Ear wax problems
Category: Illness or disabilities
Introduction and description
Earwax, also known as cerumen, is a yellowish waxy substance secreted in the ear canal of humans and other mammals. It protects the skin of the human ear canal, assists in cleaning and lubrication, and also provides protection from bacteria, fungi, insects and water. Earwax consists of shed skin cells, hair, and the secretions of the ceruminous and sebaceous glands of the outside ear canal.
Ear wax may block the ear and cause partial deafness. It may be itchy, or profuse and ‘embarrassing’ in its quantity. And we may think we need to go to the doctor to get rid of it, but first perhaps we might be better understanding something about what ear wax does in the body and why it may be running out of our ears by the bucket full, or not, as the case may be!
Ear wax as medicine
We are apt to think of the human ear canal as a sort of passive conduit for sound going in. But it is not! And what goes out is ear-wax. Enough that it can be measured in terms of “cerumen production in weeks/months, PMID: 9433686”.
Very few appear to realise the absolutely key role ear wax plays in the protection of the ear. It is a sort of miracle substance, anti-fungal, antibacterial and anti-viral as well as anti-parasitic. If you are producing it by the bucket full, all it means is that your immune system is doing its job, but also you are being attacked by a great number of, presumably, very virulent pathogens that the body is trying to expel.
One of the ironies about this area is that the healing properties of ear wax were known as far back as the early 1800s and before. The 1832 edition of the American Frugal Housewife said that "nothing was better than earwax to prevent the painful effects resulting from a wound by a nail [or] skewer"; so they used it as an ointment!
Furthermore, it was used in medieval times, to prepare pigments used by scribes to illustrate illuminated manuscripts, in other words the earwax acted as a preservative – so they knew too.
Its constituency changes according to the types of pathogen in a region, and the pathogens attacking you, thus one person may have sticky brown wax, another grey almost flaky wax.
The viable populations of seven species of bacteria were reduced 17% to 99% by treatment with a 3% suspension of human cerumen of the soft or "wet" type. Species tested for susceptibility to cerumen were Staphylococcus aureus, Staphlylococcus epidermidis, Streptococcus pyogenes, Propionibacterium acnes, Corynebacterium spp, Escherichia coli, and Serratia marcescens. The reduction depended upon the species of bacterium and the age of the culture. Pathogenic species appeared to be more susceptible than others… PMID: 6370076
So it is even more miraculous, in that it doesn’t attack our friendly bacteria.
To assess the antibacterial and antifungal properties of human cerumen by studying its effect on the growth of Staphylococcus aureus, Esherichia coli, Pseudomonas aeruginosa and Candida albicans….. Cerumen samples were collected from 75 normal, healthy subjects aged from seven to 80 years, without ear pathology, …RESULTS: A decrease in Staphylococcus aureus growth was observed for 27 of the 31 samples. All 31 samples induced decreased growth of Pseudomonas aeruginosa, while 29 induced decreased growth of Candida albicans. However, only four samples induced decreased growth of Escherichia coli. PMID: 18694532
And another example:
Freshly collected cerumen (dry form) suspended at a concentration of 3% in glycerol-sodium bicarbonate buffer showed bactericidal activity against some strains of bacteria tested. This suspension reduced the viability of Haemophilus influenzae, Escherichia coli K-12, and Serratia marcescens by more than 99%, whereas the viability of two Pseudomonas aeruginosa isolates, E. coli K-1, Streptococcus, and two Staphylococcus aureus isolates of human origin was reduced by 30 to 80%. The results support the hypothesis that cerumen functions to kill certain foreign organisms which enter the ear canal. PMID: 7447422
The external auditory canal is vulnerable to bacterial infections, but little is known about the chemical compositions of ear wax regarding antimicrobial peptides. We, therefore, studied the protein concentrations of ten well-known human antimicrobial peptides from ear wax. Twenty ear wax samples from healthy individuals were analysed using enzyme-linked immunosorbent assay (ELISA) to determine the protein concentrations of the antimicrobial peptides hBD1-3, lactoferrin, LL-37, BPI, hSLPI and HNP1-3. All ten antimicrobial peptides are present in ear wax. … Antimicrobial peptides in ear wax prevent bacteria and fungi from causing infections in the external auditory canal. PMID: 21298458
indeed a marvellous design from Nature..
The essential nature of fatty acids and cholesterol in its production
Earwax varies its composition, but if we look at some samples that have been analysed, the one common substance that all ear wax contains and is made from is cholesterol
Lipids were extracted from "wet" cerumen and analyzed …The lipid fraction comprised 52% of the dry weight of cerumen and consisted of squalene (6.4%), cholesterol esters (9.6%), wax esters (9.3%), triacylglycerols (3.0%), fatty acids (22.7%), cholesterol (20.9%), ceramides (18.6%), cholesterol sulfate (2.0%), and several unidentified polar components (7.5%). …PMID: 2254469
At which point you should be realising that our rather unwise use of statins and other cholesterol lowering medication, not to mention the insistence that children have ‘low fat’ spreads, opens them, and us, up to a host of infections via the ear, as we have effectively scuppered our only defence.
Ear plugs and hearing aids
There are discussions going on at the moment about the effects that ear plugs from computers and mobile devices has on this flow and doctors seem to be issuing warnings:
ear plugs can increase the likelihood that the wax doesn’t come out on its own….. Hearing aids may be associated with increased earwax impaction. It is also estimated to be the cause of 60–80% of hearing aid faults.
Treatment - Leave well alone
Earwax is also a self-cleaning agent, with protective and lubricating properties. There are tiny glands in the outer ear canal that constantly pump out the wax. The earwax is helped to work its way out of the ear by chewing and other jaw movements. This is why it is a very stupid thing to poke in your ears with anything. By doing so you can stop the flow and compact the wax. In the worst case scenario you may also perforate the ear drum and that is very serious, as it lays you open to all manner of pathogens
unfortunately, many people feel the need to manually 'remove' cerumen from the ears. This can result in further impaction and other complications to the ear canal. The saying, "Don't put anything smaller than your elbow in your ear," holds true.
Cotton-tipped swabs or other objects should NEVER be used to remove earwax. Oral jet irrigators and the alternative medicine technique called ear candling are also strongly advised against.
It appears that the body knows if the ear drum is perforated, however small the perforation, even when the person themselves and their doctor do not. Thus occasionally the earwax is there to deliberately block up the hole. It is impacted because it needs to be to do a good blocking job, thus by attempting to remove the wax, untold damage could be done, resulting in permanent hearing loss.
Claims arising from ear syringing mishaps account for about 25% of the total claims received by New Zealand's Accident Compensation Corporation ENT Medical Misadventure Committee. While high, this is not surprising, as ear syringing is an extremely common procedure. Grossan suggested that approximately 150,000 ears are irrigated each week in the United States, and about 40,000 per week in the United Kingdom. Extrapolating from data obtained in Edinburgh, Sharp et al. place this figure much higher, estimating that approximately 7000 ears are syringed per 100,000 population per annum. In the New Zealand claims mentioned above, perforation of the tympanic membrane was by far the most common injury resulting in significant disability.
References and further reading
- J Am Acad Dermatol. 1990 Nov;23(5 Pt 1):845-9. Composition of cerumen lipids. Bortz JT1, Wertz PW, Downing DT. 1Marshall Dermatology Research Laboratories, Department of Dermatology, University of Iowa College of Medicine, Iowa City 52242.
- J Invest Dermatol. 1956 Sep;27(3):165-70. Studies on the growth of bacteria in the human ear canal. NICHOLS AC, PERRY ET. PMID: 1336752
- J Am Acad Audiol. 1997 Dec;8(6):401-10. The active earcanal. Oliveira RJ1. 1Hearing Components, Inc., Oakdale, Minnesota 55128, USA.
- J Laryngol Otol. 2009 Apr;123(4):375-8. doi: 10.1017/S0022215108003307. Epub 2008 Aug 11. Antibacterial and antifungal properties of human cerumen. Lum CL1, Jeyanthi S, Prepageran N, Vadivelu J, Raman R. 1Department of Otorhinolaryngology, University Malaya, Kuala Lumpur, Malaysia.
- Eur J Clin Microbiol Infect Dis. 2011 Aug;30(8):997-1004. doi: 10.1007/s10096-011-1185-2. Epub 2011 Feb 6. Human antimicrobial proteins in ear wax. Schwaab M1, Gurr A, Neumann A, Dazert S, Minovi A. 1Department of Otorhinolarnygology, Head and Neck surgery, St. Marienhospital Vechta, Marienstr. 6-8, 49377, Vechta, Germany. email@example.com
- Ann Otol Rhinol Laryngol. 1984 Mar-Apr;93(2 Pt 1):183-6. Bactericidal activity of wet cerumen. Stone M, Fulghum RS.