cerumenolytics

Cerumenolytics are substances used to soften or dissolve earwax (cerumen) in the external ear canal to facilitate removal. They include peroxide-based preparations, oils, glycerin, saline, and combination products. The most widely used OTC cerumenolytics contain carbamide peroxide 6.5% in glycerin, which releases oxygen to loosen and soften wax. Hydrogen peroxide (often about 3%), glycerin, mineral oil, olive oil, and saline are also used. Some products pair a surfactant with oil or humectant to aid wax loosening.

Mechanism and use: Cerumenolytics soften wax, enabling it to be expelled or rinsed away. They are intended for mild to moderate cerumen buildup presenting with fullness or muffled hearing. They are not for sudden hearing loss, severe pain, or suspected perforation.

Contraindications and safety: Avoid use with tympanic membrane perforation, active otitis externa or media with drainage, prior ear surgery in the affected ear, or in young children without medical advice. Side effects include local irritation, itching, dizziness, or transient hearing loss; rare allergic reactions.

Administration: Use according to product directions, typically a few drops in the affected ear for several minutes, then drain and rinse if advised. Seek medical care if symptoms persist, worsen, or are accompanied by fever or discharge.

Efficacy: Evidence is mixed; wax removal is often feasible with self-care, but impacted cerumen may require examination and removal by a clinician, and irrigation should be performed with appropriate instruction or by a professional.