Wet-type human earwax on a cotton swab.

Earwax, also known by the medical term cerumen, is a yellowish, waxy substance secreted in the ear canal of humans and many other mammals. It plays an important role in the human ear canal, assisting in cleaning and lubrication, and also provides some protection from bacteria, fungi, and insects. Excess or impacted cerumen can press against the eardrum and/or occlude the external auditory canal and impair hearing. Image File history File links Download high resolution version (1674x2709, 504 KB) Equipment Camera: Canon 5D. Lens: Canon 100mm f/2. ... Image File history File links Download high resolution version (1674x2709, 504 KB) Equipment Camera: Canon 5D. Lens: Canon 100mm f/2. ... Q-Tip redirects here. ... See drugs, medication, and pharmacology for substances that are used to treat patients. ... The ear canal (external auditory meatus, external acoustic meatus), is a tube running from the outer ear to the middle ear. ... This article is about modern humans. ... Subclasses & Infraclasses Subclass †Allotheria* Subclass Prototheria Subclass Theria Infraclass †Trituberculata Infraclass Metatheria Infraclass Eutheria Mammals (class Mammalia) are warm-blooded, vertebrate animals characterized by the presence of sweat glands, including milk producing sweat glands, and by the presence of: hair, three middle ear bones used in hearing, and a neocortex... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... For the fictional character, see Fungus the Bogeyman. ... Orders Subclass Apterygota Archaeognatha (bristletails) Thysanura (silverfish) Subclass Pterygota Infraclass Paleoptera (Probably paraphyletic) Ephemeroptera (mayflies) Odonata (dragonflies and damselflies) Infraclass Neoptera Superorder Exopterygota Grylloblattodea (ice-crawlers) Mantophasmatodea (gladiators) Plecoptera (stoneflies) Embioptera (webspinners) Zoraptera (angel insects) Dermaptera (earwigs) Orthoptera (grasshoppers, etc) Phasmatodea (stick insects) Blattodea (cockroaches) Isoptera (termites) Mantodea (mantids) Psocoptera...

Production, composition, and different types

Dry-type human earwax

Cerumen is produced in the outer third of the cartilaginous portion of the human ear canal. It is a mixture of viscous secretions from sebaceous glands and less-viscous ones from modified apocrine sweat glands.^[1] The primary components of earwax are the final products in the HMG-CoA reductase pathway, namely, squalene, lanosterol, and cholesterol. Cartilage is a type of dense connective tissue. ... Viscosity is a measure of the resistance of a fluid to deformation under shear stress. ... Secretion is the process of segregating, elaborating, and releasing chemicals from a cell, or a secreted chemical substance or amount of substance. ... Schematic view of a hair follicle with sebaceous gland. ... A diagrammatic sectional view of the skin (magnified). ... The HMG-CoA reductase pathway, also known as MVA pathway or mevalonate-dependent (MAD) route, is an important cellular metabolic pathway present in virtually all organisms. ... Squalene is a natural organic compound originally obtained for commercial purposes primarily from shark liver oil, though there are botanic sources as well, including amaranth seed, rice bran, wheat germ, and olives. ... Lanosterol is a tetracyclic triterpenoid which is the compound from which all steroids are derived. ... Cholesterol is a sterol (a combination steroid and alcohol). ...

There are two distinct genetically determined types of earwax: the wet type, which is dominant, and the dry type, which is recessive. Asians and Native Americans are more likely to have the dry type of cerumen (grey and flaky), whereas Caucasians and Africans are more likely to have the wet type (honey-brown to dark-brown and moist).^[2] Cerumen type has been used by anthropologists to track human migratory patterns, such as those of the Inuit.^[3] This article is about the general scientific term. ... In genetics, the term dominant gene refers to the allele that causes a phenotype that is seen in a heterozygous genotype. ... It has been suggested that this article or section be merged into Dominance relationship. ... Asian people[1] is a demonym for people from Asia. ... This article is about the people indigenous to the United States. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... World map showing location of Africa A satellite composite image of Africa Africa is the worlds second_largest continent in both area and population, after Asia. ... This is about the social science. ... For other uses, see Inuit (disambiguation). ...

The difference in cerumen type has been tracked to a single base change (a single nucleotide polymorphism) in a gene known as "ATP-binding cassette C11 gene". In addition to affecting cerumen type, this mutation also reduces sweat production. The researchers conjecture that the reduction in sweat was beneficial to the ancestors of East Asians and Native Americans who are thought to have lived in cold climates.^[4] Base pairs, of a DNA molecule. ... DNA strand 1 differs from DNA strand 2 at a single base-pair location (a C/T polymorphism). ... ATP-binding cassette transporter genes (ABC-transporter genes) are a superfamily of genes which encode the ABC-transporter proteins. ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ...

Function

Wet-type earwax fluoresces weakly under ultraviolet light.

Image File history File links Download high resolution version (1673x2709, 265 KB) Equipment Camera: Canon 5D. Lens: Canon 100mm f/2. ... Image File history File links Download high resolution version (1673x2709, 265 KB) Equipment Camera: Canon 5D. Lens: Canon 100mm f/2. ... For other uses, see Ultraviolet (disambiguation). ...

Cleaning

Cleaning of the ear canal occurs as a result of the "conveyor belt" process of epithelial migration, aided by jaw movement.^[5] Cells formed in the centre of the tympanic membrane migrate outwards from the umbo (at a rate equivalent to that of fingernail growth) to the walls of the ear canal, and accelerate towards the entrance of the ear canal. The cerumen in the canal is also carried outwards, taking with it any dirt, dust, and particulate matter that may have gathered in the canal. Jaw movement assists this process by dislodging debris attached to the walls of the ear canal, increasing the likelihood of its expulsion. This article is about the epithelium as it relates to animal anatomy. ... Human jaw front view Human jaw left view Human jaw top view The jaw is either of the two opposable structures forming, or near the entrance to, the mouth. ... The tympanum or tympanic membrane, colloquially known as eardrum, is a thin membrane that separates the outer ear from the middle ear. ... The umbo is the most depressed part of the tympanic membrane. ...

Lubrication

Lubrication prevents desiccation, itching, and burning of the skin within the ear canal (known as asteatosis). The lubricative properties arise from the high lipid content of the sebum produced by the sebaceous glands. In wet-type cerumen at least, these lipids include cholesterol, squalene, and many long-chain fatty acids and alcohols.^[6][7] Desiccation is the state of extreme dryness, or the process of extreme drying. ... For other uses, see Skin (disambiguation). ... Some common lipids. ... Cholesterol is a sterol (a combination steroid and alcohol). ... Squalene is a natural organic compound originally obtained for commercial purposes primarily from shark liver oil, though there are botanic sources as well, including amaranth seed, rice bran, wheat germ, and olives. ... In chemistry, especially biochemistry, a fatty acid is a carboxylic acid often with a long unbranched aliphatic tail (chain), which is either saturated or unsaturated. ... This article does not cite any references or sources. ...

Antibacterial and antifungal roles

While studies conducted up until the 1960s found little evidence supporting an antibacterial role for cerumen,^[8] more recent studies have found that cerumen has a bactericidal effect on some strains of bacteria. Cerumen has been found to be effective in reducing the viability of a wide range of bacteria (sometimes by up to 99%), including Haemophilus influenzae, Staphylococcus aureus, and many variants of Escherichia coli.^[9][10] The growth of two fungi commonly present in otomycosis was also significantly inhibited by human cerumen.^[11] These antimicrobial properties are due principally to the presence of saturated fatty acids, lysozyme and, especially, to the relatively low pH of cerumen (typically around 6.1 in normal individuals^[12]). Binomial name Haemophilus influenzae (Lehmann & Neumann 1896) Winslow 1917 Haemophilus influenzae, formerly called Pfeiffers bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Dr. Richard Pfeiffer during an influenza pandemic. ... Binomial name Rosenbach 1884 Staphylococcus aureus , literally Golden Cluster Seed and also known as golden staph, is the most common cause of staph infections. ... E. coli redirects here. ... For the fictional character, see Fungus the Bogeyman. ... Otomycosis (also known as Singapore Ear) is a fungal ear infection; a superficial mycotic infection of the outer ear canal. ... In chemistry, saturation has four different meanings: In physical chemistry, saturation is the point at which a solution of a substance can dissolve no more of that substance and additional amounts of that substance will appear as a precipitate. ... Lysozyme single crystal. ... For other uses, see PH (disambiguation). ...

Removal

Excessive cerumen may impede the passage of sound in the ear canal, causing conductive hearing loss. It is also estimated to be the cause of 60–80% of hearing aid faults.^[13] As mentioned above, movement of the jaw helps the ears' natural cleaning process, so chewing gum and talking can both help. If this is insufficient, the most common method of cerumen removal by general practitioners is syringing with warm water (used by 95% of GPs^[14]). A curette method is more likely to be used by otolaryngologists when the ear canal is partially occluded and the material is not adhering to the skin of the ear canal. Cotton swabs, on the other hand, push most of the earwax further into the ear canal and remove only a small portion of the top layer of wax that happens to adhere to the fibers of the swab. The term "cerumenectomy" is occasionally used to describe the removal of cerumen. This article is about audible acoustic waves. ... Conductive hearing loss is a failure in the efficient conduction of sound waves through the outer ear, typanic membrane (eardrum) or middle ears (ossicles). ... Behind the ear aid For the song, see Flood (album). ... Chewing gum Chewing gum is a type of confectionery designed for fun and chewing. ... A general practitioner (GP), family physician or family practitioner (FP) is a medical doctor who provides primary care. ... A syringe nowadays nearly always means a medical syringe, but it can mean any of these: A simple hand-powered piston pump consisting of a plunger that can be pulled and pushed along inside a cylindrical tube (the barrel), which has a small hole on one end, so it can... Noun A spoon-shaped surgical instrument for cleaning a diseased surface. ... Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. ... Q-Tip redirects here. ...

Cerumenolysis

In cases of those who have the "wet-type" of earwax, it is usually necessary to soften wax before its removal. This process is referred to as cerumenolysis, and is achieved using a solution known as a cerumenolytic agent which is introduced into the ear canal. The most common home-remedy for this purpose is olive oil.^[15] Other commercially available and common cerumenolytics include:

• [under multiple brand names] Carbamide peroxide (6.5%) and glycerine
• Sodium bicarbonate B.P.C. (sodium bicarbonate and glycerine)
• Various organic liquids (glycerol, almond oil, mineral oil, baby oil)
• Cerumol (arachis oil, turpentine and dichlorobenzene)
• Cerumenex (Triethanolamine, polypeptides and oleate-condensate)
• Exterol, Otex (UK brand name) (urea, hydrogen peroxide and glycerine)
• Docusate, a detergent, an active ingredient found in laxatives

A cerumenolytic should be used 2-3 times daily for 3-5 days prior to the cerumen extraction.^[16] Although most commercially available cerumenolytics available in the U.S. are identical, containing carbamide peroxide (6.5%) and glycerine,^[16] a 10% solution of sodium bicarbonate (baking soda) was found to be a more effective cerumenolytic than several commercially-available solutions (Cerumenex, Auralgan) and numerous organic liquids, including glycerine, olive oil, and alcohol.^[17] Additionally, 1 mL of docusate was also found to be a more effective cerumenolytic than several commercially-available solutions (Cerumenex, Debrox).^[18] Docusate may be extracted from liquid preparations of laxatives, such as Colace. Carbamide peroxide is an oxidising agent, consisting of hydrogen peroxide compounded with urea. ... Glycerin, also known as glycerine and glycerol, and less commonly as 1,2,3-propanetriol, 1,2,3-trihydroxypropane, glyceritol, and glycyl alcohol is a colorless, odorless, hygroscopic, and sweet tasting viscous liquid. ... Flash point Non-flammable. ... Benzene is the simplest of the arenes, a family of organic compounds An organic compound is any member of a large class of chemical compounds whose molecules contain carbon. ... Glycerine, Glycerin redirects here. ... Binomial name Prunus dulcis (Mill. ... Mineral oil or liquid petrolatum is a by-product in the distillation of petroleum to produce gasoline. ... Mineral oil or liquid petrolatum is a by-product in the distillation of petroleum to produce gasoline. ... Peanut oil is often used in cooking, because it has a mild flavour and burns only at a relatively high temperature. ... For the band, see Turpentine (band). ... Triethanolamine, often abbreviated as TEA, is an organic chemical compound which is both a tertiary amine and a tri-alcohol. ... Peptides are the family of molecules formed from the linking, in a defined order, of various amino acids. ... Oleic acid is a monounsaturated omega-9 fatty acid found in various animal and vegetable sources. ... Urea is an organic compound with the chemical formula (NH2)2CO. Urea is also known as carbamide, especially in the recommended International Nonproprietary Names (rINN) in use in Europe. ... R-phrases , , , , S-phrases , , , , , , , , Flash point Non-flammable Related Compounds Related compounds Water Ozone Hydrazine Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Hydrogen peroxide (H2O2) is a very pale blue liquid which appears colorless in... Docusate (DAH cue sate) is the generic name of a surfactant used as a laxative and stool softener, which is sold in the U.S. under the brand names: Aqualax, Calube, Colace, Colace Micro-Enema, Correctol Softgel Extra Gentle, DC-240, Dialose, Diocto, Dioctocal, Dioctosoftez, Dioctyn, Dionex, Doc-Q-Lace... An active ingredient, also active pharmaceutical ingredient (or API), is the substance in drug that is pharmaceutically active. ... Laxatives (or purgatives) are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. ... Flash point Non-flammable. ... Glycerin, also known as glycerine and glycerol, and less commonly as 1,2,3-propanetriol, 1,2,3-trihydroxypropane, glyceritol, and glycyl alcohol is a colorless, odorless, hygroscopic, and sweet tasting viscous liquid. ... For the Popeye character, see Olive Oyl. ... This article does not cite any references or sources. ... Docusate (DAH cue sate) is the generic name of a surfactant used as a laxative and stool softener, which is sold in the U.S. under the brand names: Aqualax, Calube, Colace, Colace Micro-Enema, Correctol Softgel Extra Gentle, DC-240, Dialose, Diocto, Dioctocal, Dioctosoftez, Dioctyn, Dionex, Doc-Q-Lace...

A systematic review of studies of the effectiveness of topical preparations for the treatment of earwax^[19] concluded that cerumenolysis is better than no treatment, but there is little to choose between oil- and water-based preparations (including plain water). Applying such a preparation half an hour before syringing is probably as effective as applying it for several days. Several days' treatment with some preparations not based on water or oil appears promising. More studies are needed.

Syringing

Once the cerumen has been softened, it may be removed from the ear canal by irrigation. Ear syringing techniques are described in great detail by Wilson & Roeser,^[16] and Blake et al.,^[20] who advise pulling the external ear up and back, and aiming the nozzle of the syringe slightly upwards and backwards so that the water flows as a cascade along the roof of the canal. The irrigation solution flows out of the canal along its floor, taking wax and debris with it. The solution used to irrigate the ear canal is usually warm water,^[20] normal saline,^[21] sodium bicarbonate solution,^[22] or a solution of water and vinegar to help prevent secondary infection.^[20] In medicine, saline is a solution of sodium chloride (a substance also commonly known as table salt) in sterile water, used frequently for intravenous infusion, rinsing contact lenses, and nasal irrigation (or the yogic practice called jala neti). ... Vinegar is sometimes infused with spices or herbs—as here, with oregano. ...

Patients generally prefer the irrigation solution to be warmed to body temperature,^[21] as dizziness is a common side effect of syringing with fluids that are colder or warmer than body temperature. Sharp et al.^[14] recommend 37 °C, while Blake et al.^[20] recommend using water at 38 °C, one degree above body temperature, and stress that this should be checked with a thermometer. Any other temperature may cause vertigo, just as used when testing the caloric reflex test. Many different terms are often used to describe what is collectively known as dizziness. ... For other uses, see Vertigo. ... In medicine, the caloric reflex test is a test of the vestibulo-ocular reflex. ...

A syringe should be used to gently stream water into the ear. For children the rate and speed should be lower. After irrigating, the head is tipped to allow the water to drain. Irrigation may need to be repeated several times. If the water stream hurts then the flow should be slower. It is better to irrigate too gently for a long period than irrigate too forcefully attempting to remove wax quickly. This procedure can be done at home in the shower using a self-use ear irrigation syringe with a right angle tip. After the wax is removed, the ear can be dried tipping the head then gently pulling the ear upwards to straighten the ear canal. If this does not remove enough water, the ear can be dried with a hair dryer set on low.^{[citation needed]}

Curette method

The earwax is removed through the use of an ear pick, which physically dislodges the earwax and scoops it out of the ear canal. In the west, use of a curette or ear pick is often only done in the hands of health professionals; a modified curette having a safety stop to prevent deep insertion for self-use is available. Curetting earwax using an ear pick is common in East Asia. As the earwax of most East Asians is of the dry type,^[2] it is extremely easy to remove all earwax via light scraping with an ear pick as it simply falls out in large pieces or dry flakes, often on its own. This article does not cite any references or sources. ... This article is about the geographical region. ...

Hazards

A postal survey of British general practitioners^[14] found that only 19% always performed the procedure themselves; many delegated the task to practice nurses, some of whom had received no instruction. This is problematic as the removal of cerumen is not without risk. Irrigation can be performed at home with proper equipment as long as the person is careful not to irrigate too hard. All other methods should only be carried out by individuals who have been sufficiently trained in the procedure.

Bull advised physicians: "After removal of wax, inspect thoroughly to make sure none remains. This advice might seem superfluous, but is frequently ignored."^[22] This was confirmed by Sharp et al.,^[14] who, in a survey of 320 general practitioners, found that only 68% of doctors inspected the ear canal after syringing to check that the wax was removed. As a result, failure to remove the wax from the canal made up approximately 30% of the complications associated with the procedure. Other complications included otitis externa, pain, vertigo, tinnitus, and perforation of the ear drum. Based on this (single) study, a rate of major complications in 1/1000 ears syringed was suggested.^[14] Look up Pain in Wiktionary, the free dictionary. ... For other uses, see Vertigo. ... Tinnitus (pronounced or ,[1] from the Latin word for ringing[2]) is the perception of sound in the human ear in the absence of corresponding external sound(s). ...

Claims arising from ear syringing mishaps account for about 25% of the total claims received by New Zealand's Accident Compensation Corporation ENT Medical Misadventure Committee.^[20] While high, this is not surprising, as ear syringing is an extremely common procedure. Grossan suggested that approximately 150,000 ears are irrigated each week in the United States, and about 40,000 per week in the United Kingdom.^[23] Extrapolating from data obtained in Edinburgh, Sharp et al.^[14] place this figure much higher, estimating that approximately 7000 ears are syringed per 100,000 population per annum. In the New Zealand claims mentioned above, perforation of the tympanic membrane was by far the most common injury resulting in significant disability. The Accident Compensation Corporation (Te Kaporeihana Āwhina Hunga Whara, ACC) is a New Zealand Crown Entity responsible for administering the Injury Prevention, Rehabilitation, and Compensation Act ; which supports citizens, residents, and temporary visitors who have suffered accidental injuries. ...

Cotton swabs

It is generally advised not to use cotton swabs (Q-Tips or cotton buds), as doing so will likely push the wax farther down the ear canal, and if used carelessly, perforate the eardrum. Abrasion of the ear canal, particularly after water has entered from swimming or bathing, can lead to ear infection. Also, the cotton head may fall off and become lodged in the ear canal. Cotton swabs should be used only to clean the external ear. Q-Tip redirects here. ... The tympanic membrane, colloquially known as the eardrum, is a thin membrane that separates the external ear from the middle ear. ...

Alternative practices

Ear candling

Main article: Ear candling

Ear candling, a folk medicine practice, is claimed to remove ear wax and improve ear health. It involves placing a hollow candle in the ear canal and lighting it; the rising hot air is believed to pull out wax and "toxins" from the ear. An earwax-like substance does indeed collect inside the ear candle as it burns - but it collects there even if the candle is placed in a clean, dry drinking glass instead of on an ear. Ear candles are a fringe remedy in North America and Europe, but the claimed benefits are not supported by scientific evidence.^[24] Ear candles can also drip hot melted candle wax inside a person's ear; if the hot wax lands on the eardrum, it can cause great pain and possible hearing damage.^[25] Seely, Quigley and Langman reported that, in a survey of 122 ENT physicians, 21 ear injuries were reported due to ear candling.^[26] Ernst, in a review of the literature, finds that ear candling has no real effect on earwax removal, and poses a danger of ear injuries. He concludes that ear candling is "a triumph of ignorance over science".^[27] Ear candles also deposit candle wax into the bottom of the ear candle tube, which can be interpreted as ear wax, but is simply brown wax from the candle. James Mally, N.D., ear candling a patient in an experiment testing the effectiveness of the practice. ... James Mally, N.D., ear candling a patient in an experiment testing the effectiveness of the practice. ... A traditional healer in Côte dIvoire Folk medicine refers collectively to procedures traditionally used for treatment of illness and injury, aid to childbirth, and maintenance of wellness. ... The scientific method or process is fundamental to the scientific investigation and acquisition of new knowledge based upon physical evidence. ...

Eating earwax

While human consumption of earwax is an unusual practice, it is well-known the wax has a strongly bitter taste.^[28] Australian Prime Minister Kevin Rudd is famous for his consumption of earwax whilst in his seat at the House of Representatives.^[29] Kevin Michael Rudd (born 21 September 1957), is the leader of the federal Australian Labor Party and Leader of the Opposition in the Australian Parliament. ...

Earwax in whales

Many species of whale have an annual buildup of earwax, adding one, two, or four layers (depending upon the species) each year. Similar to the incremental dating method of dendrochronology for trees, the number of layers can be counted to determine the age of the whale after its death.^[30] This article is about the animal. ... Incremental dating techniques allow the construction of year-by-year annual chronologies, which can be fixed ( linked to the present day and thus calendar or sidereal time) or floating. ... The growth rings of an unknown tree species, at Bristol Zoo, England Pinus taeda Cross section showing annual rings, Cheraw, South Carolina Pine stump showing growth rings Dendrochronology or tree-ring dating is the method of scientific dating based on the analysis of tree-ring growth patterns. ...

See also

• Ear pick
• List of Mendelian traits in humans

This article does not cite any references or sources. ... Several inheritable traits or congenital conditions in humans are classical examples of Mendelian inheritance: Their presence is controlled by a single gene that can either be of the autosomal-dominant or -recessive type. ...

Further reading

A comprehensive review of the physiology and pathophysiology of earwax can be found in a 1997 review article by Roeser and Ballachanda.^[31] See also the New York Times article on the Yoshiura earwax study.^[32] This article or section does not cite any references or sources. ... Pathophysiology is the study of the disturbance of normal mechanical, physical, and biochemical functions, either caused by a disease, or resulting from a disease or abnormal syndrome or condition that may not qualify to be called a disease. ...

References

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... is the 44th day of the year in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 80th day of the year (81st in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ...

External links

• Looking after your ears Deafness Research UK
• Ear wax and its treatment Patient UK
• Ear wax and its treatment Medinfo UK
• Ear wax and its treatment Deafness Research UK
• Gooey earwax is in your genes, ABC Science Online, 30 January 2006
• Nicholas Wade. Scientists Find Gene That Controls Type of Earwax in People. The New York Times, 30 January 2006