Listen up .. . you should bin ear buds
SORTING out problem ear wax is not really the most glamorous part of being a doctor but it’s something I see almost daily. Patients usually notice they can’t hear so well but they can also suffer tinnitus, terrible itching and even balance problems.
Although it’s simple enough to solve, so many people get it wrong, particularly with the dreaded cotton buds. NHS watchdog the National Institute for Health and Care Excellence (NICE) last week issued guidance to GPs on how to tackle ear wax – and made a point of advising patients not to use buds.
In my experience, people will do it whatever we say – until they end up doing damage. Here’s what you need to know about this common but much misunderstood matter…
QI’VE always used cotton buds, and never had problems. The tip of a flannel just doesn’t cut it. Are you seriously expecting me to stop?
A YES. Cotton buds, ear plugs and even hearing aids can jam in and clog wax, drying it out and solidifying it so that it can’t move. Since cotton buds are not essential, it is best to avoid using them.
There is also a small risk of ear drum perforation if you go too far, or damage to the wall of the ear canal. The wax does not need to be dug out: it naturally travels along the ear canal and will remove itself.
Q
I DON’T want to be that person with yellow wax visible inside their ear. What should I do instead?
A WHILE unsightly, ear wax has a useful function in keeping the ear canals clean and free from infection, as well as waterproofing.
Sit back and let the wax clear itself. It is fine to remove wax once it is visible at the end of the ear canal. It is the rummaging around inside that is the problem. Once the wax is visible, it can be wiped away with a bud, but don’t go inside the ear.
Q
WHEN my ears have been blocked before, the nurse syringes them – it’s miraculous. But is this off-limits too?
A THERE has really just been a change in terminology as the technique for ear syringing has changed slightly, so we call it ear irrigation. Manual ear syringing used to involve a nurse using a big old-fashioned syringe to squirt in water and then suck the water and the wax out together. It was problematic as the ‘squirt’ was not pressure-controlled and could be too high, causing damage to the ear, particularly the eardrum. This is why NICE advises against it. It now recommends ear irrigation: machines are used which are pressure-controlled so the water is squirted in at a safe and consistent pressure, then the ear wax travels out with the water. Patients do indeed tell me this is miraculous.
Q
MY GP advised using olive oil to clear wax, which was really messy and didn’t work. What’s the deal with this?
A BEFORE trying ear irrigation, ear softening drops which you buy from the pharmacist or online can be useful. If wax gets stuck it is often because it is simply too dry and flaky so can’t travel easily along the ear canal to the outside.
Softening drops can be enough to moisten and soften the wax and allow it to travel. Olive oil or almond oil drops are commonly used too. Before you have ear irrigation it is essential to use drops to soften the wax for a few days.
Q
I’VE read about new versions of ear cleaning like microsuction offered by private clinics. Is it worth paying for?
A WHILE ear irrigation can be done at your local GP surgery, microsuction is usually done in a hospital setting once irrigation has not worked, as well as being offered by private clinics. Rather than washing the wax out with pressurised water, the wax is sucked out using a safe, very thin suction device and no fluid. If all else fails, another specialist option is known as an ‘aural toilet’ – the ear wax is manually scraped out with a thin stick.
Q
WHAT about hopi ear candles? They look like fun.
A THERE is no scientific evidence to prove that they remove ear wax. Research shows them to be ineffective and dangerous, not least because you are lighting a wick right by your ear and hairline.