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Ohio Head & Neck Surgeons provide answers to the most frequently asked questions and best care practices for ear, nose, and throat (ENT) diseases and disorders, allergy, hearing loss, and cosmetic treatments.

Earwax & Effects On Hearing

Over 34 million Americans are affected by some degree of hearing loss. There are many risk factors, including aging, loud noise exposure, heredity, and some medications (such as chemotherapy or large doses of aspirin). Untreated hearing loss has been associated with social withdrawal, increased social anxiety, and depression. The best way to determine if you have hearing loss is to get tested by a licensed audiologist.

All About Earwax

Earwax, also known as cerumen, is a waxy substance secreted in our ear canals that varies in color from yellow to brown. Its purpose is to protect the skin of the ear canal, assist in cleaning and lubrication, and provide some protection from bacteria, fungi, insects, and water.

Production, Composition and Types

Cerumen is produced in the outer third of the cartilaginous portion of the ear canal. It is a mixture of viscous (sticky) secretions from sebaceous glands and less-viscous ones from sweat glands. The primary components of earwax are shed layers of skin with 60% of the earwax consisting of keratin, (the fibrous, insoluble protein that is the main element of our hair and nails), about 20% of saturated and unsaturated fatty acids, and about 10% of cholesterol.

There are two distinct genetically determined types of earwax: the wet type, which is dominant, and the dry type, which is recessive. Caucasians and Africans are more likely to have the wet type (honey-brown to dark brown and moist), whereas East Asians and Native Americans are likely to have the dry type (grey and flakey).

Function of Earwax

Cleaning of the ear canal occurs by the “conveyer belt” process of epithelial migration, aided by jaw movement. Cells formed in the center of the tympanic membrane migrate outwards, at about the rate of fingernail growth, to the walls of the ear canal. As it migrates outward, it takes with it any dirt and dust that may have gathered in the canal. Jaw movement assists this process by dislodging debris attached to the walls of the ear canal to aid the migration outwards.

Lubrication prevents dehydration, itching, and burning of the skin within the ear canal. The lubrication properties come from the high lipid content of the sebum produced by the sebaceous glands.

Antibacterial and antifungal effects
Recent studies have found the cerumen has an effect on some strains of bacteria. It reduces the viability of a wide range of bacteria including Haemophilus influenza, Staphylococcus aureus, and many variants of Escherichis coli, sometimes by 99%. The growth of two fungi commonly present in otomycosis was also significantly inhibited by cerumen. These antimicrobial properties are due primarily to the presence of saturated fatty acids and the slight acidity of cerumen.


Excessive cerumen may block the passage of sound in the ear canal causing hearing loss. Softening the earwax with over-the-counter preparations will cause the earwax to more easily move out of the ear canal. The use of a syringe and warm water will help irrigate the ear canal after the cerumen has been softened. The most common method of cerumen removal by general practitioners is syringing with warm water. An ear, nose, and throat (ENT) specialist is more likely to use a curette or suction while viewing the cerumen under an operating microscope to precisely remove it. Cotton swabs, on the other hand, push most of the earwax further into the ear canal while only removing a small portion of the top layer of earwax that happens to adhere to the fibers of the swab.

Did you know?

  • Fear, stress and anxiety can result in increased production of earwax from the ceruminous glands.
  • Cerumen-type has been used by anthropologists to track human migratory patterns, such as those of the Inuit.
  • In medieval times, earwax was used as pigments by scribes to illustrate illuminated manuscripts.
  • Ear candling does not remove earwax, and is considered dangerous. The dark residue that is left after the procedure is not earwax, and is present whether or not the candle is inserted in the ear.
  • The TV show MythBusters showed that candles made of earwax can sustain a flame, but do not burn long or bright enough to be as practical as other candles.
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