Hearing management

Updated 07 December 2017

What do I do about the stuff in my ears?

Take a look at these frequently-asked questions on ear wax.

1. Is it normal to have wax in your ears?
Yes. Ear wax (also called cerumen) is a normal by-product of a healthy ear. It is produced by modified sweat glands deep inside the outer ear canal.

Everyone produces ear wax, although some people produce more than others – just like some people perspire more than others.

The production of ear wax is essential for the healthy ear. It keeps the tissues of the ear canal lubricated and provides a sort of safety net that protects the ear drum from foreign objects.

2. How do I know if I have too much wax in my ears?
The healthy ear has a self-cleaning system: the tiny hairs that line the ear canal act as a conveyer belt and remove the wax very slowly as it accumulates.

When you pull a small amount of wax from the opening of your ear canal, you are removing cerumen that has been moved several millimetres from where it was produced. It's important to never disturb this self-cleaning system by placing a finger, Q-tip, or other small pointed object into the ear canal. Not only can this cause traumatic injury to the delicate tissues of the ear canal, but it will push the wax deeper and tighter into the ear canal.

3. How do I know if I have impacted ear wax?
If you have pushed wax deep into your ear, you might experience a great deal of pain. The outer ear canal is very sensitive.

Even if you do not have pain, you might notice a sudden loss of hearing, ear fullness or ear noise. All of these symptoms might be an indication that the ear wax is impacted deep in the ear canal.

If this is the case it is important to seek the opinion of a physician or audiologist. These professionals are able to look into your ear and see if the ear wax is impacted. Either a physician, nurse, or audiologist are qualified to remove ear wax.

If it has been determined that you have a severely impacted ear canal, you would be referred to a physician who specialises in ear problems. The ear specialist, called an otolaryngologist will use a special microscope to remove the impaction.

4. I never stick anything in my ear, but I still have impacted wax, why is that?
The self-cleaning system I mentioned does not work as well as you age. Some elderly patients have to have their ears cleaned annually by an ear professional due to this.

Also, certain medical conditions or hearing aid use might compromise the effectiveness of your body's ability to remove the ear wax on its own. For example, if you are over the age of 70, and you wear hearing aids, you might need to have the wax removed every one or two years.

You should discuss this with the professional who dispensed hearing aids to you. Many hearing care professionals are trained to remove cerumen.

Also, keep in mind that there are many causes for hearing loss and an audiologist can identify and manage most of them.

5. My friend went to a doctor who used water to remove the impacted ear wax. Is this method safe?
Some professionals use pressurised water to remove the impacted wax. If the professional has a great deal of experience using the method, it might be okay. However, it is not the preferred method of most ear professionals.

A kinder approach is to use a curette (wire loop) under a very strong headlamp to gently remove the cerumen. In other cases, light suction is applied to vacuum the ear canal. Either way, the ear professional should always visualise the area being cleaned by using a strong light.

Of course, it is best to discuss the various techniques with your hearing care professional.

- (Brian Taylor, Clinical Audiologist)


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Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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