Health Maintenance > Ear wax

Ear wax

Ear wax (cerumen) generally does not pose a medical problem, even if the amount seems excessive.  Excessive ear wax does not cause middle ear infections, and is not usually involved in swimmer’s ear.  Ear wax does not often cause hearing problems in children (although this is a more common problem in adults).  So there’s usually not much medical reason for parents to clean their children’s ears, though the wax may be unattractive.

Folklore would have us clean ears with a cotton swab or Q-tip.  But this is not a good way to clean the ears; the cotton swab often pushes the wax farther back into the ear canal, which may form a ball that is difficult to remove.  I don’t recommend cleaning ears with cotton swabs.

Sometimes I will recommend rinsing the ears regularly at bath time, since removing excess ear wax might allow me to see eardrums that might otherwise be difficult to examine in the office.  If your baby’s ears get waxy, I suggest that you run clean water into the ears at bath time, to loosen the wax and perhaps flush some of it out.  (Folklore says that water in the ear canals might cause an ear infection, but fortunately this is not true.)

Hydrogen peroxide (from the pharmacy) is quite effective at softening ear wax, though some kids don’t like the “fizzy” feeling in their ears.  Using a syringe or dropper, gently squirt or drop the Hydrogen Peroxide into each ear canal, then let it run out.  You can do this twice a day routinely, perhaps when you brush the teeth.

Medical treatments such as Debrox can be used to soften and flush the wax, but I don’t find that they work better than Hydrogen Peroxide.

If you really want to get "down and dirty" with the earwax, check out this detailed article.  This fellow recommends using hydrogen peroxide with a battery-operated WaterPik; this is also what we use in our office, to flush out ear wax.

     – David Epstein, MD