Cerumen (Earwax) - Definition, Structure, Benefits, Natural Cleaning

Natural Ear Secretion

 

Where is earwax produced?

Cerumen or earwax, which is a protective oily secretion is produced in the external ear. This secretion is regularly disposed from the inside out. Normally, dust, particles, foreign bodies, microorganisms coming from the external environment adhering to the external ear canal are ejected by this regular self-cleaning request.

Here are some synonyms for "cerumen (earwax)":

• Ear secretion
• Earwax
• Auditory wax
• Ear discharge
• Ear canal wax
• Timpanic wax
• Otic wax

What are the benefits and tasks of earwax?

"Earwax" is a useful antiseptic secretion. The production and structure of this epidemic (such as dry earwax and oil ear wax) can vary depending on the genetic characteristics and whether the skin is oily or not. Ingredients contained in the earwax prevent virus, bacteria and fungal growth. It also has alcohol-like content that insects don't like at the same time.

I've added a video about this topic below:

The structure of the earwax can vary according to genetic characteristics and age!





Ears that are not in Asia and Asia produce different ear secretion according to scientists at Monell Institute in Philadelphia. Chromosome 16 is home to a "wet" or "dry" gene for the wax - the wet wax variant is dominant.

A minor change in the ABCC11 gene is related to both dry type earwax and the axillary body odor seen in Chinese, Japanese and Korean individuals.

The American study measured the concentration of 12 volatile organic compounds found in the earwax in Eastern Asian and white male groups, with 11 of the 12 compounds presenting the Caucasus ear with larger amounts of scented compounds.

Can smell of earwax provide information about the any disease or ethnicity!

Recently, researchers have begun to study whether the smell of earwax can eventually be used to detect the disease in our body. In a rare genetic disorder known as maple syrup urine disease, it has been investigated whether or not a simple diagnosis can be made with earwax examination. (source link >> Earwax Odor Can Offer Information About Disease, Ethnicity)

In the photo above, a ring-shaped, normal protective earwax layer seen in the external auditory canal is seen in a pediatric patient.

This study, conducted by researchers at the Monell Chemical Senses Center in Philadelphia, explored how health information could be derived from the ears. Research has shown that a gene called ABCC11 that tends to smell under the seat of a person is also related to the color and texture of the earwax. A variant of ABCC11, normally found in people of East Asian origin, causes dry, white earwax and less body odor; Another variant of the gene, usually found in people of African and European origin, causes earwax, which tends to cause age and yellow-brown color and more body odor (source link >> Secretion secrets: things you didn’t know about ear wax).

In studies that associate body odor with the disease, ABCC11 has constituted the link between the two. For example, a 2009 study published in The FASEB Journal found that the variant of the fragrant armpit and the wet ear occlusion gene was associated with an increased risk of breast cancer. It was emphasized that the type of earwax may be associated with a gene that causes bad smells under the armpit. In early diagnosis and treatment of breast cancer, life-saving clues may have been highlighted (source link >> Association between breast cancer risk and the wild-type allele of ...).

Researchers at the Monell Institute said "smells in the smell of ear can tell us what a person eats and where they eat." have made the statement. It has been emphasized that "earwax, as a source of information, its potential is a neglected body secretion" (source link >> Earwax - Monell Chemical Senses Center).

I've added a video on youtube to the topic below:

The cells in the ear canal are unique in the human body!

The cells in the ear canal are unique in the human body - hücr they migrate. A few ink drop can be ejected into the eardrum and can be traced within a few weeks, and the progress of the ink can be seen by the movement of the cells. Without such a thing, the small area of the ear canal would soon be filled with dead cells created by the natural process of shedding the skin. This movement also allows the candle produced by the modified sweat glands that change the ear canal to be pushed outwards. The normal movements of the jaw are thought to be helpful in this movement through eating and speaking.

How should we clean our ears?

Normally, you can use a simple and practical method to accelerate the removal of dirt in our ears. If your eardrum is healthy and normal, you can transfer warm water (no shampoo, soap, detergent residue, cold or warm) to the external ear canal. Transfer the water slowly to the outer ear path before leaving, and then flip your head over the towel. Get out. You can do the same on the other ear. If you want the moisture in the ear canal, you can keep the hair dryer in the low setting for 1-2 minutes in the external ear canal. In the meantime, if you pull the earplate backwards and upwards, the outer ear canal is fully opened. This way you can dry both ears. So there's no need to use a cotton swab!

How do ENT specialists clean or remove earwax?

Ear wax accumulates and can cause hearing loss when it blocks the external ear canal (impacted earwax). Regular swabs from earpads can accelerate the accumulation of earwax. It causes the aqueous part in the cerumen to be absorbed and the oily part is dried and pushed towards the eardrum in the outer auditory canal.

Aspiration of earwax by endoscopy or microscope under microscope is the most recommended application. Ear cleaning in the form of ear cleaning, to damage the eardrum and the bottom of the membrane hole if there is a risk of serious infection and middle ear trauma.

Below you can watch the video of endoscopic earwax aspiration:

What Is Earwax (Cerumen) and How Does It Form?

Earwax, or cerumen (its medical term), is a physiological secretion naturally found in the external ear canal. Although often perceived by the public as an unnecessary or dirty substance, cerumen is a normal component of a healthy external ear canal. It is formed by the combination of secretions from ceruminous and sebaceous glands located primarily in the cartilaginous section of the ear canal and shed skin cells. As this mixture moves along the ear canal, hair, small skin fragments, and environmental particles may also become incorporated into it.

The primary purpose of cerumen production is not to "dirty" the ear, but to maintain the skin integrity and protective functions of the external ear canal. Therefore, it is normal for a healthy individual to have some amount of earwax in the ear canal. Not every instance of cerumen requires removal; specifically, cerumen that causes no symptoms and does not obstruct the examination of the eardrum generally does not need to be actively removed.

What Is the Composition of Earwax?

Cerumen is not composed of a single substance. Its composition includes sebum (secretions from oil glands), secretions from modified apocrine glands, and shed squamous epithelial cells. Consequently, the consistency of earwax can vary from person to person; some individuals may have softer, oilier cerumen, while others have drier, harder wax.

As cerumen moves outward through the ear canal, it can mix with shed skin cells, hair, and environmental particles. This characteristic allows cerumen to form a protective barrier that prevents small particles in the outer ear canal from migrating into deeper regions.

Therefore, earwax should not be viewed merely as "accumulated skin debris." Cerumen is a biological material that protects the skin surface of the outer ear canal and acts as a barrier against environmental factors.

What Are the Benefits of Earwax?

Cerumen (earwax) serves several important functions regarding the external ear canal. Chief among these are protection, lubrication, and natural cleansing. Cerumen helps prevent the skin of the external ear canal from becoming excessively dry and contributes to maintaining the integrity of the skin surface exposed to the external environment.

Cerumen also plays a protective role regarding the microbial environment of the external ear canal. Scientific literature indicates that, in addition to its bactericidal properties, cerumen contributes to the ear canal's natural defense mechanisms. Therefore, an external ear canal that is completely dry and devoid of cerumen does not necessarily equate to a healthier one.

Furthermore, cerumen is part of the mechanism that protects the skin of the external ear canal against minor trauma and foreign particles. Thus, the answer to the question "Why is earwax beneficial?" is that cerumen is an integral part of the ear's natural defense, lubrication, and cleansing system.

How Does Earwax Clear the Ear? The Natural Ear-Cleansing Mechanism

One of the most notable features of a healthy external ear canal is its self-cleansing mechanism. Epithelial cells in the skin of the external ear canal migrate slowly from the area near the eardrum toward the canal's opening. During this movement, earwax (cerumen) is also transported outward. Jaw movements and the natural mechanical actions of the ear canal can contribute to this process.

Therefore, under normal circumstances, there is no need to clean the deep part of the ear with a cotton swab. The body's own mechanism gradually moves earwax and shed epithelial cells to the outer part of the ear canal. Once the earwax reaches the outside, it can be removed during a shower or while gently cleaning the outer ear.

If this mechanism is disrupted or the outward movement of earwax is obstructed, earwax accumulation and cerumen impaction can occur.

Why Does Earwax Harden and Dry Out?

The consistency of earwax varies from person to person. While cerumen may be oily and soft in some individuals, it can be dry, hard, or flaky in others. The secretions, shed epithelial cells, and environmental particles contained within the cerumen can influence its appearance and consistency.

When the ear canal's natural self-cleaning mechanism slows down or the cerumen fails to move outward, the accumulated material can become denser and harder over time. In particular, the regular insertion of cotton swabs into the ear canal can cause the cerumen to be pushed deeper and become impacted, rather than being transported outward.

Therefore, the answer to the question "how is hard earwax removed?" is not simply to attempt more physical cleaning. First, the reasons behind the cerumen accumulation and the integrity of the eardrum must be assessed.

Should Cotton Swabs Be Used to Clean Earwax?

Although the use of cotton swabs is widespread, using them to clean the deeper parts of the ear canal is not advisable. Instead of facilitating the expulsion of cerumen (earwax), cotton swabs can push the material toward the eardrum in some individuals, potentially contributing to cerumen impaction.

Furthermore, the skin of the external ear canal is quite delicate. Repeated mechanical contact can lead to irritation, minor trauma, and infections of the external ear canal. Therefore, the fundamental approach to daily ear hygiene is to avoid inserting any objects deep into the ear canal and to allow the ear's natural self-cleaning mechanism to function.

Particular caution regarding self-cleaning of the ears is advised for individuals with a history of eardrum perforation, ear surgery, or other issues involving the external ear canal.

Does Earwax Cause Hearing Loss?

Normal amounts of cerumen generally do not impair hearing. However, when earwax significantly blocks the external auditory canal, it can lead to conductive hearing loss. Additionally, symptoms such as a sensation of fullness, buzzing or ringing, itching, and ear pain may occur.

It should be noted that cerumen accumulation can also affect the results of hearing tests. Dense cerumen can hinder the examination, particularly when assessment of the external auditory canal or the eardrum is required. Therefore, if earwax is observed in a patient with hearing loss, an otoscopic evaluation should be performed to determine whether the complaint is truly caused by the cerumen.

Does Earwax Cause Tinnitus and a Sensation of Fullness?

In some individuals, earwax (cerumen) that significantly blocks the ear canal can lead to complaints such as a sensation of fullness, reduced hearing, and tinnitus (ringing in the ears). However, earwax is not the cause in every patient experiencing tinnitus or hearing loss; these symptoms can also be associated with various other ear conditions.

Therefore, the presence of earwax should not automatically be assumed to be the cause of all ear-related complaints. If symptoms such as hearing loss, tinnitus, pain, or a sensation of fullness persist even after the earwax has been removed, other underlying causes must be investigated.

When Should Earwax Be Removed?

Not all earwax requires removal. Current clinical guidelines do not recommend the routine removal of earwax that is asymptomatic and does not interfere with necessary ear examinations. However, treatment may be required if the earwax causes hearing loss, a sensation of fullness, pain, itching, or other symptoms, or if it obstructs the visualization of the ear canal and eardrum.

This distinction is also important for SEO purposes, as a significant number of users search for the answer to the question, "Must earwax be removed if it is present?" Distinguishing between "normal cerumen" and "cerumen impaction" in the article will be beneficial for both medical accuracy and user experience.

What Is Earwax Blockage (Cerumen Impaction)?

Cerumen impaction does not simply refer to the presence of earwax in the ear canal. A clinically significant situation arises when accumulated cerumen causes symptoms in the patient or obstructs the necessary ear examination or hearing assessment. Therefore, complete occlusion of the ear canal is not a prerequisite.

Symptoms associated with cerumen impaction may include hearing loss, a sensation of fullness in the ear, tinnitus, itching, ear pain, discharge, and sometimes coughing. Cerumen can also obscure the view of the eardrum, potentially delaying the diagnosis of other ear conditions.

What Are the Methods for Removing Earwax?

Methods such as cerumen-softening drops, irrigation (for suitable patients), and manual or microscopic removal by a physician can be used to eliminate clinically problematic cerumen. The choice of method depends on the characteristics of the patient's ear canal, the condition of the eardrum, and the consistency of the cerumen.

Irrigation or the use of certain drops may not be appropriate, particularly when the integrity of the eardrum is compromised. Therefore, earwax removal should not be viewed as a simple, standardized procedure applicable to every patient. A physician's assessment is crucial for individuals who have previously undergone ear surgery, have a perforated eardrum, or suffer from external ear canal disorders.

The Relationship Between Earwax and External Ear Canal Infections

The healthy skin structure of the external ear canal, cerumen, and local environmental conditions work together to form a protective system. Cerumen contributes to lubricating and protecting the skin of the external ear canal. However, factors such as excessive moisture, trauma, frequent mechanical cleaning, and a breach in skin integrity can contribute to the development of external ear canal problems. Therefore, the goal of ear hygiene is not to render the external ear canal constantly “sterile.” Instead, the aim is to remove accumulated cerumen (earwax) using appropriate methods when necessary, without disrupting the ear canal's natural defense mechanisms.

What Does Earwax Color Indicate?

The color of earwax can vary from person to person and change over time within the same individual. Cerumen may appear light yellow, yellow-brown, brown, or darker. Factors such as how long the cerumen has remained in the ear canal, its dryness, and the cellular or environmental materials it contains can influence its appearance.

Consequently, a dark earwax color does not, in itself, signify an ear disorder. However, if the earwax is accompanied by discharge, bleeding, a foul odor, significant pain, or the sudden onset of hearing loss, the situation should not be dismissed as merely “normal earwax”.

Why Does Earwax Accumulate More in Some People?

Cerumen (earwax) accumulation varies from person to person. Factors influencing this accumulation include the anatomical structure of the external ear canal, the characteristics of the cerumen, the natural mechanism of epithelial migration, and mechanical interventions in the ear canal.

Cerumen accumulation can become clinically significant, particularly for hearing aid users. Hearing aids can interfere with the natural outward movement of cerumen from the ear canal, and accumulated wax can impair the device's function. Therefore, regular assessment of the ear canal and cerumen status may be necessary for patients who use hearing aids.

Common Misconceptions About Earwax

“Earwax must be completely removed”

No. Normal cerumen that does not cause symptoms or obstruct ear examinations does not necessarily need to be removed.

“Earwax is just a dirty substance”

No. Cerumen plays a role in lubricating and protecting the external ear canal and is part of the natural self-cleaning mechanism.

“Cotton swabs clean the inside of the ear”

Instead of helping to remove cerumen, cotton swabs can sometimes push it deeper into the ear canal.

“The presence of earwax always indicates hearing loss.”

No. While cerumen can cause hearing loss, a normal amount of cerumen in the ear canal does not imply hearing loss.

“Dark-colored earwax is a sign of disease”

A change in color alone does not indicate disease. Additional symptoms such as odor, discharge, bleeding, pain, or hearing loss should be evaluated. 

Earwax and Natural Ear Hygiene: How Should the Ear Be Cleaned?

In a healthy ear, the primary goal of daily care is not to clean deep within the ear canal, but to gently keep the outer ear (pinna) and the ear opening clean. Under normal conditions, the natural epithelial migration and cerumen (earwax) mechanism of the ear canal facilitate self-cleaning.

If there are complaints such as accumulation in the ear canal, hearing loss, or a sensation of fullness, it is safer to undergo an ear examination rather than attempting to clean the ear by inserting cotton swabs, pens, hairpins, or other objects. Methods such as at-home irrigation should be avoided, particularly if the condition of the eardrum is uncertain.

What does a cotton swab stick do?

Cotton swab cleaning rods are produced for the cleaning of curved areas of the auricle. As a little writing on the boxes, do not "insert into the outer auditory canal!" or a similar statement. It is not appropriate to insert the ear cleaning rods into the outer ear canal.

Damages of ear cleaning sticks (ear picks, ear scoops or ear spoons)

 



The ear cleaning sticks can cause the following problems when they are routinely inserted into the external ear canal:

• Removal of the protective barrier layer in the external ear canal and predisposition to external ear canal infections (fungal and bacterial infections, swimmer's ear ...)
• Absorbing the aqueous part of the earwax and depositing the solid part of the earwax into the earwax and depositing the dirt on the eardrum.
• Eardrum trauma. Occasionally, direct trauma to the eardrum can result in membrane perforation, ossicular injury, and permanent hearing loss. There are patients who forget the cotton swab in his ear and hit the phone or put his head on the pillow with a cotton swab. In the above and below photo, it is seen that there is a localized bleeding area after the cotton swab contact. In this way, as the ear ossicles and the inner ear are trauma, nerve death may also occur in the inner ear at the same time.







Excessive cleanness of the external ear canal is not healthy!

The outer ear canal, as seen in the photo below, is immaculate, unstained, although in fact many people normally want it to be; The absence of a protective ring-shaped layer of dirt in our external ear can cause bacteria, viruses and fungi to easily infect the skin of the external ear canal.

If you are planning to enter the pool, your ears have to be dirty ... Due to the effect of chlorine in the pool water and the prolonged contact with the water, the swimmer's ear can become much easier to develop.

Search result link where you can find articles prepared by Dr. Murat Enöz about "Earwax" and published on this website (you can also reach previous articles by clicking "more posts" at the end of the page) >> https://www.ent-istanbul.com/search?q=earwax

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:

Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52

E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199

Fax: +90 212 542 74 47