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Managing ear wax

Photo: Ear wax can cause problems for children who wear hearing aids, especially if they have small ear canals.

Ear wax is a natural substance which keeps our ears clean. It protects the delicate skin of the ear canal, contains antibacterial agents that help prevent infection, and catches dirt and dust. The colour and consistency of wax varies greatly between people – from thin and yellow to thick and dark red. Some people make loads of wax and others make hardly any.

Ear wax is produced in the outer area of the ear canal. It travels out of the ear, moving dust and debris away from the eardrum. If you regularly seeing wax coming out of your child’s ears, this is a good sign because it means it’s moving out of the ear as it should. Simply wipe it away with the corner of a flannel or similar.

When ear wax is a problem

For most people, ear wax isn't a problem and should be left alone. Wax only causes a problem if it’s pushed down inside the ear, as this can block the ear canal. You should never try to remove wax yourself, because putting anything into the ear (such as cotton buds, hair grips, paper clips or Hopi ear candles) will push the wax deeper, risking hearing loss and injury.

Wax and hearing aids

Children who use hearing aids sometimes have a problem with wax build-up in their ears. This is because wearing earmoulds all day prevents wax from leaving the ear as it would normally. A build-up of wax next to the ear mould means the child won’t hear as well and can cause the hearing aid to feedback, causing an annoying whistling noise. It also makes it impossible for audiologists to take good impressions for new earmoulds, or for GPs, audiologists or ENT doctors to have a good look at a child’s eardrums and take an accurate hearing test. The problem is often worse for very young children and those with very small ear canals.

If your child has a build-up of ear wax which needs to be removed, your audiologist may be able to do this for you. If not, they'll ask you to see your ENT doctor or GP to have this done.

Wax removal for children

There are three main ways to remove wax from the ears. The method used will depend on the age and development of the child, as well as the equipment available and skills of the professional you see.

Syringing

Syringing is a method of removing ear wax by pumping water into the ear. It can be carried out on children as long as the child has no previous history of perforated eardrum (hole in the eardrum), ear infections, grommets or ear surgery. It is not suitable for very young children.

Microsuction

Microsuction uses a tiny hoover to suck the wax out of the ear. This is usually the easiest and safest method. Microsuction involves lying still on a couch and having the wax ‘hoovered’ out the ear with a tiny sucker. It's very noisy and can be a scary experience for children who've had their hearing aids taken out and can’t be reassured verbally, so it’s important to explain it fully to the child beforehand. Microsuction shouldn’t be uncomfortable or painful.

Manual removal with a probe

Your doctor may choose to pick ear wax out with a probe if the other methods are not possible. This should only be done by a medical professional.

Using ear drops

Your audiologist or ENT doctor may recommend using ear drops for a couple of weeks before appointments to soften any wax build-up, to make it easier to remove. This might make the procedure quicker and less uncomfortable for your child. In some cases, the ear drops might completely remove the wax.

There’s no evidence that one type of drop works better than another, but medicinal olive oil ear drops are very gentle and safe for all ages. Ear drops should be applied at night, after your child has removed their hearing aid for the day. This is usually easiest to do with them lying down on their side. Warm the drops in the palm of your hand for a couple of minutes, then apply to alternate sides each night, putting the drops into the ear facing up. Ear drops shouldn’t hurt, but they can cause a feeling of pressure which young children might find uncomfortable. This is because they can cause the wax to expand as it softens.

Never use any ear drops if your child has a perforated eardrum (hole in the eardrum) or has grommets in their ears without advice from an ENT doctor.