cloth or tissue. A cloth should not be used internally. Cleaning is necessary only if one has symptoms due to excess wax, or there is some problem locally due to skin or connective tissue disease. Any trauma to the ear or local infection also necessitates cleaning of the wax.

Extra wax can cause discomfort, pain, sense of blocked ears, dizziness and even blunting of hearing. At times, impacted wax may get infected causing fever and severe ear pain.

Commonly, wax is pushed inside by pins, pens, etcetera, objects which people use in a bid to clean the ears. This impacted wax can lead to pain, discomfort, dizziness, among other problems. Ear plugs and hearing aids can also push it inside. Hence one using them should be careful. Besides pins and other such objects used to clean the ears can even traumatise the ear causing permanent damage. Therefore these should be avoided.

Homemade solutions which soften the wax-like saline drops, glycerin, baby oil, and others, can be used to clean the cerumen. Over the counter preparations containing sodium bi carbonate and glycerin are also available. One should put one or two drops of any of this preparation in the affected ear, hold the ear in that position for a few minutes and then straighten the head up.

The wax will soften with these solutions and come out spontaneously. If the problem persists, then it is better to seek medical help. In a health set up, the wax is removed either by syringing the ear or removing by irrigation of the ear. In case of any infection being present, antibiotic drops are used locally. If any perforation is present in the ear drum, it is repaired surgically. Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.