Dr. Komaroff, 3-13-12: Let your ears take care of earwax

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DEAR DOCTOR K: I've always used a cotton-tipped swab to clean earwax out of my ears. My husband says this is dangerous. I think it would be more harmful to leave the wax in my ears. Who's right?

DEAR READER: Is cleaning out earwax necessary? No, for most people it's not.

The ear is a self-cleaning organ. Normally, earwax moves from inside the ear canal to the outer ear. Then it either washes out or dries up and falls out, usually without any help.

Earwax is actually useful. It helps shield the ear canal from damage by water, infection or trauma. It traps particles, such as dust. And it helps eliminate bacteria that could damage the canal or eardrum.

Like you, many people insert a cotton swab into the ear. But your husband is right. As tempting as that may be, it's potentially harmful.

The swab may push the wax farther into the ear canal, where it accumulates and hardens. Pushing hardened earwax deep into the ear canal can damage the eardrum.

Hardened earwax can also cause hearing loss, ringing in the ears (tinnitus) and earaches. In people with hearing aids, hardened earwax can cause the aid to malfunction. If earwax is causing any of these problems, it DOES need to be removed.

Over-the-counter earwax removers can be effective. There is also a safe and effective home remedy for earwax blockage. Use warmed (not hot) baby oil or mineral oil or liquid docusate sodium, dripped into the ear with your head cocked (to keep it from spilling out). Hold your head cocked for 60 seconds and then drain your ear oils onto a washcloth.

Or get a bottle of hydrogen peroxide at the drugstore. Soak a cotton ball with the hydrogen peroxide. Tilt your head and drip the peroxide into your ear. You may hear it fizz as it tries to dissolve the earwax. After about 30 seconds, drain your ear onto a washcloth. If this helps, do it two to three more times. If this does not remove the wax within a few days, visit your doctor.

See your doctor first if you have significant ear pain. You could have a perforated ear drum, and flushing the ear could cause an infection.

Earwax is there for a reason and doesn't ordinarily need to be removed. Your best bet is simply to clean your outer ear with a washcloth. Leave wax removal to your ear's own self-cleaning mechanism.

Above all, don't try to remove your earwax with cotton-tipped swabs. You can do more harm than good. I'm all for home remedies -- when they work. You don't necessarily need a doctor to remove earwax. But you could need a doctor if you try to do home surgery with a swab.

We have a lot more information on ear and hearing problems in our Special Health Report, "Hearing Loss: A Guide to Prevention and Treatment." You can find out more about it on my website.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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