Earwax is a naturally occuring substance which forms within the ear canal when layers of dead skin migrating out of the ear canal combine with the secretions of the sebaceous glands (oil-secreting glands associated with hair follicles) and secretions of the sweat glands.
Ear wax plays an important part in keeping the ear canal clean and healthy; it helps trap and carry debris out of the canal, inhibits bacterial and fungal growth, and helps maintain normal moisture levels.
Ear wax usually tumbles out of the ear canal when the jaw moves and the ear canal flexes, for example when talking or chewing. However, sometimes this self cleaning mechanism breaks down, leading to an accumulation of ear wax within the ear canal. Some people simply produce more wax than the ear can easily eject, whilst others may produce overly dry or overly sticky wax. Others may have a skin condition such as eczema or psoriasis, or excessive hair in the ear canal which contributes to the problem.
The insertion of hearing aids and ear plugs will also restrict the natural migration of the ear wax out of the ear canal. Attempts to clean the ear with a cotton bud or similar, is not recommended as this could push the ear wax deeper into the canal, cause wax impaction, and also harm the sensitive tissues of the ear, and potentially lead to permanent damage.
Excessive earwax within the ear canal can cause hearing loss and discomfort, and can contribute to infection, ringing or buzzing in the ears (tinnitus), and vertigo (feeling dizzy and sick). Excessive earwax can also prevent adequate clinical examination of the ear, delaying investigations and management; for example, GPs cannot check for infection and audiologists cannot test hearing or fit hearing aids, if the ear canal is blocked with wax.