Causes of Earwax Buildup

Earwax blockage, which is also known as cerumen impaction, is caused by excessive buildup of earwax.

When the ear produces more earwax than necessary, the excess ear wax can get hard and get pushed deep into the ear canal.

Below are a few causes of earwax buildup:

• Use of hearing aids and earplugs.
  The constant use of hearing aids and earplugs can cause earwax accumulation in the ear because they prevent shed layers of skin in the ear from falling off naturally.

• Swimming.
  Frequent swimming can cause excessive production of earwax. This your ear's way of ensuring that the water that gets into your ear while swimming doesn't get into the ear canal.

• The use of certain items.
  Using items like keys, bobby pins, napkin or handkerchief corners, and cotton swabs can push earwax deeper into the ear. When this happens over time, the earwax that has been pushed back accumulates and solidifies. Also, the use of these items can introduce certain germs into the ear, which will trigger more earwax production to prevent the germs from getting into the ear canal. 

• People with narrow or malformed ear canals are more likely to have earwax blockage. People with bony growths in the outer part of their ear canal, old people, people with a hairy ear canal, and people with skin problems like eczema are susceptible to earwax blockage.

Symptoms of Earwax Blockage

When there is excessive accumulation of earwax, which results in the blocking of the ear canal, you will experience the following symptoms:

• Earache: The buildup of wax in the ear can cause you to feel pain in the ear. The degree of pain felt varies from person to person.

• Vertigo: The ear is responsible for both hearing and balance; when there is a blockage of the ear canal, you can experience loss of balance, which results in dizziness and nausea.

• Ear Infection: We stated earlier that the ear produces earwax to protect the inner ear from fungi, dirt, bacteria, and any other thing that can cause an infection. But the accumulation of earwax can counter this action and cause an infection. The accumulated dirt can infect the ear.

• Fullness in the ear: When there is an excess buildup of earwax in the ear, you may experience fullness in the affected ear. This is a very uncomfortable feeling, and it can tamper with your hearing.

• Tinnitus: Tinnitus is the hearing of sounds in the ear when there is no external noise present. Earwax blockage is one of the major causes of tinnitus.
  The accumulated ear wax prevents the ear’s normal functioning and causes the ear to generate sounds. In most cases, when the earwax blockage is removed, tinnitus will disappear.

Earwax Blockage Removal Procedure

In this section, we will be examining various ways earwax blockage can be removed. We will be classifying the procedures into two groups: medical approach and home treatment/remedies.

This will form the basis for us to answer the question of whether or not the removal of earwax can cause tinnitus.

Let's get started.

Home Treatment / Remedies

You can remove earwax blockage at home, but we advise that you do this with your doctor’s guidance. This will enable you to be sure that there is a buildup of earwax in your ear.

This is necessary because the symptoms we discussed earlier are not exclusive to earwax blockage; they are also symptoms of other conditions.

For instance, vertigo is a common symptom associated with inner ear hair cells damage; likewise, eustachian tube problems can cause a feeling of fullness of the ear.

When you visit your doctor, he will examine your ear to see if there is an accumulation of earwax; then, he can prescribe some of these home remedies.

1.Ear Drops

This is one of the cheapest ways of getting rid of excess earwax, and they can be gotten over-the-counter or online.

It is important to ask your doctor for a prescription on what ear drop to buy. This is because there are different branded and unbranded ear drops products in the market.

If you buy an ear drop over-the-counter, ensure that you follow the instructions written on the packaging.
Ear drops can be water-based or oil-based.

Below are different types of ear drops you can use to get rid of accumulated ear wax.

• Oil-based ear drops:
  A common example of oil-based ear drops is olive oil ear drops. This is one of the mildest types of ear drops. The olive oil base helps to soften the outer surface and edges out the solidified wax making it easy for the wax to slide out.
  
  Olive oil drops are gentle on the ears and well tolerated by most people, but they can take a long time to work. If you want to hasten the process, you may need to use other methods with it.
  
  There is also a possibility of the wax dissolving and sliding deeper into the ear canal instead of coming out. 

• Peroxide based ear drops:
  Some ear drops are based on peroxide, urea peroxide, to be specific. These types of ear drop work by dissolving the wax, which makes the earwax removal process faster.
  
  Peroxide-based drops contain bleach, and this can cause a painful reaction even after one application. Also, there is a possibility that the dissolved wax will slide further into the ear canal. 

• Sodium bicarbonate ear drops:
  Ear wax is acidic, while bicarbonate of soda ear drops is alkaline. When the ear drop touches the earwax, it creates a chemical reaction that dissolves the ear wax. It works fast, and within a day or two, the earwax blockage will be removed.
  
  The downside of using this type of ear drops is that if you use it for an extended period, it can strip the ear canal’s protective lining and cause infection. The dissolved earwax can also go deeper into the ear canal. 

If you have a perforated eardrum, ear drops are not for you. It is also important to note that in most cases, when you use ear drops, your hearing will get worse before it gets better.

If you suspect that you have pushed the earwax deeper into the ear canal, contact your doctor immediately.

2. Hydrogen Peroxide

This is another common way of removing earwax at home. Hydrogen peroxide can be gotten over the counter or online.

Earwax is removed by adding a few drops of hydrogen peroxide to a damp cotton ball and applying it to the affected ear. You can also drop it into the ear by using a clean eyedropper.

Ensure your head is tilted with the affected ear facing upward when applying the hydrogen peroxide. This will give the fluid enough time to drip down into your ear and melt the wax.

After a few minutes, tilt your head so that the affected ear is facing downward; this will allow the melted earwax and fluid to drain out of the ear. If you do not allow the fluid to drain out, the condition might worsen.

3. Ear Sprays

Ear sprays are placed at the entrance of the ear canal and sprayed to soften accumulated earwax. Ear sprays are not just used to remove earwax; they can also be used once a week to prevent earwax accumulation. The sprays are either oil-based or water-based.

• Oil-based ear sprays:
  These types of sprays are oil-based, like olive oil. Not only are they cheap, but also more effective in penetrating wax than ear drops. Oil-based ear sprays can reach further into the ear (farther than eardrops)
  
  Oil-based ear sprays may not be able to remove ear wax on their own; they can, however, be used as softeners before other wax removal procedures. 

• Water-based ear sprays:
  The base for these types of ear sprays is sterilized seawater or saline. They are gentle and well tolerated by most people and ideal for removing wax blockages that aren't big.
  
  The disadvantage of water-based ear sprays is that the water in the spray can get trapped behind the wax and cause a feeling of fullness in the ear. The force of the water being sprayed can also push the wax further into the ear. 

4. Rubber Ball Syringe

Earwax can be removed at home by using a rubber ball syringe filled with warm water. The syringe’s water is gently dropped into the ear with the head tilted, with the affected ear pointing upward.

After a few minutes, the affected ear should be faced downward to drain out the wax and water. The process should be repeated multiple times for maximum results.

This method of wax removal is not suitable for people who have a ruptured eardrum.

Ensure that the water being used is clean, and it must not be too cold or hot. If the water is forcefully flushed into the ear canal, it can cause dizziness or push the wax further into the ear.

5. Ear Vacuums

Ear vacuums are designed to suction wax from the ear at home, but they may not be effective. Ear vacuums can be easily purchased online, but they are not medically adapted to remove earwax. Ear vacuums feel nice to use, and they create a whirring sound when in use, but that's just about all it does.

When you pull the vacuum out of your ear, it may have some wax on it; this shouldn't be mistaken for effectiveness. The wax on it was not suctioned. Instead, it is a result of the vacuum coming in contact with the ear wax.

Ear vacuums can cause more damage than good because they push wax deeper into the ear. The amount of wax it scoops out is smaller when compared to what it pushes further into the ear.

6. Cotton Buds

The use of cotton buds for ear wax removal is very common. While it may seem like cotton buds help to remove earwax, in most cases, the cotton bud pushes the earwax deeper into the ear.

Ironically, the use of cotton buds is one of the causes of impacted cerumen or earwax blockage. The earwax being pushed in can press against the ear canal or eardrum and cause pain or perforation.

Even though cotton balls feel soft on our hands, they are harsh on the ears. This is because the ear canal’s skin is very thin, and the cotton bud often scratches it and causes minor bleeding.

Cotton buds may be great for relieving ear itching, but it shouldn't be used by people who produce excess ear wax. Because asides are irritating the skin, it can also stimulate more wax production.

7. Ear Candles

Some people attempt to get rid of earwax at home by using ear candles. This method is also known as ear coning. It is very dangerous and can cause permanent damage to the ear. Ear candles are made up of paper and wax.

A hollow fabric cone is covered in paraffin or wax and inserted into the ear. The person is expected to lie on his side with the affected ear facing up. The cone is then lighted. A paper plate is placed to prevent dripping wax from touching the skin.

The ear candle is supposed to create a suction to pull the wax out of the ear, but this is far from the truth.

The earwax that most ear candling practitioners claim that they got from the ear is not earwax; instead, it is the candle wax that melted when the fire was burning.

This method of removing ear wax is very ineffective and should be avoided. The hot wax from the melted candle can drop on the eardrum and immediately cause eardrum perforation.

The melted candle can also worsen the earwax blockage. Ear candles can also cause bleeding, ear burns, severe pain, and permanent hearing loss.

Medical Approach

These are ear wax removal procedures that are carried out by certified doctors. They are not procedures you can conduct at home because they involve the use of medical equipment.

The doctor will need to examine your ears to ensure that there is a blockage before using these methods. Your medical history will also be taken into account; this will enable the doctor to find out which procedure is perfect for you.

1.Ear Irrigation

This method is also known as ear syringing. This is usually used if ear drops don't work. In the past, a metal ear syringe is filled with warm water, the tip of the syringe is placed in the ear canal, and the water is applied into the ear.

The pressure of the water being applied is usually high so that it can dislodge the wax.
A dish is placed under the ear to catch the wax and water being flushed out.

Because the syringe doesn't have any regulator, the doctor or nurse relied on his judgment to determine the right amount of pressure to apply.

In recent times, ear syringes have been replaced with electronic ear irrigators. With this device, the doctor can control the water’s pressure and regulate the water’s temperature being flushed into the ear.

Ear irrigation or syringing alone cannot remove hard wax; the wax will have to be softened for at least two weeks before the irrigation process. The process is not painful, but you may experience some discomfort.

Ear irrigation is not suitable for people who have the following:

• People who have had ear surgery within the last 12 months.
• A person born with a cleft palate.
• Anyone who has a perforated eardrum or has had a perforated eardrum in the last year.
• People who have had a middle ear infection like otitis media
• Children that have a grommet.

Even though ear irrigation is a painless procedure, certain complications can arise. The eardrum can be perforated if the water is too hot or if the water’s pressure is high.

The risks of developing an ear infection are high, especially since there is a tendency for the force of the water to push wax, bacteria, and water beyond the eardrum into the middle ear. The process can also cause tinnitus.

Due to the complications associated with ear irrigation, many medical practitioners are not so keen on using this process for earwax removal.

2. Micro Suction

This is the most effective earwax removal method. Appropriately trained doctors and nurses can only conduct micro-suction because it requires a good knowledge of the ear’s anatomy and training on using the equipment.

Micro-suction removes earwax from the ear without spraying any liquid; therefore, it is safe to use if you have a perforated eardrum or recently had surgery.

The procedure entails using a microscope (either a standing microscope or microscopes incorporated into glasses) and a medical suction pump. The suction pump is attached to a tube, and it has a two-millimeter suction wand. The suction wand is what is used to suction the wax from the ear.

It is usually done under bright light.

The bright light and microscope enable the doctor to see exactly what is happening in your ear, making this procedure one of the safest means of earwax removal. This procedure is very fast, painless, and has zero risks of infection.

If the wax was not pre-softened, you might experience slight discomfort during the procedure. If the wax is severely impacted, you may require a second visit.

3. Dry Instrument Removal/ Manual Removal

An audiologist or an ENT surgeon usually does this. It involves the removal of wax with the aid of different shaped instruments called curettes.

Curettes look like little loops or spoons, and they are used to scoop or hook the impacted wax out of the ear canal. The procedure is done under illumination; some curettes also have a built-in light. A microscope is needed to enable the doctor to have a clear view of the ear.

The wax needs to be softened before the procedure, as this will make it easy for the curettes to pick it up when inserted.

If the wax is not softened before removal, you may experience some discomfort, and there is a little possibility of the wax being pushed further into the ear.

Is Tinnitus Normal After Ear Wax Removal?

While earwax blockage can cause tinnitus, the removal of the accumulated wax can also cause tinnitus. This, however, doesn't mean that ear wax removal procedures always result in tinnitus. Tinnitus can occur depending on the removal procedure used and the side effects of the process.

Certain home remedies for the removal of wax that involve inserting objects into the ear canal (for instance, cotton buds) can damage sensitive tissues in the ear and result in tinnitus. For instance, ear candling can burn the ear and perforate the eardrum. The hair cells in the ear can also get damaged if this happens, you will experience tinnitus.

Most of the ear wax removal methods we examined tend to push the wax blockage deeper into the ear. When the wax is pushed deeper into the ear, it can cause inner ear disease, and tinnitus is a major symptom of this disease. If the infection is not given timely medical attention, it can spread to other parts of the head and cause severe health issues, including cranial paralysis.

Also, if the earwax is pushed in a while trying to extract it, it can press against the tympanic membrane or eardrum. It can also damage the inner ear hair cells, and this can cause vertigo, which is often accompanied by dizziness and nausea.

Some ear drops and ear sprays used to soften and remove ear wax are ototoxic, which means that they can cause tinnitus. If the damage done to the ear is minimal, the tinnitus may be temporary, but if the spray or ear drop was used for an extended period, it could cause permanent tinnitus.

The irrigation method for removing earwax can also cause tinnitus. The pressure or force of the water being sprayed, as well as the noise of the irrigation process, can cause tinnitus. Sudden exposure to noise is one of the major causes of tinnitus; since this procedure is noisy, it can cause or worsen tinnitus.

The use of hot water or unclean water for the irrigation process can also introduce disease fungi or bacteria into the ear, and this can cause ear infections. And ear infections can cause tinnitus.

It is important to note that most of the methods we examined do not take out all the earwax and push earwax deeper into the ear. This explains why you still have tinnitus after the removal procedure.

If there is still some wax blocking your ear, you will still experience tinnitus. So the tinnitus may not be because the procedure damaged your ear but because the root cause of the tinnitus, which is the wax, has not been totally removed. When the impacted wax is completely removed, the tinnitus will subside or go away.

As stated earlier, tinnitus may not be exactly what you expect right after getting rid of earwax blockage. However, in most cases, tinnitus still occurs not because earwax removal is bad but because the method of earwax removal harmed your ear.

The safest way to remove ear wax without being exposed to the risk of developing tinnitus is the micro-suction method. It is the only method with little or no side effects.

If you choose to use other methods like ear candling, irrigation, syringing, cotton buds, etc., you may have tinnitus after the wax has been removed.

Conclusion

The best thing to do when you suspect earwax blockage is to book an appointment with your ENT, don't try to self medicate. The home treatments we examined above should only be used with the supervision and recommendation of a doctor.

If you have tinnitus after earwax removal, visit a doctor. The doctor will examine your ear to see if the tinnitus is caused by wax that was pushed deep into the ear or if the tinnitus is a side effect of the removal process you used.

Have you had tinnitus after earwax removal? What method of wax removal did you use? Did the tinnitus go away? Share your experience with us.