Earwax, or cerumen, is a naturally produced substance that protects the ear canal. While it serves a vital purpose, excessive buildup can lead to discomfort and other issues. Here's what you need to know about earwax removal methods.
Earwax might seem unpleasant, but it's a crucial part of your body's defense system. The yellowish wax, or cerumen, is produced as a protective mechanism for your ear canal. The ear canal is self-cleaning. It pushes wax out of the canal, where it eventually dries, flakes, and falls out on its own. The ear canal has tiny hairs and glands that naturally secrete waxy oil. Earwax protects the canal and inner ear as a moisturizer, lubricant, and water repellant. When you use your jaw to talk or chew, the motion helps move the wax toward your ear’s outer opening, where it can drain out. Along the way, the wax gathers and removes harmful dirt, cells, and dead skin that can lead to infection.
Most people don’t need to clean their ears. Unless the wax in your ears forms a blockage, you shouldn’t have to go out of your way to clean them. Once earwax naturally moves toward the opening of the ear canal, it typically falls out or washes away. Washing your hair is usually enough to remove the wax on your ear’s surface. During a shower, a small amount of warm water enters the ear canal and loosens any wax accumulated there. Use a damp washcloth to wipe away any wax outside your ear canal.
However, some individuals produce more wax than their body can naturally eliminate, resulting in a buildup over time. This condition, known as impacted earwax, can cause discomfort or other problems. About 5% of adults have excessive or impacted earwax. Some people naturally produce more earwax than others. And earwax that doesn’t move quickly or gathers too much dirt along the way can get hard and dry. Other people produce an average amount of wax, but it can get impacted when earbuds, earplugs, or hearing aids interrupt the natural flow.
Impacted earwax is often caused by wax being pushed deeper into the canal. A common culprit is cotton swabs like Q-tips, which people use to remove earwax. Over time, this can cause complete blockage. Earbuds, hearing aids, and swim plugs can also push wax deeper with repeated use.
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Impacted earwax can affect your hearing and cause discomfort. If you have impacted earwax, you may experience symptoms including:
The symptoms of impacted earwax can seem like other health conditions or problems. If you have any of these symptoms, talk with your care team to get a proper diagnosis.
Your health care provider can see if you have earwax blockage by looking in your ear. Your provider uses a special tool that lights and magnifies your inner ear (otoscope) to look in your ear. Through the otoscope, your physician can look at the amount and consistency of your earwax and determine if it’s blocking your ear canal.
Treatment depends on your symptoms, age, and health history. It also depends on the severity of your wax buildup. Impacted cerumen treatments involve both at-home and in-office methods.
You can use cerumenolytic solutions (solutions to dissolve wax) in your ear canal. These solutions include:
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With these solutions, you put a few drops into the affected ear and lie on the opposite side. This way, the solution can drip into your affected ear. These oils should be used sparingly. If using an over-the-counter earwax removal, follow the directions provided.
Over-the-counter ear drops - which often contain hydrogen peroxide as the main ingredient - can help soften hardened wax. Your physician can tell you how many drops to use each day and how many days to use them. Your PCP may advise against using ear drops if you have:
Another option is irrigating or syringing your ear. This involves using a syringe to rinse out your ear canal with water or saline solution. Generally, you should soften the wax first by using a cerumenolytic solution. Then, you’ll gently irrigate your ear with a bulb syringe. Irrigating (gently rinsing) your ear canal can reduce the risk of earwax impaction. It involves using a rubber bulb syringe to squirt water or a saline solution into the ear canal. When the water or solution drains out of the ear, it also flushes out loose ear wax. Use wax-softening ear drops before rinsing out your ear for the best results. And be sure to warm the solution to your body temperature. Cold water can stimulate the vestibular nerve (related to motion and position) and cause dizziness.
Your health care provider can remove excess wax by using a small, curved tool called a curet or by using suction techniques. Your provider can also flush out the wax using a syringe filled with warm water and saline or diluted hydrogen peroxide. Medicated ear drops may also be recommended to help soften the wax, such as carbamide peroxide (Debrox Earwax Removal Kit, Murine Ear Wax Removal System).
Finally, your healthcare provider can remove earwax manually using special instruments. They might use a cerumen spoon, forceps, irrigation, or a suction device. Earwax removal is the most common otolaryngologic (ear and throat) procedure performed by primary care physicians (PCPs) in the United States. Your physician knows how to soften and safely remove earwax using special instruments such as a wax spoon, suction device, or ear forceps - a long thin tool used to grab earwax.
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If earwax buildup continues, you may need to visit your health care provider once or twice a year for regular cleaning. Your health care provider may also recommend that you use earwax-softening agents such as saline, mineral oil, or olive oil. This helps loosen the wax so that it can leave the ear more easily.
The safest way to clean your ears if you have excess wax is to see your health care provider. If you're prone to earwax blockage, your health care provider can show you safe ways to reduce wax buildup at home, such as using ear drops or other earwax-softening agents. People shouldn't use ear drops if they have an ear infection unless it's recommended by a health care provider. Talk to your healthcare provider before trying any treatment.
As you prepare for your appointment, it's a good idea to write a list of questions.
Several common home methods are not recommended, as they can do more harm than good.
Some people try to remove earwax themselves using a technique called ear candling (ear coning). Essential oils - such as tea tree oil or garlic oil - are also not a proven treatment for earwax blockage. There is no data that shows they are safe for earwax removal, or that they work. Talk to your health care provider before trying any alternative remedies for removing earwax.
Build-up of earwax is a common reason for attendance in primary care. Current practice for earwax removal generally involves the use of a softening agent, followed by irrigation of the ear if required.
A review of studies on earwax removal methods found the following:
Although softeners are effective, which specific softeners are most effective remains uncertain. Evidence on the effectiveness of methods of irrigation or mechanical removal was equivocal.
Clean the outside of your ear with a washcloth. After showering or bathing, dry your ears as much as possible.
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