Wax in the Outer Ear Passage
Otitus Externa
Otitis externa has many different names
depending on the stage of the disease. Some call it swimmer's ear.
Others refer to a "fungus" in their ears. The most closely related
condition anywhere else in the body is eczema.
This condition usually starts when the natural wax barrier in the ear is
damaged. Wax is a substance produced by the skin in the outer passage of
the ear which protects the ear from moisture and bacteria. It is not a
waste product. Sooner or later, all artificial attempts to remove wax
damage the protection of the outer passage of the ear. This is why
we are so opposed to using cotton-tipped applicators, hair pins, and
other instruments as part of personal hygiene. The wax is formed
within the ear and slides out the ear where the movement of the jaw
joint crumbles the dried wax and allows it to flake out. Beyond the
unsightly wax which appears at the very edge of the ear passage and
which can be easily reached with a damp face cloth gently twirled on the
finger, there is usually no visible wax in the rest of the ear passage.
The two major enemies of the waxy defense system in
the outer ear passage are water and mechanical scratching or rubbing.
Once the wax defenses are broken, certain bacteria begin to invade and
create an alkaline environment which makes the ear weep and become
itchy. Usually, this results in more scratching.
The first symptom of this condition is excess wax formation. This is a
natural attempt by the ear to protect itself. Sooner or later, the wax
glands become exhausted and the ear is super clean. It also itches. The
irresistible urge to rub the ear now sets the ear up to be invaded by
bacteria and it becomes moist and swollen. Finally, the repeated cycles
of infection make the ear passage scar down and close.
The best way to avoid this disorder and the simplest
way to reverse it once it begins is by avoiding anything that wets the
ear or touches or rubs the inside of the ear. Wax should be
removed only from the outermost edge of the ear passage. Cotton-tipped
applicators will only push wax further down into the ear passage where
it will accumulate and overload the transportation mechanism. Swimmers
need only be sure that their ears are perfectly dry before retiring at
night. Ear plugs are not usually necessary and may even be
undesirable. They push the wax further down inside the ear while at the
same time providing a surface for the constantly moving ear passage to
rub against. The best way to assure that the ear is dry is to use
some form of drying drop which usually consists of some sort of mildly
acetic substance. (Equal parts of rubbing alcohol and white vinegar can
do as a drying drop in a pinch.) A hair dryer works well in drying the
ear. Occasionally, oral antibiotics are required to control an
acute flare-up. We like to avoid the use of any drops which are
available on the market for dissolving ear wax since our experience has
been that these drops have difficulty telling where the wax stops and
your healthy ear passage begins.
If you find that you have a very hard wax, then a scheduled visit to the
doctor is in order. Hydrogen peroxide is too watery to use more than
rarely and should be used with specific doctor's instructions. It is
helpful to use a few drops of mineral oil or baby oil at bedtime the
night before the visit.