Earwax is a substance produced by glands located in the external ear canal. This ear wax as it is sometimes called plays a valuable protective role for our hearing system. Also, it is important not to try to clean it too deeply, at the risk of causing an earwax plug to form.

Earwax (from the Latin “cera”, wax) is a substance naturally produced by the body, in the ear.

Secreted by the ceruminous glands located in the cartilaginous part of the external auditory canal, earwax is composed of fatty substances, amino acids and minerals, mixed with the sebum secreted by the sebaceous glands also present in this duct, as well as with debris keratin, hair, dust, etc. Depending on the person, this earwax can be wet or dry depending on the amount of fatty substance.

The outer wall of the ceruminous glands is covered with muscle cells which, when contracted, evacuate the cerumen contained in the gland. It then mixes with the sebum, takes on a liquid consistency and covers the walls of the cartilaginous part of the external auditory canal. Then it hardens, mixes with dead skin and hairs it traps, to form the earwax at the entrance to the external ear canal, a earwax that is regularly cleaned – it seems wrong. .

Far from being a “waste” substance, earwax fulfills different roles:

• a role of lubricating the skin of the external auditory canal;
• a role of protection of the external auditory canal by constituting a chemical barrier but also a mechanical one. Like a filter, earwax will indeed trap foreign bodies: scales, dust, bacteria, fungi, insects, etc .;
• a role of self-cleaning of the auditory canal and of the keratin cells which are renewed there regularly.

Occasionally, earwax collects in the ear canal and creates a plug that can transiently impair hearing and create discomfort. This phenomenon can have different causes:

• improper and repeated cleaning of the ears with a cotton swab, the effect of which is to stimulate the production of earwax, but also to push it back to the bottom of the ear canal;
• repeated bathing because the water, far from liquefying the earwax, on the contrary increases its volume;
• regular use of earplugs;
• wearing hearing aids.

Some people are more prone to these earplugs than others. There are several anatomical reasons for this that hamper the evacuation of earwax to the outside:

• their ceruminous glands naturally produce larger amounts of earwax, for reasons unknown;
• the presence of numerous hairs in the external auditory canal, preventing the earwax from evacuating properly;
• a small diameter ear canal, especially in children.

It is strongly recommended not to attempt to remove the earplug yourself with any object (cotton swab, tweezers, needle, etc.), at the risk of damaging the ear canal.

It is possible to obtain in pharmacies a cerumenolytic product which facilitates the elimination of the cerumen plug by dissolving it. It is generally a product based on xylene, a lipophilic solvent. You can also use lukewarm water with the addition of baking soda or hydrogen peroxide, to leave for ten minutes in the ear. Caution: These methods involving fluids in the ear should not be used if there is a suspicion of perforation of the eardrum.

The excision of the earwax plug is done in an office, using a curette, a blunt handle or a small hook at right angles and / or using a suction to extract the debris from the plug . A cerumenolytic product can be applied beforehand in the external auditory canal to soften the mucous plug when it is very hard. Another method consists of irrigating the ear with a small jet of lukewarm water, using a pear or a syringe fitted with a flexible tube, in order to fragment the mucous plug.

After removing the earwax plug, the ENT doctor will check the hearing using an audiogram. Earwax plugs usually do not cause any serious complications. However, it sometimes causes otitis externa (inflammation of the external auditory canal).

Prevention

With its lubricating and barrier function, earwax is a protective substance for the ear. It should therefore not be removed. Only the visible part of the ear canal can, if necessary, be cleaned with a damp cloth or in the shower, for example. In short, it is advisable to be satisfied with cleaning the earwax which is naturally evacuated by the ear, but without looking further into the ear canal.

The French ENT Society recommends not using a cotton swab to thoroughly clean the ear in order to avoid earwax plugs, eardrum lesions (by compression of the plug against the eardrum) but also eczema and infections favored by this repeated use of the cotton swab. Experts also advise against the use of products aimed at cleaning the ear, such as ear candles. A study has indeed shown that the ear candle was ineffective in cleaning the ear.

Different signs may suggest the presence of an earwax plug:

• decreased hearing;
• a feeling of blocked ears;
• ringing in the ear, tinnitus;
• itching;
• ear pain.

Faced with these signs, it is necessary to consult your doctor or ENT doctor. An examination using an otoscope (an instrument equipped with a light source and a magnifying lens for auscultation of the external auditory canal) is sufficient to detect the presence of a plug of earwax.