How to safely remove ear wax?

From the Guidelines

To safely remove ear wax, use over-the-counter ear drops like Debrox, Murine, or generic carbamide peroxide solutions, and avoid inserting objects into the ear canal. The most effective and safest method for removing ear wax is by using ear drops to soften the wax, followed by irrigation with warm water using a rubber bulb syringe 1.

Important Considerations

• Never insert cotton swabs, hairpins, or other objects into your ear canal as these can push wax deeper or damage your ear 1.
• If you experience ear pain, drainage, hearing loss, or if the wax is severely impacted, see a healthcare provider 1.
• Ear wax is actually protective, containing antimicrobial properties that help prevent infection, so only remove it when there's an excess causing discomfort or hearing issues 1.
• For irrigation, use a rubber bulb syringe filled with warm (body temperature) water to gently flush the ear canal 1.

Prevention and Maintenance

• Patients can purchase wax-softening drops or home irrigation kits as part of an ear hygiene regimen to help prevent recurrence of cerumen occlusions 1.
• Proper care and routine cleaning of hearing aids with instructions from a healthcare provider can also help prevent cerumen impaction 1.
• Educating patients on the risks and benefits of specific control measures, such as instilling prophylactic topical preparations or irrigating the ear canal, can help reduce the risk of cerumen impaction 1.

Key Points to Remember

• Cerumen production is a normal physiologic process, and preventive measures should focus on those at greatest risk for developing occlusion, such as children, the elderly, and the cognitively impaired 1.
• Hearing aid users have a higher incidence of impaction, and proper care and cleaning of hearing aids can help reduce this risk 1.
• Empirical evidence supporting measures to reduce the recurrence of cerumen impaction is limited, but consensus opinion from clinicians recommends against using cotton-tipped swabs and ear candles due to the risk of injury or exacerbating impaction 1.

From the FDA Drug Label

Directions FOR USE IN THE EAR ONLY. Adults and children over 12 years of age: Tilt head sideways and place 5 to 10 drops into ear Tip of applicator should not enter ear canal Keep drops in ear for several minutes by keeping head tilted or placing cotton in the ear Use twice daily for up to 4 days if needed, or as directed by a doctor Any wax remaining after treatment may be removed by gently flusing the ear with warm water, using a soft rubber bulb ear syringe Uses for occasional use as an aid to soften, loosen, and remove excessive earwax Active ingredients Carbamide peroxide 6.5% Purpose Earwax removal aid

To safely remove ear wax, you can use hydrogen peroxide (OTIC) ear drops. The recommended procedure is to:

• Tilt your head sideways and place 5 to 10 drops into your ear.
• Keep the drops in your ear for several minutes by keeping your head tilted or placing cotton in the ear.
• Use the drops twice daily for up to 4 days if needed, or as directed by a doctor.
• Any remaining wax after treatment may be removed by gently flushing the ear with warm water, using a soft rubber bulb ear syringe 2. Hydrogen peroxide (OTIC) is used for occasional use as an aid to soften, loosen, and remove excessive earwax 2, and its active ingredient is Carbamide peroxide 6.5% for the purpose of earwax removal aid 2.

From the Research

Safe Removal of Ear Wax

To safely remove ear wax, it is essential to understand the different methods available and their effectiveness.

• Ear drops can be used to soften ear wax, making it easier to remove 3.
• There are various types of ear drops, including oil-based and water-based compounds, as well as non-water, non-oil-based solutions 3.
• The effectiveness of these ear drops in removing ear wax has been studied, with some showing promising results 3, 4.

Methods of Ear Wax Removal

Different methods can be used to remove ear wax, including:

• Ear irrigation (syringing) 5
• Manual removal (other than ear irrigation) 5
• Wax softeners prior to irrigation 5
• Wax softeners alone 5
• Using a loose tip cotton bud, which may be safer than traditional cotton buds 6

Risks Associated with Ear Wax Removal

There are risks associated with ear wax removal, particularly when using cotton buds (Q-tips) 7, 6.

• Cotton buds can push ear wax deeper into the ear, causing damage or infection 7, 6.
• The use of cotton buds can also lead to eardrum perforation or other complications 7, 6.

Recommendations

Based on the available evidence, it is recommended to:

• Avoid using cotton buds to clean the ear canal 7, 6
• Use ear drops to soften ear wax before removal 3, 4
• Consider using a loose tip cotton bud or other safer methods for ear wax removal 6