The unexpectedly protective qualities of ear wax

by Gillian Mayman on November 12, 2012

Small children are excellent at two things: producing excessive quantities of ear wax and getting ear infections. My kids, in particular, excelled in both of these areas.

As a parent, I’ve always assumed that having a lot of ear wax somehow caused, or at least exacerbated, ear infections in children. I’d never considered the possible mechanisms behind this; it’s just a blind assumption that I’ve carried around with me.

It turns out that I’ve been almost completely wrong. Earwax is useful for something other than handlebar mustaches and old timey lip balm.

Ear wax is a natural antibiotic. It protects the outer ear from infection by bacteria, viruses, and fungi.

Researchers in Malaysia studied samples of ear wax from 31 patients. They tested the ear wax for growth of three types of bacteria and one type of fungus: Staphylococcus aureus, Escherichia coli (E. coli), Pseudomonas aeruginosa, and Candida albicans.

Cultures of each of the bacteria and fungi were mixed with each sample of ear wax (or cerumen if you want to use the scientific name). E. coli was the only microorganism that did not seem affected by the presence of the ear wax. The other bacteria and fungi all showed significant amounts of decreased growth when the ear wax was introduced.

The researchers concluded that ear wax has the ability to kill both bacteria and fungi. Ear wax may help prevent and get rid of outer ear infections such as swimmer’s ear. Unfortunately, the type of ear infection that most young children suffer from is an infection of the middle ear (also known as otitis media). This study only suggests that ear wax is protective of outer ear infections.

In 1985, researchers looked at the relationship between too much ear wax and middle ear infections in a study published in the British Medical Journal. They found that there was actually less wax in the ears of children who had middle ear infections.

The mechanism behind this correlation is unclear. However, the researchers speculated that the raised temperature of the inflamed eardrum might actually be enough to melt the earwax.

[I'll pause while you process that idea.]

This is not to say that ear wax is completely innocuous. According to the clinical practice guideline on Cerumen Impaction, too much ear wax can be responsible for “hearing loss, tinnitus, fullness, itching, otalgia, discharge, odor, or cough”.  Every year, 12 million people in the United States go to the doctor for ear wax-related problems.

It might not be time to throw out the Q-tips quite yet*.

*Q-tips should not be used to clean inside the ear. This can lead to impacted ear wax. See symptoms above for why you don’t want that to happen.

CMDoran (@TheFebrileMuse) November 12, 2012 at 9:05 am

Might the children with less ear wax production be more susceptible to middle ear infections? Did they follow the children for a long time and get baseline earwax amounts (when infection not present)?

Margaret November 12, 2012 at 10:58 am

Fun post, this was a quick and easy read.

Your first cartoon confused me a little. I was wondering what I was missing, you did talk about it a little in your post, but I think the uses of ear wax might have gone a little above my head. I liked this post though I did have to look up a few medical words: tinnitus and otalgia. I don’t think that I will be nearly as self conscious about the amount of wax in my ears when I go to a doctor.

Thanks Margaret

Gaythia Weis November 12, 2012 at 11:29 am

I think it would be interesting to know more about those of us with waxy ears. Is this just evolutionary overkill? Did people historically just go deaf? Or are we keeping the system perpetually off balance in efforts to clear out the wax?

Shara E November 13, 2012 at 10:44 am

Hmn…..what about ear candles?? I’ve heard both good things and bad about them, apart from that whole potentially-setting-your-hair-on-fire issue. Off the top of my head: Good – they get more our, without the risk of impaction Bad: They create a mini vacuum in your ear which could be damaging?

I have no idea…..though i think you’d probably have a hard time getting your kids to sit still for it, never mind the part where they have to hold still because you’re sticking a flaming tube in their ear….

Tom November 13, 2012 at 6:40 pm

Ear candling is completely bogus.

TheBrumell November 14, 2012 at 10:45 pm

Ear candling does absolutely nothing, except make the “patient” look silly and provide a nice bit of flame for the event.
“Good – they get more our, without the risk of impaction”
No. There is no effect at all. Nothing comes out.
“Bad: They create a mini vacuum in your ear which could be damaging?”
No. They do not create “a mini vacuum” at all. There is no pressure difference. There is no movement of any material inside the ear canal associated with ear candling.
Utterly useless.
I had a couple of ear infections as a child, which is how I discovered my only (known) allergy: erythromycin. Neither part of that experience was any fun.
The connection between ear wax and ear infections didn’t occur to me until I had an ear infection as an adult. Wax built up in my left (outer) ear slowly enough that I assumed I had reduced hearing in that ear due to excessive volume when listening to music through headphones (I was warned many, many times about this growing up, but how loud is too loud? and what about background noise? but I digress). Then I started to get painful earaches on that side, and a doctor very quickly diagnosed me with an infection, probably caused by water retained behind the wall of wax, against my eardrum, and a nice warm stagnant habitat. A round of antibiotics cleared the bacteria, and repeated dosing with warm oil (canola, in my case) over a few days cleared the wax.

The Q-tips thing is written on the box, but I always jam them in there anyways. I have found no other method of clearing the wax from my ears – the warm oil treatment just broke the blockage into chunks, which had to be scooped out with a Q-tip. What other tool can accomplish this task?

Prof.Pedant November 14, 2012 at 11:08 pm

“What other tool can accomplish this task?”

A paperclip. Grasp the paperclip so that the wire ends are covered by your finger and thumb and are pointed away from your ear. Grasp the paperclip so that the maximum distance you can insert it in your ear is less than the depth of your ear. Gently scoop out the earwax.

TheBrummell November 19, 2012 at 1:00 am

Hey, that’s pretty good, Prof.Pedant! I’ll have to try it. Thanks!

M.Khaled May 12, 2013 at 7:27 am

Actually, there are two main types of antibiotics, the one that inhibits htem and the one that kills them. And Earwax is of the first type. It can only inhibit the microorganisms you’ve mentioned. Means, they can be their but they can not continue multiplying to dangerous levels. Thats why when they performed the experiment, there were colonies of bacteria in the plate, each of which resembles one cell or more.
Besides, many of these microorganisms residing the ear are opportunistic pathogens. They only wait there for a chance to infect the ear. So, when the environment is suitable, like decreased wax due to excessive showering or anything like that, ear injuries, etc., they turn to be infectious and just infect the ear.
And about the middle ear, it is isolated from the external environment, however, microorganisms can get their through the Eustachian tube. Some of these can cause infection under certain conditions and others can just decrease the opportunity of other organisms in causing infection, like alpha hemolytic Streptococci which inhibits the growth of pathogenic S. pneumoniae and H. influenzae. And now, nasal sprays of this organism are intended to be developed.

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