Ear wax in kids is a common occurrence. Ear wax, also known as cerumen, is a normal secretion and a part of the ears’ self-cleaning mechanism. It usually gets expelled from the ear through the jaw’s motions, such as chewing or talking. Nonetheless, if the wax gets clogged in the ear and causes build-up, it might eventually impair hearing abilities. This is known as impacted ear wax, and the process of this build-up is known as impaction. In case of a build-up, the child might complain of discomfort. The wax can be wiped off using a cloth or in a clinic. Read about the importance of ear wax, symptoms of its impaction, risk factors, treatments, and home measures to remove ear wax in children.

Why Do Ears Make Wax?

Ear wax (cerumen) is produced by the ear for cleaning and protecting itself (1). It is a thinly coated sticky, waterproof, and protective layer near the external opening of the ear canals. It comprises dead skin cells and hair along with the following three components (2) (3).

Keratin: It is the predominant component of cerumen and acts as a protective barrier.

Sweat: It is secreted by the modified sweat glands (ceruminous glands). These glands secrete a modified sweat that has bactericidal and fungicidal properties.

Sebum: It is the oil produced by the sebaceous glands. The oil compromises fat molecules (lipids), which keep the ear canal lubricated.

Together, these three components of ear wax protect the ear canals from physical damage and microbial invasion. Along with the hair outside the ear canals, ear wax traps dust and other foreign particles that can damage ear structures, such as the eardrums. 

What Are The Symptoms Of Ear Wax Build-up?

Ear wax build-up or impacted cerumen usually does not cause any discomfort and comes out on its own (4). However, in some cases, excess ear wax may cause ear canal blockage, mild hearing impairment, and various other ear-related symptoms, including (3):

Ringing in the ear (tinnitus)

Earache or pain in the ear (otalgia)

Dizziness (vertigo)

Irritation in the ear

Foul smell from the ear canal

Ear discharge

Itchiness in the ear

A sensation of fullness in the ear

What Are The Risk Factors For Ear Wax Build-up In Children?

Ear wax build-up or impacted cerumen can occur in any individual, regardless of age, gender, or clinical status. However, in a healthy population, it has been estimated that ear wax build-up is more common in the pediatric population (1 in 10 children) than in adults (1 in 20 adults). The frequent incorrect use of cotton swabs or insertion of other items in the ear to clean it is the most common cause of impacted ear wax. Ear swabs and other items push the wax deeper, causing it to become impacted. Cotton swabs must never be used for children (5). Dr. Rachel Dawkins, MD, Medical Director and Director of clinical experiences for physicians in training at Johns Hopkins All Children’s Hospital, says the following about cleaning a child’s ear with cotton swabs, “First I would say, don’t. If you feel the need to clean ears use the corner of a washcloth.” Besides cotton swabs, the following factors may also increase the child’s risk of developing ear wax build-up (3).

Use of earplugs, earbuds, and hearing aids

Children with developmental delay

Certain skin diseases, such as eczema

Anatomical changes in the ear, such as stenosis (narrowing) or osteoma (benign bony growths in the external ear canals)

Failed keratinocyte separation in the external ear canals as part of skin turnover

Overgrowth of hair in the ear canals

When To See A Doctor?

You should consult a doctor if your child experiences the following conditions.

Ear discharge

Continuous pulling and tugging of the ear

Impaired hearing

Dizziness and ringing in the ear

Earache

A doctor will check for the possible reasons for ear wax build-up, including the presence of underlying health conditions, causing excess ear wax formation, or its poor movement.

What Is The Treatment For Ear Wax Build-up?

The treatment will depend on the underlying cause of ear wax build-up and the extent of ear wax impaction. You may be referred to an otorhinolaryngologist (ENT specialist) specializing in ear wax removal. The doctor may consider any of the following treatments to remove excess ear wax (6).

How To Remove Ear Wax At Home?

If your child is younger than six years, you must see a doctor for any ear wax build-up. You may consider the following home remedies for children older than six years (7). Avoid pouring oils or glycerine in your child’s ear since it may affect the ear drum or may cause irritation. Never try ear candling since it could increase the risk of burns (9). If your child has no relief from ear wax build-up for four days, consult a doctor for treatment.

References:

Avoid cleaning your children’s ears with cotton swabs or buds Don’t use hairpins or toothpicks to clean the ears, as they may scratch the ear canal, leading to infection Don’t use ear candles to clean the ears Limit the use of earplugs If your child complains of ear fullness or pain, contact a doctor