Wax is produced by specialised glands in the outer part of the ear canal. Although much maligned it is an important part of the defence of the ear against infection of the ear canal (otitis externa). Wax is best left alone and it is important not to use cotton buds in the ear which can result in pushing the wax further in the ear canal where it can become trapped.
Occasionally wax can become a problem causing hearing loss if the wax is against the ear drum or completely blocking the ear canal.
Wax softening drops can help loosen the wax and allow it to come out naturally. No one type of drop has been shown to be superior to others. If this is not successful then referral to the ENT department is recommended where we can remove the wax either by using a small suction device with the use of a microscope or with small instruments to remove the wax. In young children they may find this difficult and in some cases if it is causing significant issues a brief anaesthetic may be necessrary to allow the wax to be removed.
Some children are especially prone to issues with wax such as those wearing hearing aids, children with very narrow ear canals or those who have previous surgery to the ear.
If wax is an issue then it is best to avoid in the ear headphones and to avoid putting anything in the ears. Regular use of wax softening drops (once a week) has been shown to be helpful if preventing issues in those who have frequent difficulties.
Wax absorbs liquid and expands and in some people where the wax is almost completely blocking the ear canal when the ear gets wet or they use drops, the wax expands and completely blocks the ear causing hearing to worsen.