I will be the pattern of all patience; I will say nothing.

I know I’ve complained a lot about this in the last year or so, but in the interest of spreading knowledge, I feel I need to tell you the best way to clean your ear. After all, what’s the point of getting my ear infected every six months if I don’t learn something from it, right?

First, about earwax. It’s basically a secretion in the ear canal which provides some protection from bacteria, fungus and (eww) insects. It also helps clean and lubricate it, because the skin in the ear canal is really quite delicate, and if it’s dry it gets itchy.

So apparently, there are two distinct types of earwax. The wet type which is more common in Caucasians and Africans, and the dry type is more common in Asians and Native Americans. But wet or dry really depends on your genes, with the wet type being dominant and the dry type, recessive. The dry type of wax is hard and gray, with the wet one being honey coloured.

Additionally, the difference in the wax type is caused by a single gene, and the mutation in the gene also reduces sweat production, which could’ve aided the ancestors of the East Asians and Native Americans (since they might have lived in cold climates).

For details on the stuff above, check out the earwax wikipedia stub.

So now we’ve got the lowdown about earwax, the next question is – how do we get rid of it?

The ear apparently should be self cleaning. The wax will build up, and through movements in your jaw, it’s supposed to move to the outter bits of your ear canal and finally flake off when it reaches the outside. To aid this natural action, you could talk a lot or chew gum. However, not all ears are built the same, and sometimes people have ear anatomies that tend to collect wax instead of drain it off.

Add to that, wax production tends to increase as you get older, so for me it was merely a matter of time.

Doctors would always tell you that you shouldn’t use a Q-tip to clean your ear. I suppose I’m living proof of that. Although it feels good, you’re actually pushing the wax to the back of your ear canal – and I know this because the first time I had my ear syringed, the wax from my left ear (the drier ear with no problems) was shaped like a potato chip – a curved flap – like it was pushed by a Q-tip against the back of the ear canal.

There are three things you can do to remove the wax in your ear. I think it really depends on how desperate you are. If you don’t have ear problems, you probably don’t need to do any of this. And if you’re not sure what your ear problem is, see a doctor.

Cerumenolysis
For normal maintenance, it would seem the safest way is to use a cerumenolytic agent. [Cerumen = earwax] There are several types of cerumenolytics, but the commonest home remedy seems to be olive oil, mineral oil, sweet almond oil or baby oil. Apply a couple of drops to a tilted head at night. Leave it for a few minutes. Drain the excess off. It’s supposed to coat the wax, loosen its grip to your ear canal, and should drop or drain off naturally in a few days.

You can also get cerumenolytics from the pharmacies here – but they’ve not really worked that great for me. Waxol is docusate sodium bp 0.5% – docusate is (hahaha) a laxative, and regularly used as a stool softner. Earex is equal parts peanut oil, almond oil and camphor oil. I think it’s probably better for regular maintenance.

You can also get a cerumen extraction kit from US pharmacies, they mostly contain a cerumenolytic like carbamide peroxide 6.5% in a glycerine base. And it might or might not include an ear syringe. So the idea is you soften with the cerumenolytic for a few days, then syringe the ear to flush the softened wax out.

Reportedly, good old sodium bicarbonate does a great job of dispersing the wax. 10% in water should do the trick. Let it bubble in your ear (tilt so it stays) for a few minutes and let it drain out.

Syringing
Though it sounds rather drastic, it’s nothing more than shooting a gentle warm stream of water to the top and back of the ear canal so the water can cascade from the back, irrigate the ear and push the wax from inside out. You can use water, or sodium bicarbonate in water. But the key is that the water should be warm (body temperature) or you might suffer dizziness. Or grow a third ear at the back of your head.

Ok, kidding about the third ear.

You have to soften the wax with a cerumenolytic first. Most sources say you should use the cerumenolytic thrice a day for 3-4 days before syringing, and I suppose it’s a good idea to do so especially if you’ve impacted cerumen. There’s really no good way to know if your earwax is so full in your ear it’s impacted, but if you can’t hear in one ear, most likely that’s the case.

Most of the times, my ear is usually impacted and infected, requiring a weeklong treatment with ear drops before I get to have it syringed. So in addition to the discomfort of an ear full of wax, it itches or hurts.

The moral of the story here is: don’t use Q-tips to clean your ear! If you really really have to, use olive oil, baby oil, almond oil or Earex to soften it first – drop a couple of drops in your ear canal, tilt your head to keep it in for a few minutes, drain the excess and then use your Q-tip to trap the rest. Don’t push it to the back of your ear, and be gentle because the skin in your ear is fragile.

If you’ve never had your ear syringed, get it done by a doctor. If fact, if you’ve no idea what’s wrong, get it checked by your doctor. It is, after all, your ear. You don’t really want to mess with it. And if you do get it syringed by a doctor, make sure he checks your ear again after syringing to verify that the ear is indeed clear. You don’t want a re-occurance because he did a shoddy job the first round.

If you’re still intent on syringing at home, you can get one here. I’d get one if it 1) weren’t such a dodgey site, 2) were a quarter the price. Tell me if it works for you!

Get professional help
Ok. If you really can’t stand the build-up of wax in your ear, are too impatient to wait for the cerumenolytics to work but too chickenshit to syringe your own ear – I won’t blame you it’s difficult to look down your own ear canal – go to your regular GP. They’ll either do the water syringing thing, or vacuum it out. I’ve not had my ear vacuumed, so I can’t tell you if it’s better or worse. However, a freshly syringed ear is the best feeling ever. It’s a mixture of relief, refreshed perspective and heightened awareness! For the first day or so you’ll hear everything! Every little crackle, every echo every snort or pin drop. Everything will be loud and the echo in your ear will drive you nuts! But after a while either the wax comes back or your brain filters off the extra sounds and it’s back to your regular programming.

When I had my ear syringed at Raffles Medical, it cost about S$50. If you work with at the local Big Why with me – that’s not covered by our medical plan, it’ll have to come out of your own pocket.

Ok. After this long discourse, I’m still stuck with otitis media so I’m on anti-infective and anti-inflammatory ear drops, before I can do anything else.

And I thought this was interesting: local online pharmacies (!!)

1. Changi General Hospital Pharmacy: the best of the lot. Nice promotions section, decent UI and search and free delivery for purchases $70 and over. For the rest, it costs $5. They also have customer support and a pretty extensive FAQ section. This gets my vote!
2. NTUC Healthmart: is a pretty pathetic site, uncategorised, unsearchable and doesn’t load nicely in Firefox. It’s a complete failure, so don’t bother visiting it.
3. Tan Tock Seng Hospital Pharmacy: $8 delivery with a minimum order of $50. Search works, and has a good range of products. Weird layout, very typical sg e-commerce look and feel.

And this concludes my research on my ear ailment. Again, check with your doctor if you’re not sure what’s going on with your ear or have experienced the symptoms for the first time. Try the remedies above at your own risk.

Take care and have a Happy New Ear ahead!