Have you ever wondered if ear wax can cause tinnitus? Or how much ear wax is too much? What is the purpose of ear wax, anyway?
Ear Wax, Tinnitus - What's the Link?
It is possible that ear wax is the culprit causing the tinnitus if it is blocking sound from entering the canal. An important thing to know is that ear wax, also referred to medically as cerumen, occurs naturally and serves to protect the skin of the ear canal.
Below, you'll find a guide to know if and when ear wax is causing tinnitus, and what can be done about it to improve your tinnitus.
What is Ear Wax Made Of?
Ear "wax" is a bit of a misnomer in that it is not really wax like the substance of candles.
Instead, ear "wax" is a naturally occurring substance in the ear canal and outer ear that is comprised of:
- Skin cells
- Oil from cerumenous and sebaceous glands
What is the Purpose of Ear Wax?
Why is there wax in the ear in the first place?
A healthy amount of ear wax won't cause tinnitus, and the tinnitus may subside on its own. Consider these significant signs that tinnitus is going away.
Ear wax should be present in the ear and should only be managed if it presents a medical problem, such as a blocked ear canal (which is otherwise referred to as a "cerumen impaction").
Ear wax serves to:
- Moisturize the skin to prevent dry skin
- Protect the skin
How Does Ear Wax Affect the Ears?
Ear wax should exist in the ears but it can become problematic if:
- It blocks sound from entering the ear canal, thus causing tinnitus
- It interferes with using ear buds, noise cancelling ear buds, or hearing aids
- It causes irritation or discomfort in the ear*
*It's important to bear in mind that there are other causes of ear discomfort and irritation. It's recommended to consult a general practitioner or otolaryngologist if ear symptoms persist.
Different Textures and Qualities of Ear Wax
Ear wax can vary from person to person and it depends on a number of variables such as genetics and ethnicity.
Some common variations in ear wax are:
- Dark / Purple / Red / Brown / Black generally suggests that ear wax has been in the canal for longer period of time
- Hard or impacted deep in the canal
- Wax may be present in very small amounts or not be visible or noticeable at all
- Wax may occur in clumps or in only certain parts of the canal
How Do You Know If You Have Too Much Ear Wax?
A normal amount of ear wax won't interfere with hearing nor will it cause discomfort or irritation to the ears.
The amount of wax in the ears can vary from ear to ear, person to person, and from time to time.
Here are common signs that you may be producing an excessive amount of ear wax:
- You notice fullness or difficulty hearing that may be constant or intermittent, in one ear or both
- You notice tinnitus
- You notice an excessive amount of ear wax on ear buds or hearing aids
If you don't notice these signs of producing too much ear wax, it's possible that you don't have too much ear wax.
Consider what causes tinnitus and possible culprits besides ear wax.
What Should You Do About Excessive Ear Wax?
How Can Ear Wax Be Treated at Home?
Healthy ears are "self cleaning" and usually do not need to be cleaned regularly. Some people accumulate an excessive amount of ear wax that can be managed at home.
Ear wax located in the outer ear can be cleaned using a towel or ear swab after showering or bathing. This is the safest and easiest way to routinely manage ear wax.
Ear swabs should not be used in the canal due to the risk of scratching or irritating the skin in the canal with the swab or impacting wax deeper into the canal.
How Not to Treat Ear Wax at Home
There are a number of methods that aren't recommended based on safety concerns.
Here's a list of ear wax removal methods to avoid:
- Ear candles or any method that recommends using heat could burn or otherwise the damage the ear, skin, or ear drum
- Using ear swabs in the canal can irritate or damage the skin on the canal or damage or perforate the ear drum
- Do not use any other sharp object in the canal, which can damage or perforate the ear drum
- Do not pour liquid or powder in the ear canal, unless directed by a medical practitioner
- If you have a history of a tear or hole in the ear drum (medically referred to as a tympanic membrane perforation) or ear surgery, consult an otolaryngologist for wax removal
How Do Professionals Treat Ear Wax?
A medical professional may also recommend softening the wax with a cerumenolytic (i.e. ear wax softener) before coming to the office for removal.
Then, you'll return to their office so that the wax can be flushed or suctioned out of the canal.
Professionals, such as a general practitioner or otolaryngologist, may use a microscope to view wax in the ear as well as the ear canal and tympanic membrane before using one or a combination of the following tools to remove excessive or bothersome ear wax:
- An ear swab
- A curette or loop
- Irrigation using sterile water and / or hydrogen peroxide
- A suctioning tool, mechanical or electric / powered - this may seem loud while the suction is in the ear canal
Ear wax removal by a professional is often the most thorough way to make sure the wax has been safely removed and that there are no other concerns about the external ear including the canal.
For people with surgically altered ears, the gold standard for wax removal is removal under direct vision using a microscope or endoscope with microsuction.
Ear syringing to remove ear wax is not the best method of at home ear wax removal and in fact, ear syringing is contraindicated for people who:
- Have ever had ear surgery
- Have ever had a history of ear drum perforation
- Are immunosuppressed, e.g. have diabetes
There are more preferable alternatives to ear syringing for at home ear wax removal:
- Insert a few drops of olive oil into the affected ear at night for a couple weeks
- Olive oil will assist the ear in removing the ear wax in a safer, more natural way than ear syringing
- If using olive oil isn't effective, sodium bicarbonate drops can be more potent but carry a small risk of drying out the skin in the ear canal and predisposing the ear to otitis externa (an infection of the skin in the outer ear canal)
If these methods aren't successful, the best course of action is to consult a healthcare practitioner such as a general practitioner, audiologist, or otolaryngologist / ENT surgeon to determine a safe and effective way to manage the war wax build up.
How Often Does Ear Wax Need to Be Removed?
Ear wax protects the skin of the ear canal and should not be removed unless it presents a problem.
Most people will not need to have ear wax managed, but for those who do, how often to have ear wax checked, managed, or removed depends on a variety of factors:
- Do you have a history of having excessive wax buildup?
- Can the ear wax be managed at home?
- Does the ear wax build up and block the canal?
- Does the ear wax cause difficulty hearing, ear fullness, irritation, itching, tinnitus, or other ear complaints?
It's a good idea to discuss if and when to have wax removed with your ear and hearing care professionals to determine if pre-scheduling ear wax removal appointments is necessary, or if there are at-home techniques that can be safe and effective.
For people who need professional wax removal, the procedure typically scheduled once every couple weeks to months.
Does Removing Ear Wax Improve Tinnitus?
For wax removal to improve tinnitus, the ear wax must be blocking sound from passing through the ear canal and removal method must remove enough of the ear wax so as to create a pathway for sound.
It's possible that wax removal can improve tinnitus if it softens the wax such that it comes out of the ears naturally.
Removing ear wax that is blocking sound from passing through the ear canal to the ear drum can improve tinnitus immediately.
The tinnitus may go away completely or it may simply just improve (sound softer or seem more tolerable).
Sometimes the tinnitus does not improve, and in this case, the ear wax is assumed to not be the only contributor to the tinnitus.
What If Wax Removal Doesn't Help The Tinnitus?
There are many reasons why removing ear wax may not help the tinnitus:
- The ear wax was a normal amount that is not blocking the canal
- There are other causes of tinnitus, such as hearing loss
If wax removal doesn't help the tinnitus, Oto is here to help. Check out Oto's resources for treating tinnitus including positive lifestyle tips for living with tinnitus and how to sleep with tinnitus.