Blog - How do I clean my ears?

How do I clean my ears?

Everybody’s ears make wax – also known as cerumen. Cerumen serves a purpose, several purposes, in fact. It keeps our ear canals moist, prevents dust and grime from getting deeper into our canals, helps migrate dead skin cells out of our ear canals, and it actually helps prevent infections. Different people make different types and quantities of ear wax. It ranges from light colored, dry and flaky to thick, dark and moist. Some people produce a lot of wax, some people produce very little. For the majority, ear wax doesn’t need to be cleaned – our ears can take care of themselves.

The most common way people clean their ears is with a Q-tip (aka cotton swab). Q-tips carry some risks. In people who make moist wax, the Q-tip acts like a ramrod and packs the cerumen deeper into the canal. It can lead to a complete occlusion of the ear canal. In rare instances, the Q-tip gets jammed in too deep and can rupture the ear drum (tympanic membrane) and damage the tiny hearing bones (ossicles). If you decide you want to use a cotton swab it should be swirled at the opening of the ear canal to pick up cerumen that accumulates there. It should never be inserted deeper than the cotton tip.

There are several other commercial devices for cleaning ears that are available. Ear vacuums, ear swirly brushes, wax loops, etc. None are very effective. However, one of the newer items that is available shows promise. It is a miniature camera that allow someone to directly see the wax and remove it. These are pricy, but are safer than the other options.

Candling is a practice that, in spite of the evidence against its use, is becoming more common. An ear candle is a piece of cloth rolled into a cone and embedded in wax. The cone is held with the broad end over the ear canal. The candle is lit and allowed to burn for 10 to 15 minutes. The claim is that it works in one of two ways: like a chimney and creates a negative pressure that draws wax from the ear canal or that it heats the wax which when softens and comes out of the ear canal on its own over the following days. There have been several studies regarding the efficacy of candling. In one study researchers created an artificial ear canal. They measured the pressure within the ear canal during candling. No negative pressure was created by the candle. That study also found a powder deposited on the ear drum, which, when tested, turned out to be residue from the candle. Another experiment in Canada measured air temperature 10mm (about the length of the ear canal) from the end of the candle while it was burning. The highest temperature recorded was 22∞ C – well below body temperature. And finally, a small clinical trial divided patients into two groups – those with ear wax and those without. They all used an ear candle. Pictures were taken of the ear canals before and after. Those photos showed no ear wax removed from the ear canals that had wax, and candle wax in the ear canals that previously didn’t have wax.

Another common method is trying to irrigate out the ear canal. There are several over the counter products sold for that purpose. Or, people often use hydrogen peroxide to rinse out their ears. Peroxide is a common ingredient in the over the counter products as well. The problem is, peroxide is ototoxic. Meaning, if it were to get into the space behind the ear drum it could cause hearing loss. For that reason, I don’t recommend any product containing peroxide.

So, no to ear candles, no to over the counter products, no to Q-tips, and no to hydrogen peroxide. How do you clean your ears?

The best and safest option is to use a 50/50 mixture of vinegar and tap water. That mixture can be irrigated into the ear canal using a blue bulb syringe – the kind often used for cleaning babies’ noses. They can be found at any drug store. The mixture is drawn into the syringe. Hold the ear to be irrigated facing downward and irrigate the mixture into the ear canal. Make sure the mixture is at or near body temperature. If it’s too warm, or more importantly too cold, it will make you dizzy. This mixture is safe in any ear. The acetic acid (vinegar) will soften the wax and lower the pH in the ear canal. This will kill any bacteria in the ear as well as facilitating wax removal. The mechanical irrigation will wash out the wax. After irrigating, you can swirl a Q-tip – just at the opening. Vinegar/water can be used every day, or multiple times a day. Often, once or twice a week is enough to keep the ears clean and happy.

If all else fails, let one of the providers at the Idaho Ear Clinic clean your ears. We use a microscope and micro instruments to clean the ears. For some people, it is the only good option.