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Hearing BODY HANDBOOK
Hearing · §42
Earwax
The ear canal is the one patch of skin that cleans itself: old skin migrates outward at about the speed a fingernail grows, carrying wax out to the rim. Earwax isn't dirt. It's slightly acidic, it kills bacteria, and it waterproofs the canal. The cotton swabs and ear candles people reach for after every shower are the leading cause of the wax plugs, infections, and torn eardrums they claim to prevent. For a healthy ear, the correct amount of cleaning is none.
Avoid · As-needed Evidence Moderate Chapter Hearing

Wax is a system working. Glands in the outer third make it; the canal skin rides a slow conveyor outward and sheds at the opening, carrying trapped dust and wax along. The wax is acidic, around pH 4 to 5, and its fatty fraction kills common skin and respiratory bacteria 1. The smear on your pillow is the export line delivering.

A cotton swab does the opposite of clean. The shaft fits the outer canal perfectly, so it pushes wax past the narrow point and packs it against the gland-free zone near the eardrum, where the conveyor can't reach. Each session compacts it harder. The "my ears make too much wax" plug is usually years of swab-driven compaction, plus scratches that let in infection. Cotton-tip applicators send about 12,500 U.S. children a year to the emergency room 2.

The whole adult routine is a wipe of the outer ear. Nothing narrower than your elbow goes inside. The rest is knowing when to hand it to a clinician.

The product barely matters: mineral oil, olive oil, and peroxide drops perform about the same 3. Buy the cheapest.

Three groups have real work beyond "leave it alone." Hearing-aid wearers: the mould presses wax inward, and a blocked receiver is the top reason an aid goes silent, so get a six-month check. Swimmers: the problem is a wet canal, so dry it with a few drops of half isopropyl alcohol, half vinegar after water. Over-60s: wax turns drier and migrates worse, so "her hearing is going" is often a five-minute fix 4.

Leaving healthy ears alone pays off invisibly: within months you stop thinking about your ears at all. The loud payoff belongs to two groups. People stuck in the itch-scratch cycle find it quiets within a few weeks, as the skin re-greases and the infections stop recurring. People with an established plug get a step-change from one appointment: the standard report after removal is that the world had been turned down and someone turned it back up.

The fine print — when to skip it, and what people get wrong

No home drops or rinsing if you have or ever had a perforated eardrum, any ear surgery or tubes, hearing in only one ear, or uncontrolled diabetes or a weakened immune system 4. See a clinician instead.

Wax at the ear opening is where it belongs; wet versus dry is set by one gene, not by washing 5. Ear candles create no suction; the FDA logs burns and perforations 6 7.

References
  1. 1Chai TJ, Chai TC (1980). Bactericidal activity of cerumen. Antimicrobial Agents and Chemotherapy. link
  2. 2Jatana KR, Rhoades K, Milkovich S, Jacobs IN (2017). Pediatric Cotton-Tip Applicator-Related Ear Injury Treated in United States Emergency Departments, 1990–2010. Journal of Pediatrics. link
  3. 3Aaron K, Cooper TE, Warner L, Burton MJ (2018). Ear drops for the removal of ear wax. Cochrane Database of Systematic Reviews. link
  4. 4Schwartz SR, Magit AE, Rosenfeld RM et al. (2017). Clinical Practice Guideline (Update): Earwax (Cerumen Impaction). Otolaryngology–Head and Neck Surgery. link
  5. 5Yoshiura K, Kinoshita A, Ishida T et al. (2006). A SNP in the ABCC11 gene is the determinant of human earwax type. Nature Genetics. link
  6. 6Seely DR, Quigley SM, Langman AW (1996). Ear candles—efficacy and safety. Laryngoscope. link
  7. 7FDA (2010). Ear Candles: Risk of Burns and Ear Injuries. link
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