Only my usual admonishment about putting something in your ear where you can't see what's going on. I don't know much about it, but I would worry about perforating the ear drum or setting my hair on fire, to be honest, Brian.
Whislt snorkelling both my ears hurt muchly if I dive deeper than say 8 feet, even though I pinch my nose and blow to equalise the pressure across my ear drum, yet when I fly myself unpressurised to 10K feet I have no pain at all.
Yes, the issue is that your middle ear is a little room with an airlock, aka your eustachian tube. When you fly, the pressure outside your ear is lower than in the little room so you are letting air *out* of the airlock and when you scuba, the pressure outside your middle ear is higher so you are forcing air *in* to the airlock.
The valsalva/nose plug thing pops open your eustachian tube and then with the airlock open, the pressure normalizes itself. For some reason, your eardrum does not like the increased pressure, but doesn't mind the decreased. I don't know why that might be and you should ask an ENT who can look in your ear, but I wonder if you've had ear infections in the past and maybe have a spot where your ear drum ruputred in the past, leaving you with a weak spot? Totally speculation on my part, but I hope you can solve it and get to scuba!
Wow Thank you for your insight. I did understand the physiscs and anatomy because most mammals have the same design.
Never had any ear infections, and passed all my toddler medical hearing tests at school.
I had the usual childhood self-cure diseases; chicken pox, measles, mumps. Thankfully not vaccinated against any of them, but did have to take the polio and BCG vaccines when they were trialled in the UK.
Valsalva is what it's called eh, but the trick makes no difference for me, and I tried hard many times whilst diving.
I failed the scuba test dive because of the acute pain, so never persued it: Took up hang-gliding and flying instead.
The fact that the valsalva trick didn't help suggests to me there's a one-way valve flap not functioning as it ought in both eustachain tubes.
For now, I'll put that down to a developmental quirk! :)
Thank you for your helpful comments, they will assist others I'm sure.
I once had some med-tech clean my earwax with a spray bottle and a drip pan. It was extremely awkward and uncomfortable, and I got zero education about what was happening or why.
The piece about wet vs dry ear wax is fascinating.
I wonder what your thoughts are about ear candling. I found it very relaxing, but I never understood how it worked or if it was effective at what they said it should do...or if it was even somewhat detrimental. I always trust my own intuition and instincts, and even though I found it relaxing, something in me didn't want to keep doing it - which is what makes me think it might be somewhat detrimental. Perhaps a topic to cover someday, or something we could co-author...a listicle of popular "natural" treatments, how they work or why they aren't a good idea.
Teri Leigh, good idea! I don't know anything much about candling, but my standard worry about putting anything into one's ear where one cannot see what one is doing obtains. That would be an interesting article to think about!
Ear wax is tough to manage once you have hearing aids,that come with wax trap. $8 for 10 replacements. I have dry for which 30-minutes of soaking does little to nothing to facilitate removal.
My husband has dry wax that forms large balls/chunks. I flush out his ears whenever his hearing starts to get affected. The first few times, I was completely grossed out. Dry wax is not the same color or consistency as wet wax at all! Gray and chunky… Now I can flush his ears without gagging and it’s all worth it because he can hear well again! Thanks for this article!
I have never had earwax issues (I have “wet” wax), but one of my sisters has constant wax issues. I use qtips very carefully after I shower and only occasionally see a little bit of orange wax on them. I guess people vary greatly in the amount of wax their ears produce.
Earwax as a diagnostic for cancer is already being used in oncology hospitals in Brazil. There is ongoing research into its usefulness for other diseases as well like diabetes and Alzheimer’s.
Also interesting, but obviously will need something more than Joy’s nose to make work on a large scale. (Haha!)
I too came upon the earwax assay story through a news report initially. It included excerpts from an interview with the lead biochemist on the project. His take was that we have lots for treatment at this point, but the problem is adequate, correct diagnosis of many conditions. He figured an earwax assay could/should be a regular test within 10 years all over the world.
The way I see it is that this is probably the closest we will come to a cure for cancer: earliest diagnosis, treatment that is not required to be overly aggressive or prolonged, and so much less trauma - both physical and emotional - for patients and their families. And to top it all off: CHEAP and less intrusive.
Who wins? Definitely patients, their families, medical systems that are government funded. Who loses? Expensive imaging interests, and big pharma. We will see.
I wear hearing aids (HAs) so I've had to become not-grossed out by ear wax. Every time I take my HAs out, they have wax on them and I regularly clean the wax out of the tubes and vents. I know I'm not supposed to but I use a cotton bud (q-tip) after I wash my hair to get the soap out my ears. I don't go in very far. If I don't clean it out, the soap gunges up my HAs, blocking the vent holes and tubes (and it's difficult to clean out), so my hearing is even worse.
I had a steroid injection through my ear drum two years ago to try to save my hearing so I have a feel for how far it's safe to go in (plus wearing HAs, you get used to the feel of where the mould sits in the ear canal)
(I’m Asian). Both my ears are always popping. No wax - dry, wet, damp. And left ear hurts sometimes. My ENT says it’s just some kind of drainage. I need another ENT.
I didn't have to this year but the last 2 years I had to buy and use the ear wax drops after a lifetime of no problems....seemed to happen when it was hot and I had fan on me at night....wierd.....
I have not had a problem this year. So far. But I definitely thought there was a correlation….
Have you ever wrote about how a person's ability to sweat changes as you get older ?
Something else I've noticed. No matter how hot or how physical active I don't sweat like I used to when my shirt used to be soaked with sweat. I still sweat of course….last summer to test that I went outside on one of the hottest days of the summer and chopped wood …….long ago I would have been drenched in sweat…..but not anymore.
And I liked your ear wax article which I stumbled across somehow……without looking.
There are little cameras you can get that pair to a phone app so you can carefully take a look inside your own ear. It's pretty fascinating. I was having trouble like your patient, but knew probably what was causing it from experience...so I got one. Like your patient, one ear was clear but the other was full of wax. I couldn't see my eardrum. I have dry wax, so I used the earwax kit softening oil, then the bulb syringe. I didn't get any impressive pieces to come out, so took another look. The little camera has a tiny scoop on the end of it, and with the wax now really soft, I gently scooped it out bit by bit till it was gone and I could see my eardrum (which is unmistakeable and really pretty...kind of a pearlescent white). I felt accomplished to be able to do that myself and the little camera makes sure you can see where in the ear you are. You can see exactly what you are doing and therefore don't do any damage
I don't see how earwax can commonly cause a blockage if ears are self-cleaning. I'd guess the ears of those with dry wax don't self-clean nearly as readily as you imply.
As to ear wax being gross, I don't understand. I remember having it washed out when I was young (50 years ago). I found the process generally pleasant and seeing the removed wax simultaneously cathartic and proof of why it had been so much of a nuisance.
Also, if earwax is gross to many, it seems peculiar that there are many videos online showing earwax removal. Note: Don't watch these if you think earwax is gross.
Ears are self-cleaning, OKRickety, but like everything else in the world, not perfectly, especially for dry ear wax. It may also be that back when we did not get our food from the grocery store and we were chewing a lot more than we do now that our external ear canals were in greater motion and the wax dumped out more readily. All that said, it's best not to put small, hard things into soft spaces where you can't see what you're doing.
As to earwax being gross and videos, you'd have to check out a psychology blog, lol. I do think that some people enjoy looking at videos of things they think are disgusting. How else to explain Dr Pimple Popper's popularity?
Glad I read this. My NP offered to remove my earwax at my physical this week and I said no thanks. I’m under a lot of stress and I just didn’t wanna deal with it. But I’ve had vertigo before and that was one concern I had about getting my ears cleaned out I was thinking what if it gives me vertigo and then I read the thing about the wrong temperature watercausing extreme dizziness. No thanks. I’ll just let the earwax work itself out.
Good plan, Kelly! I don't think I've said it in Doctoring Unpacked, but one of the things I say most frequently irl is "We can make you worse." It's always true! I can only remember one bad effect of ear washing and that was a woman with very dry ear wax; we could only get some of it out, but the rest fully hydrated itself and completely blocked the external ear canal off. She came in a couple days later, miserable, and now it was all soft and we removed it, but she had a very unpleasant couple days in between.
My best "wrong temperature" water was something I did to myself when I was about 25. I did not understand the importance of the proper temperature and I used water that was too cold. I literally could not stand up straight for about five minutes. Because I was young and dumb, I thought it was fascinating. Fortunately, I didn't fall or break anything. Double fortunately, since it was so long ago, there are no pictures!
Any thoughts on the use of candling for eart wax, Doc?
Only my usual admonishment about putting something in your ear where you can't see what's going on. I don't know much about it, but I would worry about perforating the ear drum or setting my hair on fire, to be honest, Brian.
Whislt snorkelling both my ears hurt muchly if I dive deeper than say 8 feet, even though I pinch my nose and blow to equalise the pressure across my ear drum, yet when I fly myself unpressurised to 10K feet I have no pain at all.
It prevented me taking a scuba course.
Any thoughts on this?
Yes, the issue is that your middle ear is a little room with an airlock, aka your eustachian tube. When you fly, the pressure outside your ear is lower than in the little room so you are letting air *out* of the airlock and when you scuba, the pressure outside your middle ear is higher so you are forcing air *in* to the airlock.
The valsalva/nose plug thing pops open your eustachian tube and then with the airlock open, the pressure normalizes itself. For some reason, your eardrum does not like the increased pressure, but doesn't mind the decreased. I don't know why that might be and you should ask an ENT who can look in your ear, but I wonder if you've had ear infections in the past and maybe have a spot where your ear drum ruputred in the past, leaving you with a weak spot? Totally speculation on my part, but I hope you can solve it and get to scuba!
Wow Thank you for your insight. I did understand the physiscs and anatomy because most mammals have the same design.
Never had any ear infections, and passed all my toddler medical hearing tests at school.
I had the usual childhood self-cure diseases; chicken pox, measles, mumps. Thankfully not vaccinated against any of them, but did have to take the polio and BCG vaccines when they were trialled in the UK.
Valsalva is what it's called eh, but the trick makes no difference for me, and I tried hard many times whilst diving.
I failed the scuba test dive because of the acute pain, so never persued it: Took up hang-gliding and flying instead.
The fact that the valsalva trick didn't help suggests to me there's a one-way valve flap not functioning as it ought in both eustachain tubes.
For now, I'll put that down to a developmental quirk! :)
Thank you for your helpful comments, they will assist others I'm sure.
Colin, a developmental quirk sounds like a good explanation. Interesting. You’re welcome and thank you for an interesting convo!
I once had some med-tech clean my earwax with a spray bottle and a drip pan. It was extremely awkward and uncomfortable, and I got zero education about what was happening or why.
The piece about wet vs dry ear wax is fascinating.
I wonder what your thoughts are about ear candling. I found it very relaxing, but I never understood how it worked or if it was effective at what they said it should do...or if it was even somewhat detrimental. I always trust my own intuition and instincts, and even though I found it relaxing, something in me didn't want to keep doing it - which is what makes me think it might be somewhat detrimental. Perhaps a topic to cover someday, or something we could co-author...a listicle of popular "natural" treatments, how they work or why they aren't a good idea.
Teri Leigh, good idea! I don't know anything much about candling, but my standard worry about putting anything into one's ear where one cannot see what one is doing obtains. That would be an interesting article to think about!
Ear wax is tough to manage once you have hearing aids,that come with wax trap. $8 for 10 replacements. I have dry for which 30-minutes of soaking does little to nothing to facilitate removal.
AFCz, I have no great ideas for you, except to see if your audiologist has any suggestions.
That I understand, between visits the best I can do is clean the wax from my hearing aids after every use.
My husband has dry wax that forms large balls/chunks. I flush out his ears whenever his hearing starts to get affected. The first few times, I was completely grossed out. Dry wax is not the same color or consistency as wet wax at all! Gray and chunky… Now I can flush his ears without gagging and it’s all worth it because he can hear well again! Thanks for this article!
You are welcome, Kelly. I'm glad you enjoyed it.
Well Dr Mary that was a fun one! (And not too long either)
Lol. Thank you, Ronald.
I have never had earwax issues (I have “wet” wax), but one of my sisters has constant wax issues. I use qtips very carefully after I shower and only occasionally see a little bit of orange wax on them. I guess people vary greatly in the amount of wax their ears produce.
I think so, Elizabeth! Also, wax will typically only get stuck in one side or the other!
If you are interested in the very most amazing earwax information I’ve ever heard of, check this out: https://www.nature.com/articles/s41598-019-48121-4
Earwax as a diagnostic for cancer is already being used in oncology hospitals in Brazil. There is ongoing research into its usefulness for other diseases as well like diabetes and Alzheimer’s.
Erin, thank you! Also, check this out. I read a lovely narrative article about Joy which I cannot find now, but this will have to do as it gets the main points: https://www.npr.org/sections/health-shots/2020/03/23/820274501/her-incredible-sense-of-smell-is-helping-scientists-find-new-ways-to-diagnose-di
Also interesting, but obviously will need something more than Joy’s nose to make work on a large scale. (Haha!)
I too came upon the earwax assay story through a news report initially. It included excerpts from an interview with the lead biochemist on the project. His take was that we have lots for treatment at this point, but the problem is adequate, correct diagnosis of many conditions. He figured an earwax assay could/should be a regular test within 10 years all over the world.
The way I see it is that this is probably the closest we will come to a cure for cancer: earliest diagnosis, treatment that is not required to be overly aggressive or prolonged, and so much less trauma - both physical and emotional - for patients and their families. And to top it all off: CHEAP and less intrusive.
Who wins? Definitely patients, their families, medical systems that are government funded. Who loses? Expensive imaging interests, and big pharma. We will see.
You are welcome. I found it fascinating too. If you are keen for more, a follow up study was published in April by the same team: https://www.nature.com/articles/s41598-025-97440-2
This is highly fascinating. Thank you for offering the link!
Connie, I copied my comment to Erin above because I wanted to be sure you saw it.
Erin, thank you! Also, check this out. I read a lovely narrative article about Joy which I cannot find now, but this will have to do as it gets the main points: https://www.npr.org/sections/health-shots/2020/03/23/820274501/her-incredible-sense-of-smell-is-helping-scientists-find-new-ways-to-diagnose-di
Yep. That’s why even other vampires loathe earwax vampires.
Thanks for reminding me to get my ears cleaned—professionally, by a doctor!—as I do every six months now to prevent this sort of thing from happening.
You're welcome, Josh! Thanks for reading and commenting.
I wear hearing aids (HAs) so I've had to become not-grossed out by ear wax. Every time I take my HAs out, they have wax on them and I regularly clean the wax out of the tubes and vents. I know I'm not supposed to but I use a cotton bud (q-tip) after I wash my hair to get the soap out my ears. I don't go in very far. If I don't clean it out, the soap gunges up my HAs, blocking the vent holes and tubes (and it's difficult to clean out), so my hearing is even worse.
Makes sense, Helen. Be careful with the Q-tip! Sounds like you have figured out just how far you can go in.
Yup, definitely don't want to go in too far!
I had a steroid injection through my ear drum two years ago to try to save my hearing so I have a feel for how far it's safe to go in (plus wearing HAs, you get used to the feel of where the mould sits in the ear canal)
I think that's true, Helen, that having the extra stimulation over time in the ear canal teaches you a lot about where a sensation is coming from.
(I’m Asian). Both my ears are always popping. No wax - dry, wet, damp. And left ear hurts sometimes. My ENT says it’s just some kind of drainage. I need another ENT.
Sounds like a good plan, Gautam. Thanks for commenting.
I didn't have to this year but the last 2 years I had to buy and use the ear wax drops after a lifetime of no problems....seemed to happen when it was hot and I had fan on me at night....wierd.....
Dodobbird.pixels.com (art)
Interesting, Dodo. Please try moving the fan off you and then back on and report back! Thanks.
I have not had a problem this year. So far. But I definitely thought there was a correlation….
Have you ever wrote about how a person's ability to sweat changes as you get older ?
Something else I've noticed. No matter how hot or how physical active I don't sweat like I used to when my shirt used to be soaked with sweat. I still sweat of course….last summer to test that I went outside on one of the hottest days of the summer and chopped wood …….long ago I would have been drenched in sweat…..but not anymore.
And I liked your ear wax article which I stumbled across somehow……without looking.
Dodobbird.pixels.com
There are little cameras you can get that pair to a phone app so you can carefully take a look inside your own ear. It's pretty fascinating. I was having trouble like your patient, but knew probably what was causing it from experience...so I got one. Like your patient, one ear was clear but the other was full of wax. I couldn't see my eardrum. I have dry wax, so I used the earwax kit softening oil, then the bulb syringe. I didn't get any impressive pieces to come out, so took another look. The little camera has a tiny scoop on the end of it, and with the wax now really soft, I gently scooped it out bit by bit till it was gone and I could see my eardrum (which is unmistakeable and really pretty...kind of a pearlescent white). I felt accomplished to be able to do that myself and the little camera makes sure you can see where in the ear you are. You can see exactly what you are doing and therefore don't do any damage
Interesting, Emmy! I'd not heard of such a device, but it makes sense that they exist.
It was $25 on Amazon...back when I was shopping on Amazon.
Amazingly cheap! Gonna go look that up!
I don't see how earwax can commonly cause a blockage if ears are self-cleaning. I'd guess the ears of those with dry wax don't self-clean nearly as readily as you imply.
As to ear wax being gross, I don't understand. I remember having it washed out when I was young (50 years ago). I found the process generally pleasant and seeing the removed wax simultaneously cathartic and proof of why it had been so much of a nuisance.
Also, if earwax is gross to many, it seems peculiar that there are many videos online showing earwax removal. Note: Don't watch these if you think earwax is gross.
Ears are self-cleaning, OKRickety, but like everything else in the world, not perfectly, especially for dry ear wax. It may also be that back when we did not get our food from the grocery store and we were chewing a lot more than we do now that our external ear canals were in greater motion and the wax dumped out more readily. All that said, it's best not to put small, hard things into soft spaces where you can't see what you're doing.
As to earwax being gross and videos, you'd have to check out a psychology blog, lol. I do think that some people enjoy looking at videos of things they think are disgusting. How else to explain Dr Pimple Popper's popularity?
Glad I read this. My NP offered to remove my earwax at my physical this week and I said no thanks. I’m under a lot of stress and I just didn’t wanna deal with it. But I’ve had vertigo before and that was one concern I had about getting my ears cleaned out I was thinking what if it gives me vertigo and then I read the thing about the wrong temperature watercausing extreme dizziness. No thanks. I’ll just let the earwax work itself out.
Good plan, Kelly! I don't think I've said it in Doctoring Unpacked, but one of the things I say most frequently irl is "We can make you worse." It's always true! I can only remember one bad effect of ear washing and that was a woman with very dry ear wax; we could only get some of it out, but the rest fully hydrated itself and completely blocked the external ear canal off. She came in a couple days later, miserable, and now it was all soft and we removed it, but she had a very unpleasant couple days in between.
My best "wrong temperature" water was something I did to myself when I was about 25. I did not understand the importance of the proper temperature and I used water that was too cold. I literally could not stand up straight for about five minutes. Because I was young and dumb, I thought it was fascinating. Fortunately, I didn't fall or break anything. Double fortunately, since it was so long ago, there are no pictures!