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  • Writer's pictureAlan Frischer, MD, MPH


Not a day goes by in my practice without several patients complaining about earwax. While we have all heard that we are absolutely NOT to use cotton swabs to clean our ears, Unilever continues to profit handsomely. Just what is proper ear care?

Let’s be clear: Earwax in our ear canals is completely normal and good to have. Actually not wax at all, cerumen is a natural cleanser for the ears; moving from the inside of the ear canal to the outer part. Along the journey, it picks up dead skin cells, dirt, and even hair. It may have antibacterial and antifungal qualities.

Normal earwax varies – it can be dark brown, light brown, orange, yellow or off-white, and the texture and quantity vary from person to person. As with so many things, genetics plays a big role. Earwax can be wet or dry (the dry form is common among those with East Asian ancestry), and some of us have little or no earwax, causing the ears to be dry and itchy.

When a buildup of wax causes symptoms, including aching in the ear, fullness or ringing, impaired hearing, an odor, dizziness, or a cough, it needs to be cleaned out. Impacted earwax can even lead to an ear infection, which requires medical attention. Hearing aids, earplugs, or earbuds may lead to excess earwax buildup. As we age, we tend to make more. The shape of the ear canal may make it more difficult for it to exit the ear canal naturally. If the earwax does get impacted, most health care practitioners can clean it out easily and quickly.

So, why shouldn’t we use cotton swabs, or (shudder!) small objects like bobby pins or paper clips? Objects like these can push wax deeper into the ear canal, or even damage the ear canal or tympanic membrane. Many of us have heard the rule; nothing smaller than your elbow in your ear! Another idea to discard: Ear candles. Please don’t. They can (obviously) cause injury from the lit candle or from the hot wax.

So, how should we clean our ears at home? Use cotton swabs only on the outside of the ear or, better yet, try wiping the area with a warm, damp washcloth. Pharmacies sell over-the-counter ear drops like Debrox, which may contain mineral oil, baby oil, glycerin, hydrogen peroxide, or saline. You place the drops in the ear, wait for a few minutes, and then rinse with a bulb syringe. If that doesn’t take care of it, I urge you to visit your health practitioner.

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