Do you often find yourself reaching for a cotton bud to “clean” your ears? Do you think that ear wax is dirty and should be removed as often as possible? If you answered ‘yes’ to those questions, you could actually be doing more harm than good to your ears.
One of the most common ear complications every ENT specialist sees is earwax impaction. In simplest terms, earwax impaction occurs when a lot of wax builds up close to the eardrum and hardens causing pain, blockage, hearing loss, ringing in the ears and discharge.
And cotton buds are a common cause of such impaction. Each time you push a cotton bud far into your ear, you remove only some of wax, while more of it gets pushed deeper into the ear canal. Besides, there is also the risk of causing an infection by scratching the sensitive skin of the ear canal, or even damaging the ear drum. While using the ear bud for the outer ear is fine, we often tend to go all the way in, posing a risk.
As Dr Krishna Kumar, Senior ENT Specialist at Apollo Hospitals points out, there is actually no need to clean our ears. “Normally, the ears are self-cleansing. Researchers have shown that wax constantly migrates outwards. But when people put buds into their ears regularly, they keep pushing the wax back in.”
As the wax accumulates, he goes on to explain, it can harden and, in extreme cases, lead to keratosis, where the accumulated wax sticks to skin lining the ear canal. “At that stage, it becomes very painful, and the patient would require anaesthesia to remove the accumulated wax,” says Dr Krishna Kumar.
Dr Krishna Kumar, Senior ENT Specialist, Apollo Hospitals.
According to guidelines of the American Academy of Otolaryngology – Head and Neck Surgery, roughly one in 10 children and one in 20 adults suffer from excessive build-up of earwax. For such patients, it’s necessary to visit an ENT specialist to remove the wax through manual scraping, syringing warm water into the ears, and suction. But all of these should be carried out by a trained doctor, and should not be attempted at home.
Avoid water and oil too
Besides cotton buds, another major myth about ears is the belief that the ear canal should be regularly washed with water or treated with oil when blocks occur. However, says Dr Krishna Kumar, both water and oil can also cause further problems. “If there is wax build-up in the ears, water will cause the wax to swell. If people are prone to fungal infections, these infections thrive in a moist atmosphere. And if there is a hole in the eardrum, water going in can start a cycle of pus discharge,” he explains. As far as possible, he adds, one should avoid getting water in the ears by wearing swimmer’s earplugs or a cotton plug when bathing or swimming.
Caring for the ears
At home, the best we can do is clean the outer part of the ear with a clean and wet cloth. Even if ear buds are used, it must only be used for the outer ear. While not putting anything into the ear is a good rule of thumb, it’s also important to pay attention to any symptoms involving the ear. These include pain, but also a feeling of blockage or fullness of the ears, hearing loss, flaky or itchy skin, and pus or watery discharge from the ears. “The problem is that people give a lot of importance to pain, but not to the other symptoms. When we ask patients how long they’ve had pain, it would usually be two or three days. But with ear discharge, for instance, it could be months or sometimes years. And people often simply go to a pharmacy and buy some ear drops and use it,” observes Dr Krishna Kumar. However, he explains, it’s important to see a doctor when there is blockage, hearing loss or pus discharge, as these could indicate more serious infections.
One common condition, particularly among people with diabetes, is malignant otitis externa, which occurs in the ear canal but can also affect the middle and inner ear and bones of the jaw and face. This extremely painful condition can often be treated with antibiotics, but may also require surgical treatment in some serious cases.
Another is secretory otitis media, which can result after a respiratory infection like a cold, or from high altitude travel or deep sea diving. Here, fluid builds up inside the middle ear, behind the ear drum, causing pain, blockage, and hearing loss. If the condition is not treated promptly and thoroughly, it can also become chronic, leading to damage to the eardrum, and over time to other bones around the ear.
Such acute and chronic infections are particularly common among children, who may not always be able to express symptoms clearly, says Dr Krishna Kumar.
At the end of the day, he adds, there are two important rules of thumb: Don’t put any foreign objects into your ear canals, and consult a doctor as soon as you notice any pain, pus, block or hearing loss.
This article was created by TNM Marquee in association with Apollo Hospitals.