Ear wax is common to all animals that have external ears - that is ALL mammals.

Ear wax is shed skin from deep in the ear canal mixed with oils and antimicrobials from hair follicles.

New skin is constantly being formed and old skin being shed. When this process happens in the ear canal it has the potential to end in a build up of shed skin, causing a blockage and reducing sound getting to the ear drum. Additoinally, the shed skin in a deep, dark canal is also a great breeding ground for infections.

To avoid both issues we evolved ear wax. Skin deep in the ear canal moves outwards on a metaphorical spiral escalator as it ages. This means it is shed when further out, not deep in the canal. Once the skin is shed it mixes with oils and antimicrobials made by hair follicles in the outer third of the ear canal.

The oils help lubricate the ear canal and allow the wax to move further out and be shed. The antimicrobials make the ear canal a hostile place for bacteria, viruses and fungi.

The mixture of shed skin, oils and antimicrobials is what we commonly call ear wax.

Ear wax is your ears' way to clear the canal of shed skin and prevent ear infections.

Since ear wax is made up from oils secreted from special sweat glands at the bottom of hair follicles, wax can be altered in situtations that stimulate sweat glands. This includes exercise, stress, temperature, humdidity, infections etc.

For this reason the colour and texture of ear wax can change from time to time and from ear to ear.

Additionally, as we get older we produce less oils and shed more hair in the canal which also alters ear wax.

Ear wax is an essential component of a healthy ear. Your ear is self cleaning and does not require intervention in the form of cotton buds. In fact, the use of cotton buds actually pushes the majority of the wax deeper into the ear canal - making the self clearing mechanism less effective and resulting in hearing loss from ear wax build up.

However, on occasion, ear wax cannot be easily shed and begins to build up in the ear canal causing hearing loss. This situation is more common in

1. Ageing (as less oils are made)

2. Men (who have more hair that is shed and makes ear wax movement harder)

3. Hearing aid use

4. Skin conditions that cause more shedding of skin (eczema/dermatitis)

5. Narrow or tortuous ear canals

When hearing loss results from wax build up intervention is appropriate.

When ear wax has built up and hearing loss has resulted intervention is appropriate.

IMPORTANT: WAX DOES NOT CAUSE SUDDEN DROP IN HEARING. IF YOUR HEARING HAS SUDDENLY DROPPED PLEASE SEEK MEDICAL ATTENTION

In this situation you can consider ear drops. There are 2 types of drops, oil based that lubricate the ear canal and make it easier for the natural mechanism to clear the ear and water based drops that cause the ear wax to break down into smaller pieces.

Olive oil is natural and is unlikely to cause skin irritation. Olive oil can be heated to body temperature and then 2 drops instilled through the ear hole.

Sodium bicarbonate drops help break down the wax into smaller pieces making it easier for the clearing mechanism. This chemical solution can sometimes irritate the skin to cause more sheeding of skin!

There is no evidence to suggest that one type of drop is more effective than another.

If drops do not improve the hearing you should seek medical help.

ENT surgeons can easily, quickly and painlessly remove ear wax using a tiny vacuum cleaner under microscope view, designed specifically for ear wax removal.

Hollow candles placed in the ear canal have been sold for many years as a cure to ear wax build-up. It is thought that as oxygen is used up by the candle flame, a vacuum of air will develop in the hollow of the candle, pulling the wax into it.

Studies show that no vacuum ever builds up and wax does not get pulled off the ear canal wall. However, nearly every ENT surgeon has had to deal with injuries caused by these candles, so please do not use them.

Ear wax is an essential component for a healthy hearing ear.

However, very rarely, ear wax can itself cause problems.

When the ability to shed and clear dead skin from deep in the ear canal is damaged, the shed skin can build up with high pressure and cause pain and hearing loss. This condition is called karatosis obturans and requires urgent ENT review.

When dying skin is shed in the middle ear (behind the ear drum) a rare condition called cholesteatoma can result. The growing sac of dying skin can irritate and dissolve important structures of the middle ear and requires urgent ENT review. Patients with this condition report offensive smelling green discharge from their ear that does not respond to antibiotic ear drops.