How to remove impacted ear wax in child

Dealing With Earwax (for Parents)

Why Do Ears Make Wax?

Earwax is made in the outer ear canal, the area between the fleshy part of the ear on the outside of the head and the middle ear. The medical term for earwax is cerumen (seh-ROO-mun).

Earwax has some important jobs. It:

acts as a waterproof lining of the ear canal, protecting it and the eardrum from germs that can cause infection
traps dirt, dust, and other particles, keeping them from injuring or irritating the eardrum

The wax makes its way through the outer ear canal to the opening of the ear. Then it either falls out or comes out during bathing. In most people, the outer ear canal makes earwax all the time, so the canal always has enough wax in it.

Does Earwax Need to Be Removed?

Usually, there's no need to remove earwax because it comes out by itself. Sticking anything into a child's ears raises the risk of infection or damage to the ear canal or eardrum. Cotton swabs are handy for a variety of grooming needs, but should not be used to remove earwax. In most cases, regular bathing is enough to keep it at healthy levels.

While some people have more earwax than others, in general the ear makes as much wax as it needs. Rarely, kids' ears do make too much earwax. And sometimes earwax can build up and block the ear canal, especially when pushed in by a finger, cotton swab, or other object. This is called "impaction." If it affects hearing or causes pain or discomfort, a doctor can remove it.

Parents — and kids — shouldn't attempt to remove earwax at home, even with remedies that promise to be safe and effective. Doing so risks damage to the ear canal and, possibly, a child's hearing.

What Can Parents Do?

If your child complains of ear discomfort and you see earwax in the ear, it's OK to wipe the outside of the ear with a washcloth. But don't use a cotton swab, a finger, or anything else to poke inside the ear. It could damage the delicate ear canal and eardrum, or pack the wax in even further.

Check with your doctor before using an over-the-counter earwax removal treatment.

When Should I Call the Doctor?

Call the doctor if your child has:

ear pain, itchiness, or discomfort (like a blocked feeling in the ears)
hearing problems

In infants and toddlers, tugging at the ears can be sign of an ear problem.

Sometimes doctors will remove earwax:

if it's painful, itchy, or uncomfortable
if affects hearing
to get a better view of the eardrum to check for problems

Earwax removal usually is done in the doctor's office. There might be a little discomfort but it isn't painful. If a child can't sit still or cooperate, the doctor can remove it in an operating room while the child is under general anesthesia.

Doctors can remove earwax in different ways, including:

scooping it out, pulling it out, or suctioning it out with special instruments designed for this purpose
flushing it out with warm water. Sometimes a doctor will put drops into the ear canal to soften the wax and break it down. Or they might ask you to do this at home and then return to the doctor for wax removal.

Removal takes only a few minutes. If there's a sign of infection, the doctor may prescribe antibiotic ear drops.

What Else Should I Know?

Ear candling has gained a lot of attention as a home remedy for earwax removal. But it hasn't been proved to be safe or effective, and can be dangerous.

In ear candling, one end of a cone-type device is inserted into the ear canal and the other end is set on fire. The idea is that the fire and the cone form a vacuum and extract the wax. But trying this at home carries a high risk of:

burning the ear canal
punching a hole in the eardrum, which can cause permanent hearing damage

Whenever you have any concerns about your child's ears or hearing, call your doctor.

Earwax Buildup

Is this your child's symptom?

Earwax (cerumen) buildup or blockage
Questions about earwax removal

Symptoms of Earwax Buildup

Too much earwax can cause rubbing of the ear or poking in the canal.
A piece of ear wax can become dry and hard in the ear canal. This creates a feeling that an object is in the ear.
Complete blockage (plugging) of the ear canal by wax causes more symptoms. These include decreased or muffled hearing.
A large piece of earwax may be seen inside the ear canal.

Causes of Earwax Buildup

Cotton Swabs. Earwax buildup is usually from using cotton swabs. They push the wax back in and pack it down.
Fingers. A few children (perhaps 5&percnt;) normally produce more wax than others. It usually will come out if it's not pushed back by fingers.
Ear Plugs. Wearing ear plugs of any type can also push wax back.

Earwax is Normal

Everyone has earwax. Earwax is normal and healthy. Earwax is not dirty or a sign of poor hygiene.
Earwax is also called cerumen.
Earwax is made by special glands in the outer third of the ear canal.
Earwax has a purpose. It protects the skin lining the ear canal. It is a natural water-proofing agent.
Earwax also has germ-killing properties.
New earwax is soft and a golden-yellow color.
Older earwax becomes dryer and turns to a brown or black color.

Ear Canals are Self-Cleaning

Ear canals are designed to clean themselves.
The ear canal skin slowly moves out of the ear canal. It carries the earwax along with it. The wax dries up and becomes flaky. It falls out of the ear on its own.
There are some people who produce much more earwax than others. For such people periodic ear cleaning may be needed.
Earwax only needs to be removed from inside the ear if it causes symptoms. Examples of symptoms are decreased hearing, discomfort, fullness or blockage.

Problems from Using Cotton-Tipped Swabs

The cotton-tipped swab pushes the wax back in. The earwax builds up and causes symptoms.
Ear canal blockage
Decreased or muffled hearing.
Trapped water behind the wax (can lead to Swimmer's Ear).
Itchy or painful canals, especially in teens who often use Q-tips. A dry ear canal is always itchy.
Sometimes, bleeding or damage to the eardrum.
Cotton swabs cause more than 10,000 ear injuries each year in the US. More than 2,000 are punctured ear drums. Never allow young children to play with cotton swabs.

Prevention of Blocked Ear Canals

Never put cotton swabs (cotton buds or Q-tips) into the ear canal.
Cotton swabs just push the earwax deeper into the ear canal. Reason: Cotton swabs are usually wider than a child's ear canal.
Earwax doesn't need any help getting out. You can't hurry the process.
Never try to dig out pieces of earwax with toothpicks, match sticks or other devices. Usually, doing this just pushes the wax back in.
These objects can also scratch the ear canal and cause an infection.
If all of the ear wax is removed (as with cotton swabs), the ear canals become itchy. They also become more prone to swimmer's ear. This can occur in teens when cotton swabs are smaller than the ear canal.
Limit the use of ear plugs.

When to Call for Earwax Buildup

Call Doctor or Seek Care Now

Ear pain or bleeding after object (such as cotton swab) was inserted into ear canal
Ear pain after ear canal flushing to remove wax and it's severe
Walking is very unsteady
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Ear pain after ear canal flushing and it lasts more than 1 hour
Pus (yellow or green discharge) from the ear canal
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

History of ear drum perforation, tubes or ear surgery. Reason: don't remove wax at home.
Complete hearing loss in either ear
Age less than 6 years with earwax problems
Earwax problems not better after using Care Advice
You don't want to try to remove earwax at home
You have other questions or concerns

Self Care at Home

Questions about earwax removal

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

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Everett
Federal Way
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Care Advice for Earwax Buildup

What You Should Know About Earwax Buildup:
- Earwax is good.
- In general, leave earwax alone.
- It will come out and fall away on its own.
- If you see some wax right at the opening, you can flick it away. Use something that won't push it back in, such as a paper clip.
Reasons to Flush out the Ear Canal:
- Earwax is completely blocking an ear canal and can't hear on that side.
- If the hearing seems normal on that side, the blockage is only partial. You can leave it alone.
Age 6 Years and Older - Ear Canal Flushing with Water:
- Under age 6, use only if advised by your child's doctor.
- Buy a soft rubber ear syringe or bulb from the pharmacy. No prescription is needed.
- Have your child lean over the sink. Reason: To catch the water.
- Use lukewarm water (body temperature). Reason: To prevent dizziness.
- Gently squirt the water into the ear canal. Then tilt your child's head and let the water run out. You may need to do this several (3-4) times.
- If the earwax does not seem to be coming out, tilt the head. Then, flush it with the head tilted. Have the ear with the wax in it facing downward. Gravity will help the water wash it out (the waterfall effect).
- Endpoint: Flush until the water that comes out is clear of wax. Also, the ear canal should be open when you look in with a light.
- Afterwards dry the ear thoroughly. You can do this by putting a drop of rubbing alcohol in the ear canal. Or you can set a hair dryer on low. Hold it a foot away from the ear for 10 seconds.
Caution - Ear Canal Flushing:
- Do not perform flushing if your child has a hole in the eardrum or ear tubes.
- Stop flushing if it causes pain or dizziness.
- Do not use a water jet tooth cleaner (such as a WaterPik) for ear flushing. Reason: The force of the jet can cause pain.
Ear Drops - Use for 4 Days to Soften the Earwax:
- If the earwax is hard, soften it before flushing the ear canal. Use ear drops to break up the earwax.
- Homemade ear drops: 15&percnt; baking soda solution. Make it by adding ¼ teaspoon (1.25 mL) of baking soda to 2 teaspoons (10 mL) of water.
- Other option for homemade ear drops: hydrogen peroxide and water solution. Mix equal parts of each.
- Drug store option: Earwax removal ear drops (such as Debrox). No prescription is needed.
- Use 5 drops in affected ear, 2 times daily, for 4 days.
How to Put in Ear Drops:
- Lie on the side with blocked ear upward.
- Place 5 drops into ear canal.
- Keep drops in ear for 10 minutes by continuing to lie down.
- Then lie with the blocked side down. Let the ear drops run out onto some tissue.
- Use twice daily for up to four days.
- Then flushing should be able to get everything out.
Cautions for Ear Drops:
- Do not use ear drops if your child has a hole in the eardrum. Also do not use them for children with ear tubes.
- Stop using ear drops if pain occurs.
Earwax Removal Before 6 Years Old:
- Earwax removal in this age group can be hard.
- Removal may not be needed. The ear wax should come out on its own. Don't use cotton swabs.
- Do not use eardrops or ear flushes unless it is advised by your child's doctor. This also can be done in your doctor's office.
Call Your Doctor If:
- Flushing out the ear canal doesn't return the hearing to normal
- Earache occurs
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 01/07/2023

Last Revised: 12/30/2022

A child has a sulfur plug | 1DMC

What is earwax? What to do if a sulfur plug has formed in the ear of a child?

Each person has a special secret in the ears - earwax. This secret protects us from the effects of dust, dirt, bacteria on the ear. Normally, dust particles settle on the ear wax, it thickens, dries up and is gradually removed from the ear. When chewing and talking, the wall of the external auditory canal shifts and the earwax moves closer to the exit from the ear. Thus, the outer ear is cleansed. However, in the cleaning of the outer ear, violations can occur, and then a sulfur plug forms. The sulfur plug is a conglomerate consisting of earwax, dust and epidermal cells. nine0005

What causes wax plugs in children?

Excessive secretion of sulfur, changes in its consistency, anatomical features of the ear canal may predispose to the formation of sulfur plug in a child.

Increased formation of earwax can provoke foreign bodies of the ear, otitis media in children, water getting into the ears, eczema, dermatitis, wearing a hearing aid, frequent use of headphones. A special role in the hypersecretion of the ear glands and the formation of sulfuric plug belongs to overzealous attempts to clean the child's ears with cotton swabs. This leads to irritation of the sulfur glands, an increase in sulfur production, as well as pushing, tamping and fixing the already existing secret in the bone section of the ear canal. In addition to an increased risk of sulfur plug formation, such “hygiene” is fraught with injury to the ear canal and damage to the eardrum. nine0005

The anatomical narrowness and tortuosity of the external auditory canal, which can be hereditary in a child, can contribute to the accumulation of sulfur, as well as the problem of sulfur plugs. The recurrent formation of dry sulfur plugs in a child may be due to insufficient air humidity in the children's room.

Initially, the earwax conglomerate does not completely cover the ear canal and therefore cannot be detected in any way. Gradually increasing in size, it blocks the ear canal, and thereby contributes to hearing loss. nine0005

Children with wax plugs often complain of hearing loss. Also, the appearance of reduced hearing can cause water to enter the ears. In this case, the sulfur plug swells, increases in size and completely blocks the ear canal.

How can they remove the wax plug in a child?

If all these symptoms appear, it is necessary to contact an ENT doctor so that he can correctly diagnose and treat. Similar symptoms can be observed with sensorineural hearing loss, when hearing loss is observed with inflammation in the middle ear. Direct examination of the cavity of the outer ear allows you to accurately establish the diagnosis. ENT - the doctor examines the cavity of the outer ear, where he detects a sulfur plug. In color, it can be from yellow-brown to black. With a long stay of the sulfur plug in the cavity of the auditory canal, it can cause pressure sores. nine0005

It is not allowed to attempt to independently extract the cerumen from the ear canal, as this can lead to damage to the epidermis of the external auditory canal and even the eardrum, while the cerumen will not be removed, but will move deep into the auditory canal into the bone section, from which it is quite heavy extract.

Remove cerumen in children by flushing the external auditory canal. For washing, water heated to body temperature is used, since a jet of cold liquid, hitting the eardrum, can cause disturbances in the activity of the vestibular apparatus and then the child may feel dizzy, nausea, headache, and even lose consciousness. nine0005

Sometimes sulfur plugs are very dry and difficult to separate when washed. In this case, it is recommended to instill 3% hydrogen peroxide into the ear for 2-3 days or apply Levomekol ointment. When instilling hydrogen peroxide, it must be remembered that it is a liquid that causes swelling and softening of the sulfur plug. In this regard, hearing loss can often occur due to the blockage of the ear canal with swollen cerumen. There is no need to be scared here, after washing the cavity of the ear canal, hearing will be restored completely. nine0005

After the removal of the sulfur plug, the child's hearing is usually restored immediately, and unpleasant subjective sensations disappear.

What measures are there to prevent the formation of sulfur plugs?

If the child has an increased tendency to form sulfur plugs, it is necessary to visit an otolaryngologist at least once every 6 months. It is strictly forbidden to use cotton swabs, as well as other traumatic objects to clean the ear canals; to extract excess sulfur from the auditory canal, it is recommended to use sterile cotton flagella. nine0005

Your child's health should be entrusted to professionals. If you experience the first symptoms, consult a doctor! At the First Children's Medical Center, experienced doctors will quickly recognize the signs of the disease, conduct a complete examination using modern medical equipment and provide qualified medical care. We work seven days a week and are waiting for you at any time from 8.00 to 20.00.

Pediatric otitis externa

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Otitis externa in children

What is otitis externa?

Otitis externa is an inflammatory process in the outer part of the ear: it includes the auricle, external auditory canal and the epidermal layer of the tympanic membrane. This diagnosis belongs to the category of symptomatic, that is, it combines inflammation of various origins, but the vast majority of them are attributed to bacterial infections. The second place is occupied by the fungus, and the mixed nature of inflammation is also possible - bacterial-fungal. Among the bacterial sources of inflammation, the first place in frequency belongs to Pseudomonas aeruginosa and Staphylococcus aureus, less often it is caused by streptococcus, Escherichia coli or Mycoplasma. nine0053 Like other ENT diseases, it can be acute and chronic. The chronic form (lasting more than 6-12 weeks) affects up to 5% of the world's population, but, as a rule, it develops against the background of diabetes mellitus. The acute form is very common: at least once in a lifetime, almost every person falls ill with inflammation of the outer ear. In children, it is most common acute diffuse (that is, without a pronounced focus) otitis externa, less often you can find a furuncle of the external auditory canal. nine0005

How does otitis externa occur?

For the development of an infectious process, pathogenic microorganisms must penetrate the natural protective layer of the skin. Very often, the “trigger” for this is trauma, mechanical damage to the ear, or prolonged exposure to a humid environment. The anatomical structure of the ear or a violation of the production of sulfur can also become factors predisposing to inflammation. Additional risk factors are metabolic disorders, lack of vitamins, allergies. Children who swim can sometimes be prone to otitis media, since water entering the ears breaks the protective layer of the skin, contributing to the reproduction of microorganisms. nine0053 To prevent otitis externa, it is necessary to protect the ears when swimming and swimming, and also follow the recommendations of a pediatric otolaryngologist for cleaning the ears: often the baby’s ears are injured during this procedure, as parents make excessive efforts to clean them from sulfur.

How do you know if a child has otitis externa?

The first and most important symptom of the disease is ear pain, which can radiate to the eye, neck, teeth or head. By itself, this symptom is already sufficient reason to urgently make an appointment with a pediatric ENT doctor. An indicator of otitis externa is a sharp pain when pressing on the tragus or auricle. Sometimes the inflamed ear turns red and looks swollen, itchy, stuffy, and there may be a discharge. The patient may have an increase in body temperature, enlarged lymph nodes.