Among the curious services offered in modern Japan, mimikaki cafes are possibly some of the strangest experiences for the unacquainted Westerner. In these cafes, you can have wax picked out of your ears by waitresses who also offer the weary worker/traveler a respite from the hubbub of the outside world. “Mimikaki” refers to an ear pick made of bamboo, metal, or plastic with a small scoop at the end. Waitresses at mimikaki cafes use this instrument to gently scape out your excess ear wax. While this may appear fairly benign, having your ear wax cleaned by people other than trained otolaryngologists or medical providers, may set you up with weeks of discomfort and pain!
Before delving into that, what is ear wax and why do we even produce it?
Earwax, also known as cerumen, is a yellowish waxy substance secreted in the outer third of the ear canal. It is a mixture of secretions from sebaceous and apocrine sweat glands. Evolutionarily, scientists have hypothesized that cerumen protects the ear canal, assists in cleaning and lubrication, and also provides some protection from bacteria, fungi, insects, and water. There are generally two versions of cerumen: the wet type, which is dominant, and the dry type, which is recessive. While Asians and Native Americans are more likely to have the dry type of cerumen, which is gray and flaky, people of African and European descent tend to have the wet type, which has a honey-brown to yellow-brown color and moist consistency.
Knowing that, however, why should you go to a medical professional for cerumen removal?
Cotton swabs (Q-Tips or cotton buds) and mimikakis may force the wax further down the ear canal, and if used carelessly, perforate the eardrum, resulting in pain, bleeding, and temporary hearing loss. Abrasion of the ear canal, particularly after infiltration with water from swimming or bathing, may lead to an ear infection as bacteria wind up traveling deep into the ear canal. All of these situations can occur when trying to self-remove cerumen or having it done by an untrained professional.
Image Source: Grayce Roessier
What to do when your ears feel clogged?
Severe cerumen impaction results in your ear drum (tympanic membrane) being unable to oscillate. This results in conductive hearing loss, in which sound is physically unable to travel to the auditory nerve. Unless this occurs, the American Academy of Otolaryngology discourages earwax removal unless excess earwax is causing health problems. To keep ear wax manageable, various over-the-counter (OTC) measures can be done to improve cerumen impaction. The easiest method is using an OTC ear flush kit once a month to irrigate the ear and loosen any hard wax. This is normally performed in a warm shower, in which the moisture assists in flushing out the wax. Other measures include using solutions of hydrogen peroxide or baking soda to soften wax.
If you are unsuccessful in these attempts, you should book an appointment to see an otolaryngologist or medical provider to debride or suction your wax out. In these appointments, the physician examines your ear canal under an otoscope and uses specialized instruments to extract the wax, without harming your ear canal or eardrum.
As the saying goes, if it is larger than your elbow, keep it out of your ear!
Featured Image Source: Justin Chin
