August 29, 2008

Leave That Ear Wax Alone

FRIDAY, Aug. 29 (HealthDay News) -- When it comes to ear wax, it's best to leave it alone, new national guidelines state.

While many people feel they need to remove ear wax -- technically called cerumen and a mixture of secretion, hair and dead skin -- it is actually protective since it has lubricating and antibacterial properties, said Dr. Peter Roland, an ear specialist at the University of Texas Southwestern Medical Center at Dallas. He chaired a panel that released new guidelines Friday from the American Academy of Otolaryngology--Head and Neck Surgery Foundation.

The guidelines are the first comprehensive clinical recommendations meant to help health-care professionals identify patients with impacted wax and treat them properly. Panel members reviewed scientific studies and sought expert opinion to create the guidelines.

"The conclusion is that the mere presence of ear wax does not require anything," Roland said. If the ears are functioning, and there is no problem, most people should do nothing. And that includes resisting the urge to use a cotton-tipped swab to clean out the ear, he said.

Using a swab can actually drive excess wax in further, he said, and then medical attention is often needed to remove it.

Certain people need to pay more attention to their ear wax status, he said. Those who wear a hearing aid, Roland said, "are much more likely to develop problems with ear wax." That's because the hearing aid "prevents the ear from doing its job," which is to clean out excess ear wax naturally.

As people age, ear wax problems are more common, too, he said, with those over age 65 more likely to have problems than younger people.

The guidelines, composed by a panel of experts from otolaryngology, family medicine, internal medicine, audiology, pediatrics and nursing, included some key points:

Ear wax is beneficial and self-cleaning.

Hearing aid wearers should get their ears cleaned once or twice a year by a health-care professional to avoid wax buildup, which can cause hearing aid feedback or even damage the device.

When ear wax blocks 80 percent or more of the ear canal diameter, it can result in reversible hearing loss.

About 12 million people in the United States seek medical care each year for impacted ear wax, according to the guidelines. The panel advises the use of wax-dissolving agents such as water and saline to dislodge it by a professional. Irrigation, manual removal with special instruments or ear syringes are other options.

The guidelines advise against the use of cotton-tipped swabs, oral jet irrigators and ear candling (the use of cone-shaped candles that are lit to draw out the wax).

The new guidelines make sense, said Dr. Chester Griffiths, an ear specialist at Santa Monica--UCLA Medical Center & Orthopaedic Hospital, and an assistant clinical professor of surgery at the University of California, Los Angeles, David Geffen School of Medicine.

"These guidelines are followed already by the majority of ear-nose-throat doctors," he said. The written recommendations may now help other specialists, such as pediatricians, care for patients with ear wax problems, he said.

More information

To learn more about ear wax, visit the American Academy of Otolaryngology--Head and Neck Surgery.

SOURCES: Peter S. Roland, M.D., chairman, Cerumen Impaction Guideline Panel, American Academy Otolaryngology--Head and Neck Surgery Foundation, and ear-nose-throat specialist, University of Texas Southwestern Medical Center at Dallas; September 2008, supplement, Otolaryngology--Head and Neck Surgery
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