Intended for healthcare professionals

Rapid response to:

Primary Care 10-minute consultation

Removal of ear wax

BMJ 2002; 325 doi: (Published 06 July 2002) Cite this as: BMJ 2002;325:27

Rapid Response:

It was probably in my late thirties that I first noticed pain in one of my ears.

I assumed that it was probably one of those symptoms which would subside within a few days without treatment, but it persisted, and became gradually worse until it was intolerable.

I also considered the possibility that if I didn’t do something about it that it may lead to ear damage and deafness, so I consulted a doctor.

He examined my ear with an otoscope and said that he could see that a lump of ear wax was blocking the ear canal and that he would try to remove it.

He then placed a towel on my shoulder and filled a small kidney bowl with warm water and placed it close to my neck and under my ear.

He then filled an ear syringe with some of the water and put it’s tip into the opening of my ear and then began pushing the plunger to gently force the water into the outer auditory canal, and then withdrew the plunger to suck the water out again.

As he did that repeatedly I could hear the swishing and swirling sound of the water gushing in and out very clearly but it didn’t relieve the pain.

However he was able to extract some small pieces of ear wax which he emptied into the kidney bowl.

He then filled the syringe with clean water and repeated the process about six times.

During that procedure he told me that if he couldn’t remove the wax blockage he would give me some ear drops to use to gradually dissolve the wax and that I could return to have it removed later.

He was about to give up and provide me with the ear drops when he tried one more time and a few moments later I felt an immediate relief of the pain.

He said that the wax lump had came out into the syringe and had been ejected into the kidney bowl, and then he showed it to me.

It was an uneven shape perhaps three or more millimetres in total circumference.

He then syringed my ear again several times to clear out any other loose wax debris until the water was clear.

I asked him what caused the problem and he said he didn’t know.

I suppose another ten years went by when I began to feel a sense of pressure in one of my ears, and as the weeks went by it became more and more noticeable, and somewhat uncomfortable and annoying, so I began to drag on my ear lobe in an attempt to open my ear canal wider and clear it, and it was sometimes effective.

However I eventually experienced a reduction in my hearing from that ear, and I noticed that if someone was talking to me from one side I could hear them clearly, but if they were on the other side my hearing was muffled.

That problem persisted and was no longer responding to my attempts to clear the ear canal, so I consulted a doctor again.

He inspected my ear with an otoscope and said that the outer ear canal was blocked, so he arranged for a nurse to remove it by the same method which had been used a decade earlier.

The same process of gently plunging warm water into and out of my ear canal was applied and reapplied until I noticed an immediate ability to hear clearly again, and the nurse said that she had just ejected a lump of wax into the kidney bowl to show me.

She also re-syringed the ear several times to clear any remaining debris, and applied the same method to the other ear, but only small amounts of wax were found.

When I asked her if she knew the cause she said she didn’t, so I became curious about why it should affect me and not other individuals, and whether or not it would happen again.

I was told that it was a common problem of unknown cause.

Several more years went by when I had the same problem of discomfort and muffled hearing, and went through the process of having the wax extracted again, so, although it wasn’t a serious problem, I became even more curious about the cause for the purpose of developing a way of preventing a recurrence.

One day I had just had a shower, and a few minutes later felt some mild discomfort in my ear so I placed my small finger tip against the outer indentation of the ear canal and noticed that it was occupied by a quantity of water of perhaps two or three drops, and because of it’s location I could hear the squishing sound as I gently pressed on it.

I then considered the possibility that the soap or hair shampoo which I had been using previously while showering may have been getting into my ear, and staying there, instead of running outwards, and that the soap was dissolving very small amounts of wax each time, so that it drained through the ear canal to became deposited as an accumulating lump.

I then compared it to the way in which small amounts of water drain from the top of lime stone caves to gradually form stalactites or stalagmites over a period of years, decades, or centuries.

By comparison, the amount of wax being dissolved by three drops of soapy water during two showers a day, or 730 times a year, for several years, may be what causes the gradual build up of a wax lump in the ear until it was large enough to cause the blockage.

I don’t know if it will make any difference, but I now minimise the exposure of my ears to soapy water when having a shower, and check them after each shower, and if there is any moisture present I gently remove it by softly touching the area with a towel to absorb it.

I consider it to be worth trying because it is easy, and won’t do any harm, and might solve the problem.

Competing interests: No competing interests

31 August 2014
Max Allan Banfield
Unit 6, No.6 Hartman Ave., Modbury, South Australia 5092