Cerumen or earwax is a naturally occurring substance in our ears. Special glands found in the outer half of the skin lining the ear canal produce this yellowish brown, thick, or viscous substance. Genes determine the colour of the wax.
Primarily, earwax traps dust and other dirt particles to prevent them from reaching the eardrum. Eventually, the dust and dirt laden earwax will be transported slowly by the migration of the upper layer of the ear skin towards the outer opening of the canal. As the ‘older’ wax reaches the opening of the canal, it dries out and falls away.
Aside from trapping dust and dirt, earwax also provides protection to the ear by preventing infection and inflammation. Because of the acidic nature of the wax and powerful enzyme (lysozyme) it contains, it inhibits the growth of bacteria and fungus in the ear.
Due to its oily nature, earwax also provides a waterproof layer for the canal skin, preventing water accumulation, penetration and skin maceration.
Under normal conditions, earwax is not supposed to cause any ear problems. However, there are some instances where wax will be troublesome. The most common condition is called wax impaction.
This normally occurs from attempts to remove wax using cotton buds or other implements. These objects cause the wax to be pushed into the deeper part of the ear or cause the wax to become tightly packed, preventing normal migration towards the outer part of the ear.
Other conditions that might predispose the child to earwax-related problems are:
The most common symptom associated with impacted earwax is mild hearing loss or ear fullness. This usually happens if the canal is completely blocked by earwax, otherwise hearing is maintained.
Impacted earwax is usually painless unless it touches the eardrum. An attempt to remove hard wax can cause abrasion and pain to the delicate ear canal skin. Water trapped inside the ear during a shower or after swimming will cause the wax to expand and can cause ear pain and sudden hearing loss.
Other symptoms associated with
impacted wax in the ear include: ear
itchiness, ringing in the ear and, on rare
Earwax is a natural body secretion and
there is no way to stop our body from
secreting this substance. One of the
ways to prevent impacted earwax is to
avoid the use of cotton swabs in the
The best way to clean the external ear
is to wipe the outer opening with a
damp washcloth folded over the index
finger, without going into the ear canal.
Since the rate of earwax production
varies from one individual to another, it
is advisable to check your child’s ear at
least once a month. If wax is beginning
to build up, you can start using any
of the available home remedies for
Before using any eardrops, make sure
that your child’s ear has no infection
or eardrum perforation. If your child
develops ear pain or ear discharge after
using eardrops, immediately stop using
the drops and seek professional advice.
Children wearing hearing aids should
also have their ears checked periodically
for signs of wax impaction.
Impacted wax needs to be removed if
it is causing problems such as ear pain
and hearing loss. Removal of earwax is
also necessary if it is preventing proper
evaluation of the eardrums and middle
There are several available ways of
removing earwax. The most common
home remedy is the use of a wax-softening agent, which is applied
everyday until the wax softens and
Some commercial preparations can
cause allergic reaction to ear canal
skin and should be used with caution
among children with known allergies.
Safer alternatives to these commercial
drops include mineral oil and glycerin.
If wax-softening agents fail, the next
option will be to seek professional help.
Earwax removal either by irrigation or
suctioning is normally performed in
the clinic. Earwax can also be removed
manually using special instruments
if the child is able to understand
instructions and willing to cooperate.
Manual removal of wax should not be
attempted at home if the wax is located
deep in the ear canal.
For children who cannot cooperate
with the above methods, removal
of earwax and ear examination can
be accomplished under sedation or
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