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Visualizing and Quantifying Pharmaceutical Compounds within Skin using Coherent Raman Scattering Imaging

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Exploring Cerumen as an Alternative Matrix for Drug Detection and Quantification: Method Development and Application

Dimitrios Phaedon Kevrekidis¹, Helen G Gika¹, Georgios Panagiotoglou²

¹Laboratory of Forensic Medicine and Toxicology, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Drug Testing and Analysis

|May 26, 2026

Summary

This summary is machine-generated.

Earwax (cerumen) analysis can detect psychoactive medications, offering clinical and forensic insights. This study found cerumen testing effective for monitoring drug use, even after cessation, and more sensitive for certain drugs than urine.

Keywords:

alternative biological matrix apocrine sweat clinical drug testing earwax therapeutic drug monitoring

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Area of Science:

Forensic Toxicology
Clinical Chemistry
Pharmacology

Background:

Cerumen (earwax) is a complex biological matrix.
It is emerging as a novel specimen for xenobiotic detection.
Cerumen analysis has potential clinical and forensic applications.

Purpose of the Study:

To develop and apply an LC-MS/MS method for detecting 33 psychoactive medications in cerumen and urine.
To compare drug detection in cerumen and urine in psychiatric inpatients.
To explore the utility of cerumen for monitoring drug administration.

Main Methods:

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed.
Samples of cerumen and urine were collected from 60 psychiatric inpatients.
Qualitative analysis of 33 psychoactive medications was performed.

Main Results:

Cerumen and urine results were generally consistent.
Haloperidol, quetiapine, and nebivolol were detected more frequently in cerumen.
Drugs were detected in cerumen even without recent administration or when absent in urine.

Conclusions:

Cerumen is a valuable specimen for detecting psychoactive medications, complementing urine analysis.
It aids in monitoring acute and chronic drug administration, and even post-cessation.
Drug disposition in cerumen is complex, influenced by drug properties and physiological pathways.