My son Ryan also used to have the ENT clean out his ears every 30 days or so. Over the years we began using a solution of peroxide and warm water (50/50) letting that sit in the ear for a little bit bubbling up stuff and then using a syringe or just letting the solution run out. If there is big skin it will come up. Then maybe a q-tip to remove little bits of skin. Make sure to cover side of face so solution doesn't get into eyes.