Common Ear Problems And How To Treat Them

By: Mr Mark Krishna, Pharmacist at Unity

First seen in Lifestyle Magazine (March 2014), pg 90. This article is an unbreached version of the printed edition.

Introduction

Pharmacists are often asked about ear issues. Common problems such as ear wax impaction, blocked ears and ears clogged with water can be self-treated. However, some issues require a doctor’s visit. These include ear pain (might be sign of infection) and swimmer’s ear (infection of the external ear canal – different from water clogging the ears).

Earwax Impaction

The ear canal consists of several specialized structures that act together to produce earwax. Earwax coats and lubricates the external auditory canal, providing a protective barrier against infection. Earwax does not usually cause problems. However, producing too much earwax can lead to itching of the ear, pain, tinnitus, dizziness, cough, vertigo, and increased risk of infection.

Earwax impaction can be a result of ineffective attempts to remove earwax with cotton-tipped swabs or applicators. While a bit of earwax does discolour the applicator (brownish appearance after digging the ears), the bulk of the more solid mass of earwax is pushed further into the ear by the applicator and is harden. The natural movement of earwax towards the outer part of ear canal (Ceruminokinesis) is unable to move this harder wax, and the impaction results. Hearing aid and earplug users are also more prone to earwax blockage.

Many cases of ear wax respond to home treatments. It is possible to try using a few drops of olive oil, mineral oil, baby oil, or glycerin in the ear to soften the wax. Hydrogen peroxide drops can also be used. Common ear drops available in pharmacies contain docusate sodium and glycerol to aid in softening earwax. It is also possible to remove excess wax with ear irrigation products. These self-treatment measures may be used regularly, especially if the patient experiences earwax build-up often.

Mild cases of blocked ears (Eustachian Tube blockage)

The Eustachian tube which is located at the back of the nose next to the root of mouth ends in the middle ear space. The main function of the Eustachian tube is to ventilate the middle ear space, ensuring that the pressure remains at near normal air pressure.

Eustachian tube can be blocked for a variety of reasons including sinus infections and allergies which can cause swelling of the tissue lining. Changes in altitude when flying can also cause ear blockage. Initial measures patients can take to relieve blocked ears include swallowing, yawning and performing the Valsalva manoeuvre (pinching of nose, closing mouth and forcefully breathing air out). These actions cause contractions of muscles located in the back of the throat and help regulate Eustachian tube function. If these methods do not work, decongestants, orally taken (pseudoephedrine, phenylephrine); nasal sprays (phenylephrine, oxymetazoline tramazoline, xylometazoline) or nasal drops (ephedrine, oxymetazoline, xylometazoline), can be used to shrink the membranes lining the nose and throat, allowing the ears to equalize more easily. If these measures still do not provide relief, the patient should be referred to a doctor.

Water-Clogged Ears

In general, water can enter and exit the ear without any problems. However, there are times when water can penetrate into the ear canal, clogging the ear. This may cause reduced hearing and make the person more susceptible to ear infections. Besides reducing water exposure, wear shower caps, ear plugs or ear putties while bathing or swimming, tilt and shake excess water from ears if exposed to water, clear water in the ear by instilling 2 to 5 drops of isopropyl alcohol, methylated spirit or a solution of equal part of alcohol and vinegar (50:50 mixture) with a dropper into the water-clogged ear and it can safely dry water trapped.

It is important to note that treatment of the ear problems with non-prescription products is subjected to many limitations as only a small number of conditions can be self-treated. More serious conditions such as swimmer’s ear (a bacterial infection of the outer ear canal), loss of hearing, abnormal ear discharge, ear pain not due to earwax impaction, rash in ear and perforated eardrum must all be referred as additional medical treatment such as antibiotics; antifungal ear drops might be required.