As a pediatrician I get asked many questions from concerned parents. One of the most common questions at a checkup is, “Doctor, what do I do about this orange discharge my child gets in his ears all the time?” Excessive earwax production is common and completely benign. Most often a “less is more” approach is best when dealing with cerumen (earwax). Keeping that in mind, here is a comprehensive list of earwax do’s and don’t’s.

DO:

1) Understand that earwax (cerumen) is normal. Earwax not causing symptoms or blocking the ear canal should be left alone.

2) Understand symptoms of cerumen impaction (wax blocking the ear): decreased hearing, fullness and tinnitus.

3) Seek medical evaluation if you have symptoms of hearing loss, ear fullness and ear pain if you are not certain that they are from cerumen. Otitis media (fluid behind the eardrum), otitis externa (ear canal infection), and sudden inner-ear hearing loss can all masquerade as cerumen impaction.

4) Ask your doctor about ways that you can treat your cerumen impaction at home. Your child may have certain medical or ear conditions that may make some options unsafe.

5) Seek medical attention for your child with ear pain, drainage or bleeding. These are not symptoms of cerumen impaction and they need further evaluation.

DON’T:

1) Overclean your child’s ears. Excessive cleaning may irritate the ear canal, cause infection, and even increase the chances of cerumen impaction.

2) Put anything smaller than your elbow in your child’s ear! Cotton swabs, hair pins, car keys, toothpicks…these can all injure your child’s ear and may cause a cut in the ear canal, a hole in the eardrum and/or dislocation of the hearing bones, leading to hearing loss, dizziness, ringing and other symptoms of ear injury.

3) Use ear candles. There is no evidence that they remove impacted cerumen, and candling can cause serious damage to the ear canal and eardrum.

4) Ignore your child’s symptoms if home remedies are unsuccessful. Seek medical attention if attempts at home have not resolved the problem.

5) Irrigate or try cerumen-removing/softening drops if your child has had ear surgery or a perforated eardrum, unless specifically cleared to do so by the otolaryngologist.

By Dr. Robert Jawetz

 Dr. Robert Jawetz is a pediatrician at Tenafly Pediatrics.