Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The skin on the outer part of the ear canal has special
glands that produce ear wax, also known as cerumen. The purpose of this natural
wax is to protect the ear from damage and infections. Normally, a small amount of
wax accumulates and then dries up and falls out of the ear canal, carrying with
it unwanted dust or sand particles.
Ear wax is helpful to coat the skin of the ear canal where it acts as a temporary water
repellent. The absence of ear wax may result in dry, itchy ears, and even
infection.
What does ear wax look like?
Cerumen varies
in form and appearance from person to person. It may be almost liquid, firm and solid, or dry and
flaky. The color of
ear wax varies depending upon its composition. Glandular secretions,
sloughed skin cells, normal bacteria present on the surface of the canal, and
water may are present in ear wax.
Most of the time the ear canals are
self-cleaning; that is, there is a slow and orderly migration of the skin lining
the ear canal from the eardrum to the outer opening of the ear. Old earwax is
constantly being transported from the deeper areas of the ear canal out to the
opening where it usually dries, flakes, and falls out.
When should ear wax be removed?
Under ideal circumstances, a person should never have to clean their ear canals.
However, we all know that this isn't always the case and sometimes removal of
ear wax is necessary. Excessive ear wax may build up in
the ear canal for many of reasons including:
narrowing of the ear canal
resulting from infections or diseases of the skin, bones, or
connective tissue;
production of a less fluid form of cerumen (more common in older persons due to
aging of the glands that produce ear wax); or
overproduction of cerumen in
response to trauma or blockage within the ear canal.
When wax has accumulated so
much that it blocks the ear canal (and interferes with hearing), a physician
may have to wash it out (known as lavage), vacuum it, or
remove it with special instruments. Alternatively, a physician may prescribe
ear drops that are designed to soften the wax [such as
trolamine polypeptide oleate-ear drops
(Cerumenex)].
The patient may first try an over-the-counter
product (OTC) if they need to
remove ear wax, such as Debrox or Murine Ear Drops. If the ear still feels
blocked after using these drops, a physician should be consulted. If the person does
try OTC ear wax softeners, it is imperative to know that he or she does not have a
perforated (punctured) eardrum prior to using the product. Putting ear wax
softeners in the ear in the presence of a perforated eardrum may cause an
infection in the middle ear. Similarly, simply washing one's ear in the presence of a perforation
may start an infection. If a person is uncertain whether or not he or she has a
perforation (hole) in the eardrum, consult a physician. Some individuals may
also be hypersensitive to products designed to soften ear wax. Therefore, if
pain, tenderness or a local skin rash develops,
the use of these drops should
be discontinued.
Middle ear infection or inflammation (otitis media) is inflammation fo the middle ear. There are two types of otitis media, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Seventy-five percent of children in the U.S. suffer from otitis media at some point. Treatment depends upon the type (chronic or acute).
Swimmer's ear (external otitis) is an infection of the skin that covers the outer ear canal. Causes of swimmer's ear include excessive water exposure that leads to trapped bacteria in the ear canal. Symptoms include a feeling of fullness in the ear, itching, and ear pain. Chronic swimmer's ear may be caused by eczema, seborrhea, fungus, chronic irritation, and other conditions. Common treatment includes antibiotic ear drops.
Objects or insects in the ear can be placed in the ear by patients themselves, or an insect crawling in the ear. Ear wax can also cause ear problems if Q-tips are overused to clean the ears. Symptoms of an object in the ear are inflammation and sensitivity, redness, or discharge of pus or blood. When to seek medical care for an object or insect in the ear is included in the article information.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.