Best Drops for Earwax Removal

It's about time, but some researchers actually put to the test to try and determine what is the best solution to dissolve/remove earwax.

The verdict was... WATER!

Better than mineral oil, liquid colace, and over-the-counter cerumenolytics (ie cerumol). Hydrogen peroxide was not evaluated.

How was this result determined?

Using guinea pigs, the researchers first tested whether each of these substances were safe should a hole in the eardrum be present allowing for the solution to enter the middle ear space. Colace was found to be the most ototoxic (meaning, potential for permanent hearing loss if a ear tube or a hole in the eardrum is present). Mineral oil and saltwater (normal saline) was found not to be toxic.

Next, they determined which substance provided the greatest degree of cerumen dissolving ability. Each substance was added to a cylinder filled with earwax for 5 minutes. They than determined how much weight was required for a 25G needle to fully penetrate through the earwax.

Water was found to provide far superior earwax dissolving ability compared to all other substances tested.

What is the take-home message?

Given saltwater is completely safe for hearing even if there is a hole in the eardrum along with superior earwax dissolving ability, it seems to be a no-brainer to instruct patients with lots of earwax to use salt-water to get rid of earwax.

Reference:
Ototoxicity of intratympanic docusate sodium and mineral oil in the Guinea pig. Otolaryngol Head Neck Surg. 2012 Mar;146(3):455-60. Epub 2011 Nov 18.

"Ear Picking" - A Barber Shop Service Health Hazard?

It was only recently that I heard of "ear picking," a barber shop service that is apparently quite common in Asia and recently becoming more popular in the United States in cities with large Asian populations.

In essence, ear picking is when a variety of implements - scrapes, picks, and lights - is used within the ear canal.  Why is it popular among Asians? Mainly because of the type of earwax that is produced by Asians which is mainly dry and flaky which causes an itchy sensation. Ear picking helps remove some of this cornflake-like earwax as well as get the itch "scratched" and is apparently quite a pleasurable experience... like getting an itch on your back scratched. Caucasians have more peanut butter or wet type of earwax which is not amenable to "picking".

This unlicensed service is most often performed in barber shops and unfortunately has led to a number of ear related infections (eardrum perforations, fungal ear infections, bacterial ear infections, etc) as the tools are not sterilized in between customers.

If you want a "professional" type ear cleaning, see your local ENT. Itchy ears can be treated without resorting to ear canal instrumentation along with its risks of infection and eardrum perforations!

Read more about this phenomenon here.

How to Unclog a Clogged Ear

First, one needs to know what is causing the clog before proper treatment can be initiated. There's a few assumptions here before proceeding.

• You have no ear problems typically
• There is no "pain" per se other than perhaps a pressure type pain. If there's actual PAIN present, you most likely have an ear infection and this article does not apply to you.
• You currently have no other symptoms (ie, sinus or nasal problems). An upper respiratory infection or sino-nasal problem may have triggered your ear problem, but you no longer have those symptoms anymore.
• You are older than 8 years of age.

Step 1:
Examine the ear canal with an otoscope. Look for any blockage like earwax or fluid.

If earwax is found, the first step is to get the earwax out! Although your doctor or an ENT specialist can do this for you, some rather try it at home by attempting to flush the earwax out. My personal at-home earwax flush kit favorite can be found here on Amazon.com.

Step 2:
Assuming no earwax is present, the next step is to get a hearing test. Why? The hearing nerve can become damaged causing a sense of fullness or clogged sensation. Click here to read a Washington Post article about this. Treatment must be urgently pursued as there is only a short window of time when medications can reverse the nerve damage (around 4 weeks). After this period of time, there's not much that can be done other than wait and cross-the-fingers.

Step 3:
Assuming there is no earwax and a hearing test revealed no nerve damage, you either have fluid in the middle ear (serous otitis media) or pressure (eustachian tube dysfunction).

Regardless of fluid or pressure presence, the treatment is the same. Click here to read the protocol to fix this problem.

Remember that pressure/fluid buildup in the ear is just like water/pressure contained inside an inflated (water) balloon. It needs to be "released" in a physical manner. There is no "pill" that can automatically do this for you. Watch video explanation. Read more about this here.

Mythical Treatments:
There are a couple key points to make if you have reached Step #3.

You do NOT have an ear infection and antibiotics will make little if any difference. Antibiotics help with infections and only infections. It does not get rid of pressure or fluid (ie, throwing antibiotics into a swimming pool will not make the water disappear). Other common myths also need to be dispelled:

• Sudafed and other oral decongestants do not help unless you have nasal congestion and/or runny nose.
• Antihistamines like zyrtec, benadryl, allegra, claritin, etc do not help unless you have other allergy symptoms affecting the nose.
• Saline flushes or nasal sprays also do not help unless there are associated nasal symptoms.


Products That Help Pop the Ear Due to Eustachian Tube Dysfunction or Fluid in the Middle Ear:

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Geared Toward Adults

Balloon Geared Toward Kids