Mrs A had just been called by her daughter’s teacher. ‘Blood’ was seen discharging from her daughter’s ears. The school nurse needed a second opinion from the girl’s family doctor. Upon evaluation, the doctor obtained that regular ear toileting with cotton bud was a routine by Mrs A. She had cleaned her daughter’s ears three days prior to the call from the girl’s school.
Otoscopic examination of the girl’s ears revealed impacted wax in both ears with some liquefied and flowing out of the ears. This was erroneously perceived to be blood. She had ear syringing done to disimpact the trapped wax. Mrs A was counseled against ear toileting………
Wax in the ear means different things to different people depending on their health awareness. Some individuals go an extra mile to rid their ears of wax with the thought that such effort keeps the ears clean and healthy. We need to know the fact about wax.
The wax in the ear is beneficial. It is not dirt. Among other functions, the wax helps to lubricate the ears, it traps dust, other foreign objects, and bacteria; hence it’s nature’s protective mechanism against injury and infection in the ear. Sometimes when the wax is in excess, the ‘hair-like’ structures in the ear sweep it out along with the trapped dust and dead bacteria. Many of us now perceive the ear to be dirty and start cleaning it by inserting cotton buds, tooth picks, and other harmful objects. This should stop!
What we do in fact when we use cotton bud or other materials in cleaning the ear is to cause more damage. As seen in the video, our efforts to clean the ear cause the wax to impact which may cause feeling of noise in the ear, fullness in the ear, reduced hearing, pain in some instances, et cetera. When wax is seen at the entrance into the ear canal, just wash with water +/- soap. Do not go deeper into the ear canal. Progressively, the old wax will be swept out by the ear itself as it produces new wax. Just wash it water. If dissatisfied, consult a doctor.
The ear cleans out itself. Let’s leave it alone.
Dr Ademola Orolu is a Consultant Family Physician. He holds the Fellowship of The West African College of Physicians. He is also an Associate Fellow of The National Postgraduate Medical College of Nigeria. He is in active clinical practice. He is a writer, a patient advocate, and has a passion for health education. He is the chief editor of The Family Doctors. He can be contacted via firstname.lastname@example.org