Ear Wax

Jun 10, 2019

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Thunderstorms and puppy hats. Some dogs really don't like thunder. Some hide under beds. Some run frantically around the house barking. Not Sheldon. He hardly seems to mind. During the last early morning storm, he didn't even react to the first couple claps of thunder that shook the house. By boom three he lazily wandered over from Doris's side of the bed to curl up between my feet. Hard to say if the thunder bothered him, or he was just looking for a new position to lie down in. It's nice to have a dog who isn't bothered by storms. But I couldn't help but think of our previous dog, Mellie and how she reacted to thunder a little differently.

If your dog freaks out at thunder, you might wish for puppy earmuffs to temporarily block their hearing. Some people have their hearing temporarily blocked by ear wax. When should your ears be cleaned of wax? For many people, the inner part of their ear never needs to be cleaned. Ear wax is normal. It helps keep your ears clean and healthy. Most of the time, ear wax moves slowly from the inside of the ear to the outer ear by itself. But sometimes the ear wax can build up and cause ear pain, itching, ringing in the ear, the feeling that the ear is plugged, or decreased hearing. In these cases, the ear wax may need to be removed.

The skin lining the outer two thirds of the external auditory canal (EAC) has little hairs on it. The EAC also has two types of glands, ceruminous and sebaceous. Secretions from these glands mixed with sloughed off dead skin is ear wax, or more properly called cerumen. Cerumen (ear wax) helps to lubricate and protect the ear. It water-proofs the EAC and protects it from bacteria. Cerumen (ear wax) is normally produced in small amounts and moves out of the ear by the action of the little hairs we talked about earlier and by the motions produced in the EAC during talking and chewing. The ear is usually self cleaning.

"Never stick anything smaller than your elbow into your ear." This really is good advice. Cotton swabs, Q-Tips, match sticks, pins, pencils, pens and all other small pointy objects should be kept out of your ear. They will most likely just jam the wax in there real good and cause impaction. If you are really unlucky, you might even damage your ear drum.

You know when you look at your kids, shake your head and say to yourself, "I never thought I'd have to make a rule about that." You know like, "Don't put pens in the blender", "No you can't walk to school in Crocs in winter", and "Yes, you have to wear pants to school. Yes, even if those are the same pants you wore on Monday." I feel that saying, "Sticking a burning candle in your ear is a bad idea" should be obvious, but here it goes. Don't stick a burning candle in your ear. Ear candling is where a hollow candle is placed in the ear and the end away from the ear is lit. It is supposed to draw out the ear wax. At best, it doesn't work. At worst, hot wax might cause burns and do damage to your ear if you were unlucky enough to get some down the ear canal.

There are three ways to get wax out of the ear. There is wax softening, irrigation, and manual removal. Another way to categorize them is okay to try at home, maybe try at home and never try at home.

The wax softening treatments are safe to try at home. The water based softeners basically fill up the dead skin cells in the wax with water until they pop like balloons. That hopefully breaks up the wax clumps so they can flow out. Examples would be 3% hydrogen peroxide and docusate sodium drops (not the syrup with sugar in it). They are cheap and easy to use, but when you add water to the ear, you do run the risk of growing an infection. The oil based softeners don't break down the wax, but hopefully soften and lubricate it so it flows out on its own. These include olive oil, light mineral oil, and commercially available products like Cerumol (contains Chlorbutol 5%). Cerumol has peanut oil in it, so not suitable for people with peanut allergies. The oil products don't have any water to cause infections, but some question how well they work to actually get the wax out. Murine Ear Drops (contains Carbamide peroxide 6.5%) is a little different. It is made from urea and hydrogen peroxide. You might hear some popping and crackling in your ears as the hydrogen peroxide's oxygen is release during use. That oxygen release might disrupt and loosen ear wax. Murine Ear drops is the only FDA approved non-prescription ear wax softening agent.

For all these products, you put them in the ear 4-6 drops at a time, twice a day for 3-5 days. They are generally not irritating, but their effects take a few days to be noticed. The feeling of hearing loss and fullness may initially get worse as the ear wax swells. The wax may flow out naturally, but if it doesn't, see your doctor in 3-7 days to get it syringed. Interestingly, none of these products has been proven to work any better than just putting drops of plain water in your ear twice a day for 4 days.

After softening the wax, the next step is irrigation. This is also call ear syringing. Syringing with body temperature water works great in many cases. You can buy a soft tipped rubber bulb ear syringe at the pharmacy. In the bath tub you can aim the water to the top and side of the ear canal. Try not to direct it straight at the ear drum. Don't use a high-pressure water jet like a Water-Pik. Self irrigation at home might not be a good idea for everyone. It can cause pain, dizziness, ear infection, or perforated ear drum. It is often best to get a doctor or nurse to do the ear syringing for you.

Manually sticking instruments into the ear canal to remove wax should only be done by an experienced doctor or nurse. Period.

Nighttime thunderstorms with Mellie were different than with Sheldon. Mellie wasn't a cower under the bed or bark incessantly at thunder dog. But she didn't love the noise and shaking either. So every clap of thunder, Mellie moved from my feet a little higher up my body. Severe prolonged thunderstorms produced an amusing condition Doris and I still talk about. We called it the puppy hat. Mellie would go all the way up to my head and curl around it. And she would stay there until the storm had passed. I'm glad Sheldon isn't scared of storms, but I have to admit I kinda miss waking up to a dog curled around my head on occasion.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

 


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