Earwax, or cerumen, is a natural and beneficial substance produced by specialized glands in the outer ear canal. This waxy material is a mixture of fatty secretions and dead skin cells, which functions to clean, protect, and lubricate the ear canal. The acidic nature of cerumen provides an important defense against microbes, while its sticky texture traps dust and foreign particles before they can reach the eardrum. The ears are designed to be self-cleaning, using the natural movement of the jaw from talking and chewing to gradually move old wax outward, where it eventually dries and falls out. This natural process means that most children never require any intervention, but when the wax accumulates excessively or hardens, it can become impacted and cause problems. This impaction is the only reason to consider removal, as interfering with normal wax is unnecessary and potentially harmful.
Identifying When Removal is Necessary
Visible earwax at the opening of the ear is usually normal and a sign of the ear’s self-cleaning mechanism. Intervention becomes necessary only when the wax builds up to the point of causing symptoms, which is referred to as cerumen impaction. One of the most common signs is a complaint of muffled hearing or a noticeable decrease in auditory responsiveness. The child might also experience a persistent feeling of fullness or pressure in the affected ear.
Impaction can also cause physical discomfort, such as an earache or persistent itchiness inside the ear canal. In some cases, a child may experience ringing or buzzing sounds, known as tinnitus, or balance issues like dizziness. If the earwax is completely blocking the canal, it can trap water, which may lead to irritation or potentially an infection. Parents should monitor for these specific complaints or behaviors, such as a child tugging at their ear, to determine if the earwax is problematic.
Safe and Gentle Home Removal Methods
If a child is symptomatic and there is no suspicion of a perforated eardrum or existing ear infection, the safest first step is to soften the wax at home. This is done using cerumenolytic agents, which are solutions designed to loosen the hardened wax. Parents can use a few drops of mineral oil, baby oil, or glycerin, applied twice daily for up to five days. Another option is a homemade solution of hydrogen peroxide mixed with an equal amount of room temperature water.
To administer the drops, the child should lie on their side with the affected ear facing upward for several minutes so the liquid can penetrate the wax. The solution should be at body temperature to prevent dizziness, which can be triggered by cold fluid in the ear canal. After the softening period, a gentle, warm shower can encourage the loosened wax to drain out on its own. Any excess wax that drains from the ear should only be wiped away from the outer ear with a soft washcloth, without inserting anything into the canal.
Absolute Don’ts: Dangerous Practices to Avoid
The most important safety rule is to never insert anything smaller than an elbow into a child’s ear canal. This means strictly avoiding the use of cotton swabs, which are a frequent cause of impaction. Swabs do not remove wax effectively; instead, they push the cerumen deeper into the narrow ear canal, packing it against the eardrum and worsening the blockage. This action can also scratch the skin lining the canal, introducing bacteria and leading to infection.
Inserting any sharp or pointed object, such as hairpins, keys, or toothpicks, carries a risk of injury. These items can easily puncture the eardrum, which is a painful injury that can lead to infection and hearing loss. Ear candling, a practice that claims to use suction to draw out wax, is also strongly discouraged. This method is ineffective and poses a high risk of burns from hot wax or flame, or even causing a secondary blockage from the candle wax dripping into the canal.
When Professional Medical Help Is Required
Home treatment should be discontinued, and a medical professional consulted immediately if the child experiences severe ear pain, fever, or any discharge of pus or blood from the ear. These signs may indicate an underlying infection or a perforated eardrum, and introducing any drops or water could cause complications. Children with a history of ear tubes or a known eardrum perforation must also see a doctor before any at-home softening is attempted.
If home softening methods are unsuccessful after several days, or if the child has unmanageable pain or sudden hearing loss, professional intervention is necessary. Specialized techniques are used to remove the wax safely. These methods include professional low-pressure irrigation, which gently flushes out the softened wax, manual removal using small, curved instruments called curettes, and micro-suction, which involves using a tiny suction device and a microscope to visualize and gently remove the impacted wax.