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07th December 2017

Hello…..Did You Say Something?

 

Hello? Did you say something? This is something my wife is now used to hear me saying at least once or twice a year. And it’s all down to the fact that I have long suffered with ear wax problems. For me personally, it must be the worst thing I suffer from and it can have such a debilitating effect on my mood and general wellbeing until the problem is resolved. I know many of my patients also regularly suffer with the same problem of ear wax build up.

In my early years, I used to get quite embarrassed by the problem, with aunts and uncles telling me that I didn’t clean my ears regularly, so that’s why I got the problem. “Clean it with what?” I’d reply! “Cotton buds!  What else?” They would say.

It wasn’t until many years later that I realised that cotton buds are not recommended to be used when one is suffering from ear wax as it can just exacerbate the problem. In fact, there is a general saying that you shouldn't use anything smaller than your elbow to clean your ears!

Our ears are generally complex organs that are often ignored and taken for granted until something goes wrong with them. Unlike for eyes, there is no national recommendation regarding regular hearing tests. Problems with our ears are often and most commonly detected by loss of hearing, balance problems or pain.

The ear has three main parts:

Outer ear: This is the part that can be seen. It contains the ear canal, which is approximately 2.5cm long and runs from the outer ear to the eardrum and the middle ear. Earwax is secreted in this canal. Sound waves cause the eardrum to vibrate.

Middle ear: This is an air-filled space behind the eardrum that contains tiny bones that move with vibrations.

Inner ear: This contains the cochlea which transforms the sound waves into electrical impulses. It also contains the vestibule which has passages that contain fluid and help keep the body’s balance.

Earwax

This is by far the most common problem associated with ears that people self-refer themselves to the pharmacy for. Earwax is a natural substance that is produced inside your ears to keep them clean and free of germs. It usually passes out of the ears harmlessly, but sometimes too much can build up, become impacted and block the ears. Some people regularly get blocked ears because they naturally produce a lot of earwax. Other factors that can increase the risk of too much earwax include:

  • Producing naturally hard or dry earwax
  • Having narrow or hairy ear canals (the tube between the opening of the ear and the eardrum)
  • Being elderly, as earwax becomes drier with age
  • Bony growths in the outer part of the ear canal

Earwax can also block your ear if you frequently insert objects into your ear canal, such as cotton buds, earplugs or hearing aids.

A build-up of earwax in your ear can cause:

These problems will usually improve once the excess earwax has been removed.

Don't try to remove a build-up of earwax yourself with your fingers, a cotton bud or any other object. This can damage your ear and push the wax further down.

Treatment Of Earwax

If the earwax is only causing minor problems there are several different types of eardrops you can buy from the pharmacy, including drops containing sodium bicarbonate, olive oil or almond oil. Ear drops are often sufficient to treat the problem. With regular use, the wax should dissolve or fall out after about a week. Sometimes it is possible that the earwax build up is so significant that initially, the wax may need to be softened for a period of about 5 days, before a trip to the GP/Nurse for an ear irrigation treatment (flushing out the wax with water).

However, eardrops aren't suitable for everyone and some can irritate the skin. For example, eardrops shouldn't be used if you have a perforated eardrum (a hole or tear in your eardrum).

Speak to your pharmacist or GP about the most suitable product for you and make sure you read the leaflet that comes with it.

So, what does this all mean for your service user in a care setting? If you notice that a service user is not responding to you like before or like me, keeps asking you to repeat things you said, it might just be that they have a recent build-up of earwax. A conversation with your pharmacist or the service user's GP/practice nurse will help to identify if it is just earwax or whether a further investigation is required.

Right! I better dash! I can hear my wife calling me to help her with something. No excuses now that I have had my earwax cleared!

*All information is correct at the time of publishing

Topics: General

Hasnain Hassam

Pharmaceutical Specialist

Hasnain Hassam is a qualified pharmacist with over 23 years’ experience. He comes to QCS from a long career at The Boots Company, where he’s worked since he qualified. During his time at The Boots Company he has held several senior management roles including Area Pharmacy Manager, Healthcare Development Manager, and most recently Regional Care Services Pharmacist. Read more

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