Waxing lyrical: taking ear wax seriously | Hacker News Reader

Waxing lyrical: taking ear wax seriously

pmj.bmj.com

89 pointsHooke78 comments

I had some experience being treated by the NHS for blocked ears. I waited 3 weeks for an appointment. The doctor sees me, tells me it’s blocked and that he can’t do anything about it. I need to use olive oil or some over-the-counter drops.

Turns out olive oil is ineffective and the drops bleached my skin, while only causing the wax to become lodged in deeper. I finally paid £100 to get the ears cleaned by micro-suction.

I strongly agree with what the article says - no one thinks this is a big deal unless they lose hearing themselves.

I had the same situation - blocked ear, NHS doctor said they don’t usually do anything about it due to the risk of ear damage in the process.

The drops did nothing, but I ended up using one of the bulb syringes you can buy to blast it with water and it did the trick perfectly, lots of gross wax came out and I’ve had no issues since (previously they’d reoccur every now and then). Was really weird after I’d done it, everything sounded really “HD” for a while! (I remember I took advantage and went record shopping, lol)

This YouTube clip showed me how to use it properly: https://m.youtube.com/watch?v=sAHx0B7icmI

I’m no doctor so please don’t consider this medical advice and do check with yours before trying this!

Doctors IME will always advise not to do it, but also IME it works far better than anything else.

I've always had blocked ears, and my grandfather had been an NHS doctor back when this was standard (before the advice not to do it came down), so he was the one who showed me how to do it -- very, very gently and repeatedly, with slightly warm water, don't need to push the point of the bulb/syringe in. And the wax just drops out after a few applications (in big gross lumps if it's bad!).

Absolutely not medical advice, but just to confirm that it works extremely well.

> (in big gross lumps if it's bad!).

Can confirm, ha

I have had to go to a doctor only once because of impacted wax. He did pretty much the same thing. He used a massive copper syringe for the task. The only thing he did differently than the video was using cotton swabs to immediately dry the ear canal. It was painful, but he said leaving the region wet can lead to infections. I don't trust untrained people to use swabs in the sensitive regions of the canal.

Anyway, for home cleaning, 3% H2O2 or baby oil have been working well enough ever since.

I had the same experience in the U.K., twice - once about 12 years ago, once two years ago.

Olive oil does absolutely nothing that I can tell. I’ve tried it, fastidiously, as my ears are really prone to filling with wax.

My experiences on continental Europe have been entirely different, however.

Ten years ago, about 18 months after being refused treatment in the U.K., I was working in France, and woke up one morning utterly deaf in one ear. Couldn’t unclog it, so went to the local rural clinic. I had to wait about 15 minutes, and they hosed my ears out with a rubber hand-bulb. Magic. €7.20, I think, which was the standard consultation cost at the time.

Most recently, I had an ear block again a few weeks ago, and I now live in rural Portugal. Again, took myself to the local clinic, hoping to make an appointment - and they were shocked that I hadn’t gone straight to their emergency department. I had no idea or expectation that they would have an A&E - this is a tiny clinic for a population of less than 2,000. Anyway, toddled around to the back, where there is indeed an A&E, and again, they did it there and then, no cost.

I’ve found doctors in the U.K. to generally be a pretty unhelpful bunch - I think it comes from them drowning in insane KPIs and spending most of their time pushing paper or trying to keep their practice from disintegrating. They don’t have time for patients. I ended up seriously unwell as my GP kept brushing me off — and a dear friend ended up dead, as she was repeatedly told by her GP that her colon cancer was IBS, until it metastasised and ate her alive.

Your last paragraph is why to me the idea of "you only get to see a specialist if the GP refers you to one" completely ridiculous.

It's not the first time I hear about GPs brushing off potentially dangerous conditions. I don't think it's so much about paperwork but rather a narrow pidgeonholing and a patronizing feeling.

I've had the opposite experience, just if we're sharing anecdotes. Went to my GP, he recommended olive oil, put a few drops in, a fat big block of earwax naturally came out of my ear just few hours later. So it definitely works(for some people).

No matter what I try my ears both get blocked regularly, every 6 - 12 months.

The first time, a nurse syringed it after the doctor prescribed drops which contained olive oil. He said it wasn't to fix the problem (although sometimes that alone does dislodge the wax), it was to soften the wax to make the syringing safer and more effective.

These days I see a doctor who uses a suction tube and a small metal scoop and whenever he digs out something wothwhile he delights in presenting it to me to see.

I have had problems all my life, worst is diving into water and impacting wax and water leading to all sorts of issues including fungal ones that are hard to treat. Doctor said I "make a lot of wax, probably genetic". One ear is very narrow due to swimmers ear.

Then I discovered the use of hydrogen peroxide - it just eats and softens the wax, my 16 year old pulled out an enormous wad this way and all of sudden could hear properly.

Now I am sure the ear doctors will freak, but I put hydrogen peroxide that my wife uses for her hair on a cotton bud and put it in my ear/s.

After a while you will hear hissing and popping as it starts to work. You may need to repeat quite a few times to get thru it enough to lodge or loosen it, but this worked for me a number of times after multiple failed syringing's.

I'm sorry that you had that experience. My NHS practice has a nurse that "syringes" ears, and its fairly straight forward to set up an appointment. They do ask that you apply oil to your ears in the days leading up to your appointment, but this is just so that the earwax comes out more easily.

This was also exactly my experience. It's what NICE recommends:

https://cks.nice.org.uk/topics/earwax/management/management/

https://www.nice.org.uk/news/article/remove-earwax-if-a-buil...

So it's odd that there are doctors refusing to do it.

Oh, interesting. I once lost hearing in one ear due to wax blockage and finally got annoyed enough I went to an urgent care clinic. They used a wax softener and then a big syringe with warm water (and maybe something else mixed in) to irrigate my ear canal. That did the trick and cleared it out. I wonder what about using a syringe can be harmful?

> what about using a syringe can be harmful?

Pushing it too far in, using water that is too hot, pushing the water in too fast. All can damage your ears.

I have had my ears syringed twice. In both cases at my doctor's surgery by a nurse. I visited my doctor because I started to notice that I was going deaf in one ear and ear drops didn't seem to work. Syringing worked perfectly and removed a surprising large amount of wax.

That NICE guideline says not to use a syringe as it can be harmful. The other commenter used quotes so maybe it was a loose reference to the irrigation devices that they do recommend.

All ENT doctors I have ever been to in Germany as well as Taiwan offer microsuction and it was always covered by public insurance as well. It was done by the doctor and not by nurses.

Get a earcamera with a scraper, its cheap, instantly effective, and far superior.

Do you have an earcamera recommendation?

I got mine at a local mixed tech/gimmic store for 20$, not sure about the exact model but it looks alot like: https://www.amazon.se/SOONHUA-%C3%B6ronkamera-borttagningssa...

I'm pretty happy with it, but I would expect most all would work, its not a hard problem.

Thank you

Be very careful about this.

I was looking for something similar and heard some horrible stories about people breaking parts of the device inside their ears. Which would make things worse and it's hard to get the stuff out since some of it may stick in the wax. So be warned.

Thank you too

Nowadays you can DIY this with some special syringes easily available. There are also other oils that are better than olive. (both can be found in pharmacies)

But yes it is an annoying problem.

It doesn't even need to be a special syringe. I've been able to unblock my ears with warm water and a bulb syringe. It probably takes more effort though since the bulb only holds so much water and has to constantly be refilled.

I went to an ear doc in Belgium. Not a general practicioner. She did the micro-suction thing for me just fine and i believe it was covered.

The thing to do is to get one of these fiber optic endoscopes: https://youtu.be/cl3yX7-f-4U?t=10 Yeah, it looks silly, but it's by far the best solution. I've been using one for years after I had to get wax removed at the doctor once. Never had a problem since.

The problem with using Q-Tips is you can't see what you're doing, so you can push the wax farther in and even rupture your eardrum easily. With the endoscope you can see perfectly, and avoid damaging your eardrum while being sure that you got all the wax.

The ear drops sold for wax removal in stores don't work any better than plain water [1]. The process of flushing your ear with a syringe or squeeze bulb is unpleasant, loud, and carries a risk of rupturing your eardrum just as Q-Tips do. And you still can't see if you got all the wax out. Endoscopes are the way to go.

[1] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

I've been using a metal earpick for about the last 4 years every couple of days. I'm very gentle and have a very heightened awareness of the inside of my ears and don't believe I will ever rupture or harm my inner ear or eardrum. I've never had blocked ears or a bad ear infection I just enjoy the ... Ermm... Excavation process. Okay, it might be bordering on something akin to dermatillomania. Didn't even know these cams were a thing, but I've always wanted to see what I'm doing to really find the gold.

> don't believe I will ever rupture or harm my inner ear or eardrum

Has anyone who's ever harmed their inner ear or ear drum not thought this beforehand?

Too true... I have a strong suspicion that a specific person with the right technique isn't necessarily at any risk, that more harm would come to more people if it was encouraged en mass. I do sometimes worry I'll get a startle and stab my inner ear.

Sometimes they work far worse than water, they can cause a very thin hard film to coat the eardrum which is almost impossible to get rid of, and which can get infected. Finally got a usb ear cam with a scraper to remove it, but it was weeks and it got bad enough they prescribed antibiotic for the ear infection but still refused to just remove wax block. They argued it was too infected so they couldnt see what was infected and what was earwax... idiots, its not like it matters. I scraped away the pus and the wax and the infection healed in a single day. Ever since I remove the earwax block with a cam scraper once a year or so and never had the kinds of ear problems I used to again.

Is your endoscope one that has its own screen, or one that plugs into a laptop?

Hackaday published a blog post about using earwax microscopes for SMD soldering:

https://hackaday.com/2019/11/11/review-ear-wax-cleaning-came...

Neither. A fiber optic endoscope does not need a camera or a screen. It's purely optical. No electronics, zero latency.

I agree. Bought a USB-based one from Aliexpress for 10 EUR last year. It took lots of practice to master though, and I had to be extremely cautious during the first few months. But it was worth the trouble. Never going to go back.

When I was very little, the bathroom in my house had a small plastic earwax irrigator in the cupboard below the sink. I did not know what it was, and my parents wouldn't give me an explanation beyond "leave that alone and dont't play with it." One day curiosity got the better of me and I have it a squeeze. Well, it wasn't empty. A while bunch of ants came out. Good thing no one tried to actually use it.

That's hilarious and disgusting!

Thanks. I hadn't realized until now how many typos were left in that. At least the message came across.

I had to pay a visit to my doctor roughly every 6 months to get rid of excessive ear wax. To the point where I almost stopped hearing anything on my right ear. After 30 times going to the doc, I actually bought myself this big water-shooting syringe. Its so much easier to just do it at home, and another good reason to not sit in a public waiting room during these times. I figured, if a nurse is allowed to do this, I can likely do it myself. And thats pretty much true. I wonder how many things we will find that actually dont require an expensive trained person in the medical areas. I guess there is a hidden trend to fixing things up yourself after COVID. Wonder how much money the med-bussiness is loosing now that people start to realize they dont need a doctor for every hickup.

Tell me about it.

I used a water irrigation bottle to get rid of my ear wax.

Super simple. Melts the wax with slight warmer than room temperature water.

You'd be surprised how many medical problems you can solve with the insight of people who have had it on Amazon.

This had the format of a paper but was a blog post? I thought I was reading an abstract until it was blatantly obvious I didn't.

It is clearly an opinion or commentary. Scopus calls it a note. The journal marks it as "On reflection". Not everything in journals are research articles.

Warm water from the shower head with not too much pressure works fine. Tilt your head so the water runs out while doing it.

Even my doctor said that’s the way to go. Might not work for absolutely everybody but it does for the majority. There is no need for fancy, expensive devices unless you get a kick out of the actual act of removing something physically from your body.

Treatment that works for my own "wet wax" i.e. African/Western:

1. Pre-soften wax with warm water vapor, by taking a long hot shower.

2. Apply carbamide peroxide drops, available over-the-counter in US. Lie down with treated ear up, listen for popping sounds, indicating peroxide is reacting with the wax. Adjust angle of head to maximize popping rate. Expect 10-20 minutes for exhaustion of the reaction.

3. Rinse with plastic bulb syringe sold for that purpose. Water slightly above body temp, never warmer. Minimal intrusion of tip of the syringe -- it poses some danger.

4. Blow out excess water with puffs of air, delivered by the same syringe.

Prevention:

1. Avoid ear plugs for noise protection; get over-the-ear muffs.

2. Avoid cold-water exposure. Swim with a thermal over-the-ear cap, or break rule 1 and wear thermal plugs.

I've followed these same treatments steps, and it's worked well for me. It has sometimes taken a two or three treatments to fully clear the wax out. The slight warmth from the peroxide reaction was a little disconcerting at first, but it seems like a safe and effective method.

I wonder if the difference in ear wax consistency is the reason that ear wax pickers are commonly used in Asian cultures but not otherwise?

Using modern prevalence of the dry-wax gene as the basis for probability simulations, the authors estimated that the dry form of the gene diverged from the default wet version 2,006 generations back, or about 50,000 years ago (which lines up well timingwise with the out-of-Africa theory); (2) the speed with which the new gene spread through Asia suggests it conferred some evolutionary advantage; and (3) among modern Asian, Native American, and European populations alike, the dry-wax gene is more common the further north you go — supporting the earlier idea that maybe it helped humans thrive in the cold.

https://www.straightdope.com/21344485/why-is-asian-earwax-di...

Yes, an ENT told my wife that those of Asian decent more commonly have “sticky” ear wax.

It is the opposite. People of Northeast Asian descent more often have “dry” earwax, associated with a recessive allele of the ABCC11 gene. https://en.wikipedia.org/wiki/Earwax https://en.wikipedia.org/wiki/ABCC11

Yes, as mentioned in the post:

> Dry wax, which is grey and flaky, is commoner in Asians. Wet wax predominates in Africans and Caucasians, and is brown and sticky.

This is my understanding, but I don't remember where I've read it.

> Some medical conditions carry prestige and others do not

This literally affects venture investment in the life sciences. I have heard from VCs “we don’t want to have to tell our LPs that we have XXX in our portfolio.” And “We invest in serious indications: cardio and cancer.”

The big institutionals don’t care: their LPs are typically institutions themselves and so just care about the nature of the business. But smaller funds with a bunch of individuals in the LP mix are more squeamish.

Plus it’s less exciting to talk about at parties.

What finally worked well for me was an "ear loop" tool, a small, cheap plastic tool with a safety guard, that makes extracting the wax quite easy. They cost less than $10 USD, do not rely on uncomfortable squeezing of water or liquid, nor do they just push the wax farther in (unlike a cotton swab).

It was a big deal for me to discover these existed, and when I did, I was surprised I hadn't heard of them.

There are some contact lens cleaning solutions that are weak solutions of hydrogen peroxide (2-3%). (For overnight use only obv.) I tried some of this stuff in my ears and it seemed to help.

Yeah, it fizzes like crazy, but it seems to eat ear wax.

Do each ear for a minute or so then take a shower and rinse out your ears with warm water.

I know it goes against every warning label but I use those cotton tip sticks. Being careful to not stick them too far and I have never had an issue. Is there a better way to be doing this?

I don't know why you're being downvoted but in most of asia, using a metal ear pick[0] the norm for clearing the ear. Only in the past 20 years or so that a cotton ear bud has become prevalent.

[0]: https://en.wikipedia.org/wiki/Ear_pick

Yes:

https://www.amazon.com/Ear-Clear-Ear-Removal-Irrigation-Syri...

Does the syringe do anything special, or is spraying the shower in my ear going to have the same effect?

The syringe does two important things that your shower doesn't: it directs the stream of water into your ear to the right depth so that it actually pushes the wax out instead of further in, and it has a bend in it so you can't insert it deep enough to damage your eardrum.

The shower pressure is probably too high and risks at least pushing deep wax even deeper, but possibly even causing damage to your ear drum.

??? I must have totally damaged ears. I always clean them like this

For what it's worth, I visit my local ear doctor for wax removal once or twice a year. May not be possible under all health care schemes.

Since when are q-tips bad for you? Is this a new Mandela effect?

They're great until the first time you have more wax in your ear canal than you can just wipe off with a q-tip, at which point you're likely to push it farther in, where it will then take about the same time to work its way out as your fingernails take to grow. If it's a lot this can result in hearing loss or a painful impaction. Like a lot of things it can keep changing as you age until something that used to be simple/easy suddenly isn't.

Since always! You know how cannoneers used to bunch up black powder in their cannons before adding the cannonball?

If there is to much ear wax already present and it's to dried out (how are you going to check beforehand if it isn't to much or to dried out?), you're just bunching up some of it while scraping some out. But the stuff you bunch up, will just sit there, until you bunch more wax into that plug...

But what are you supposed to do instead? If you try to irrigate it out yourself regularly, you might end up getting a fungal infection anyway because it might stay to wet..

Ears just generally suck

The higher end irrigation kits (similar to clinical products) come with packets of ascorbic acid (vitamin C) which you are suggested to use as a rinse following the wax removal.

Since at least my teens (90s). I have a distinct memory of my father telling us about not putting q-tips in further than the exterior surface after he visited his GP for a checkup.

But to not go deep is to deprive the eargasm, YMMV.

Mmm, be right back

The packet says do not put them in your ear. If you push them too far you could damage your ear drum. Who knows how likely this is if you are careful though.

Anyone here wear over-ear headphones or in-ear buds everyday?

There are two ear wax types around the world wet and dry where wet is the dominant type.

Yes, and interestingly there is a single gene mutation which determines which type you have. This is as far as I know the only non-disease phenotype determined by a single DNA base change.

What I've read - and it's not mentioned in the article which is very surprising - is that the ear wax purpose in the ear is that it not let's mushrooms grow in the human ear when it's sleeping on the ground. Also stops insects to crawl in.

I've stopped using cotton tips for a while and nothing changed, really.

When I stopped using cotton tips, my airpods got disgusting after every use.

Yeah, makes sense. I don't use those things so it's not an issue for me.

Friendly reminder that the #1 reason for impacted ear wax is people sticking their fingers in there.

Ear canal skin grows outwards. If you never stick your finger in your ear, eventually everything will work it's way out.

The people spending time and money jamming stuff in their ears are like the women who used to wash out their hoo-ha's in the 50's

Earbuds/in-ear monitors are another one, and earplugs for people working in loud environments.

I disagree. It is a genetic problem; some people have problems with it and some people don't. Importantly, Asians have different ear wax than those of other races.

I was born with small ear canals and have particularly sticky ear wax. My father has it, and so does my daughter. We've all found different solutions.

Reply on news.ycombinator.com