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What causes ear wax?


One of the most common reasons for a gradual loss of hearing in adults is an excessive build-up of ear wax.

The ear consists of three parts. The outer ear is a canal, 2-3 cm long, that leads from the ear lobe into the eardrum.

Beyond the eardrum is the middle ear which contains three tiny bones that conduct sound to the inner ear. This contains special nerve cells capable of sensing vibration, and thus sound. It is only in the outer ear that wax is formed.

Wax is meant to be found in the ear. It is secreted by special glands in the outer ear canal, and slowly moves out to clear away dust and debris that enter the ear. It is not only the normal cleaning mechanism of the ear, but also acts to keep the skin lining the canal lubricated and to protect it from water and other irritants.

Only if excess amounts of wax are produced, the wax is too thick, the canal is narrow, or the person works in a dusty and dirty environment, is the wax likely to cause problems. When wax builds up on the eardrum, it is unable to receive the vibrations in the air produced by sound, and it cannot transmit the vibrations on to the inner ear. Because the ear is designed to be self-cleaning, attempts to clean the ear may aggravate the problem. Cotton buds should be banned from ears. They irritate the skin lining the outer canal and tend to pack the wax down hard on the eardrum rather than clean it out. Bobby pins, pen tops and other such objects that people use in attempts to clean their ears have similar effects.

'Nothing except your own elbow should enter your ear' is a very old but very true aphorism. Water entering the ear during bathing or swimming may cause the wax to swell. Pain and deafness can then develop quite quickly.

Once excess wax is present, an infection may start in the skin under it causing itching and pain. This, and the deafness that occurs, takes the patient to a doctor. Ear wax is removed by syringing, suction or fine forceps. In syringing, warm water is gently squirted into the ear to dislodge the wax, with large lumps being removed by forceps. The use of wax- softening drops may be necessary to facilitate the removal of particularly large or hard accumulations of wax.

Once the wax is removed, any infection present usually settles without further treatment, and normal hearing returns immediately. Those unlucky enough to have recurrent problems with ear wax may find it beneficial to use the wax-softening drops on a regular basis.

No-one should attempt to clean their own or someone else's ears. It is very easy to scratch and damage the sensitive skin lining the ear canal, spread an infection or even pierce an inflamed eardrum to cause permanent hearing loss.

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