Earwax

Definition of earwax

Earwax is a waxy, brownish-yellow discharge produced by the ceruminous and sebaceous glands located in the external portion of the ear canal. Under physiological conditions, the secreted ear wax flows slowly towards the outside of the auricle: once it has reached this site, the ear wax can be removed by careful washing.
Earwax exerts very important protective functions of the auditory duct:

It hinders the entry of foreign material into the external auditory canal (eg bacteria, fungi, insects, water, dust, etc.)
Lubricates the external auditory canal, reducing the risk of drying out

Under certain circumstances, the ear wax tends to accumulate excessively in the ear: in such situations, the overabundant ceruminous substance can occlude the external ear canal and press against the eardrum, to the point of damaging the hearing capacity to a greater or lesser extent.

Generality

COMPOSITION

Earwax is a sebaceous and greasy secretion that covers the epithelial surface of the external auditory canal. This is a waxy blend with a viscous consistency, consisting of:

Keratin (60%)
Long-chain saturated and unsaturated fatty acids, Alcohols, Squalene (12-20%)
Cholesterol (6-9%)

Earwax also contains lysozyme, a protein substance (enzyme) that boasts antibacterial properties: it is believed, in fact, that lysozyme gives earwax discrete antimicrobial properties, being able to hydrolyze (destroy) the peptidoglycans that make up the bacterial wall.
Under physiological conditions, the pH of earwax is slightly acidic (pH 6.1).

TYPE

There are two types of ear wax:

Wet / Wet Earwax: Most Blacks and West Caucasians have this type of earwax. This sebaceous secretion has a humid appearance similar to honey and a variable color from yellowish to brown. The peculiar honey-like consistency of wet earwax is due to a higher concentration of lipids and pigment granules (approx. 50%).
Dry earwax: typical of Asians and Indians (American Indians), dry earwax has a grayish color and a scaly consistency. Compared to the wet variant, dry earwax is composed of a lower percentage of lipids and pigment granules (30% approx.).

From what emerges in the magazine "Clinical Otolaryngology", it seems that in man the type of earwax seems genetically determined by a simple Mendelian character. The wet type is considered a dominant trait, while the dry type is recessive.

Functions

As mentioned in the incipit, earwax plays very important functions for the ear:

First of all, the earwax lubricates the external auditory canal, minimizing the risk of drying, itching and burning of the skin that covers it (humectant / lubricant function).
Earwax has antimicrobial effects: recent studies have demonstrated the bactericidal and antifungal (antifungal) effect of earwax.
The antibacterial action (mainly due to lysozyme) has proved particularly effective against infections sustained by some bacterial strains: Haemophilus influenzae, Staphylococcus aureus and Escherichia coli.
Earwax inhibits the fungal attack of the fungi most involved in otomycosis (Candida, Penicillium and Aspergillus). The antifungal action of earwax seems to be mainly due to two factors: presence of saturated fatty acids + slightly acidic pH.

Earwax and associated disorders

Under certain circumstances, earwax can accumulate inside the ear canal, causing serious damage. In case of failure or incorrect ear cleaning, earwax can obstruct the ear canal, forming a solid concretion called plug of earwax.
Earwax plugs can cause various ailments which, if left untreated, can seriously impair hearing:

Auditory canal occlusion
Otodynia: ear pain due to mechanical stimulation
Impaired hearing
Constant feeling of having "the" closed ear "
Ear itching and pain
Ringing in the ears (tinnitus)
Altered balance (similar to dizziness) → after a bath (eg swimming pool)
Increased Risk of Infection: Mechanical "cleaning" with cotton swabs can create abrasions within the ear canal, increasing the risk of bacterial or fungal infection.

What can promote the accumulation of earwax?

Overproduction of earwax by the sebaceous glands (glandular hypersecretion) → It seems that the production of earwax increases on certain occasions: for example, anxiety, stress and fear stimulate the earwax glands to produce greater quantities of earwax.
Ear disorders → stop the physiological sliding of the ear wax towards the outside of the auricle
Introduction of water into the ear canal → after a bath or swim, the glands in the ear canal become soaked with water, so the ear wax takes on a softer consistency. In such circumstances, ear wax tends to clog the ear canal, thus creating a "muffled" hearing and an unpleasant feeling of instability.
Incorrect ear hygiene → both lack of cleaning and incorrect ear hygiene can favor the accumulation of earwax. For example, excessive mechanical cleansing, often performed with cotton swabs, can compact the earwax towards the inside of the ear canal, compromising hearing.