Although there are entire books devoted to the subject of earwax (and no, none of them have made the best seller list!), there are two important things to remember. The first is that earwax is mostly helpful – it acts as an antibacterial and antifungal agent. The second is that, for most people, the ear is a self cleaning mechanism. The outer 1/3 of the ear canal is made of cartilage and contains glands (cerumen and sebaceous) which produce wax and oil. The inner 2/3 of the ear canal is bony and covered by very thin skin. This inner skin is constantly being produced at the eardrum and moves very slowly – like a glacier – towards the outer part of the ear. As it does so, it moves the oil and wax (and any small hairs) out of the ear. What we commonly term earwax is actually a mixture of wax, oil, skin and hair. It typically can take many months for skin to travel from the eardrum to the outside of the ear canal. One can help facilitate the process of earwax migration by allowing warm clean water into the ears during a bath or shower. We do not recommend using a Q-Tip!! Q-tips can push wax deep into the ear canal and/or scratch sensitive skin. When wax is moist and then pushed deep into the canal with a Qtip, it can block the canal, harden and possibly cause hearing loss; it can also be a challenge to remove. We also do not recommend ear candling which Health Canada warns has no medical benefits and can cause serious injury. In some cases, no matter how careful and diligent we are, earwax needs to be extracted. In these difficult cases, I do not recommend self-extraction. In general, if you can not adequately see the earwax, you can not take it out properly. There is also significant potential for injury if appropriate methods are not used. An ENT, a licensed Audiologist or your GP are the best equipped to remove earwax when necessary.