Earwax blockage

The ear canal is lined with hair follicles and glands that produce a waxy oil called cerumen. Earwax is a helpful and natural part of your body’s defenses. Sometimes the glands produce more wax than can be easily excreted out the ear. This extra wax may harden within the ear canal and block the ear.

Earwax blockage can happen to anyone but is more common in the following:

• Elderly people
• People who use hearing aids or earplugs

Earwax blockage occurs when earwax (cerumen) accumulates in your ear or becomes too hard to wash away naturally.

Cerumen or earwax is healthy in normal amounts and serves as a self-cleaning agent with protective, lubricating, and antibacterial properties ¹. Earwax cleans, lubricates and protects your ear canal by trapping dirt and slowing the growth of bacteria. The absence of earwax may result in dry, itchy ears. Self-cleaning means there is a slow and orderly movement of earwax and dead skin cells from the eardrum to the ear opening. Old earwax is constantly being transported, assisted by chewing and jaw motion, from the ear canal to the ear opening where, most of the time, it dries, flakes, and falls out.

Earwax is not formed in the deep part of the ear canal near the eardrum. It is only formed in the outer one-third of the ear canal. So, when you have wax blockage against the eardrum, it is often because you have been probing the ear with such things as cotton-tipped applicators, bobby pins, or twisted napkin corners. These objects only push the wax in deeper.

• STOP the habit of inserting cotton-tipped applicators or other objects into the ear canals.
• DON’T attempt to dig out earwax with cotton swabs or other items — such as hairpins, toothpicks, paper clips, pen caps or other things in your ear. This can push the wax farther into the ear and cause serious injury to the ear canal or eardrum (e.g. cut in your ear canal, poke a hole in your ear drum, or hurt the hearing bones) — leading to hearing loss, dizziness, ringing, ear infection and other symptoms of ear injury. You may see some earwax come out on a cotton swab, bobby pin, paperclip, or other item you put in your ear canal, but you are really only pushing earwax back into your ear, which may cause problems.
• DON’T use ear candles. Ear candles do not remove earwax and can cause serious damage to the ear canal and drum.
• DON’T irrigate or try earwax-removing/softening drops if you’ve had previous ear surgery or a hole in your ear drum unless cleared to do so by your ear, nose, and throat surgeon (otolaryngologist).
• Don’t forget to clean your hearing aids as the manufacturer and your hearing health professional recommend.

Under ideal circumstances, the ear canals should never have to be cleaned. However, that isn’t always the case. At times, your ear’s self-cleaning process might not work very well and may lead to a buildup of earwax. When this happens, earwax can collect and block or partly block your ear canal. This is impaction. Impacted earwax can cause symptoms like hearing loss, itching, or ear pain. The impaction also makes it hard for your health care provider to see in your ears. You can have symptoms when your ear canal is completely blocked by earwax or only partly blocked.

The ears should be cleaned when enough earwax accumulates to cause symptoms. Cerumen impaction or earwax blockage may cause one or more of the following symptoms:

• Earache, fullness in the ear, or a sensation the ear is plugged
• Partial hearing loss, which may be progressive
• Tinnitus, ringing, or noises in the ear
• Itching, odor, or discharge
• Coughing

If earwax blockage becomes a problem, you or your doctor can take simple steps to remove the wax safely.

Figure 1. Ear anatomy

Figure 2. Earwax blockage

Earwax blockage symptoms

Signs and symptoms of earwax blockage may include:

• Earache
• Hearing loss or decreased hearing in the affected ear
• Discharge coming from the ear
• Odor coming from the ear
• Feeling of fullness in the affected ear
• Ringing or noises in the ear (tinnitus)
• Change in hearing aid function
• Dizziness
• Cough

You should see your health care provider if you have symptoms and you are not sure if they are caused by earwax. You might have a different ear problem that needs medical care.

Earwax blockage causes

The wax in your ears is secreted by glands in the skin that lines the outer half of your ear canals. The wax and tiny hairs in these passages trap dust and other foreign particles that could damage deeper structures, such as your eardrum.

In most people, a small amount of earwax regularly makes its way to the opening of the ear, where it’s washed away or falls out as new wax is secreted to replace it. If you secrete an excessive amount of wax or if earwax isn’t cleared effectively, it may build up and block your ear canal.

Earwax blockages commonly occur when people try to clean their ears on their own by placing cotton swabs or other items in their ears. This often just pushes wax deeper into the ear, rather than removing it.

What can I do to prevent excessive earwax?

There are no proven ways to prevent cerumen impaction, but not inserting cotton-tipped swabs or other objects in the ear canal is strongly advised.

Not everyone needs prevention, but it is best for some groups. If you are elderly, use hearing aids, or have a history of making too much earwax, you may need regular treatment. It is important to remember that earwax is natural and helpful to the body. It does not always need to be removed. You do not have to do anything unless you have earwax buildup that causes symptoms or prevents your health care provider from examining your ears.

• If you are prone to repeated wax impaction or use hearing aids, consider seeing your doctor every 6 to 12 months for a checkup and routine preventive cleaning.

There is no standard course of action for preventing earwax buildup. Most people do not have to do anything unless too much earwax develops. Ask your health care provider if there is anything you should do to prevent or reduce earwax.

The type of treatment used to prevent the buildup of wax in your ear should usually not affect your hearing. If your ear canal is completely, or almost completely blocked by too much earwax, then removing the wax will allow your hearing to return to pre-blocked levels.

How is Earwax Blockage Diagnosed?

Earwax impaction is diagnosed through a physical examination and review of your medical history. Your health care provider may look in your ear canal with a tool called an otoscope or other device to see if you have impacted earwax. If you do, you may be treated for the impaction at that time or you may be sent to another provider for treatment.

How to remove ear wax blockage fast

The ear is a delicate and intricate body part, including the skin of the ear canal and the eardrum. Therefore, special care should be given to this part of the body.

• Start by discontinuing the habit of inserting cotton-tipped applicators or other objects into the ear canals.
• Don’t over-clean your ears. Too much cleaning may bother your ear canal, cause infection, and may even increase the chances of earwax impaction.

Your doctor can remove excess wax using a small, curved instrument called a curet or by using suction while inspecting the ear. Your doctor can also flush out the wax using a water pick or a rubber-bulb syringe filled with warm water (the best and fastest method). The procedures used by your doctor to remove earwax should not cause any pain. If you are putting a type of liquid into the ear it may feel funny, but should not hurt.

If earwax buildup is a recurring problem, your doctor may recommend that you use a wax-removal medication, such as carbamide peroxide (Debrox Earwax Removal Kit, Murine Ear Wax Removal System). Because these drops can irritate the delicate skin of the eardrum and ear canal, use them only as directed.

Most cases of ear wax blockage respond to home treatments used to soften wax. You can try placing a few drops of mineral oil, baby oil, glycerin, or commercial drops in the ear (Debrox Earwax Removal Kit, Murine Ear Wax Removal System). Detergent drops such as hydrogen peroxide or carbamide peroxide (available in most pharmacies) may also aid in the removal of wax.

Irrigation or ear syringing is commonly used for cleaning and can be performed by a physician or at home using a commercially available irrigation kit. Common solutions used for syringing include water and saline, which should be warmed to body temperature to prevent dizziness. Ear syringing is most effective when water, saline, or wax dissolving drops are put in the ear canal 15 to 30 minutes before treatment.

• Caution is advised to avoid having your ears irrigated if you have diabetes, a hole in the eardrum (perforation), tube in the eardrum, skin problems such as eczema in the ear canal or a weakened immune system.

Manual removal of earwax is also effective. This is most often performed by an otolaryngologist (ear, nose, and throat doctor) using suction or special miniature instruments, and a microscope to magnify the ear canal. Manual removal is preferred if your ear canal is narrow, the eardrum has a perforation or tube, other methods have failed, or if you have skin problems affecting the ear canal, diabetes or a weakened immune system.

Don’t try to dig it out

Never attempt to dig out excessive or hardened earwax with available items, such as a paper clip, a cotton swab or a hairpin. You may push the wax farther into your ear and cause serious damage to the lining of your ear canal or eardrum.

Ear Candling is NOT recommended

Some people use ear candling or ear coning, a technique that involves placing a lighted, hollow, cone-shaped candle into the ear, to try to remove earwax. The theory is that the heat from the flame will create a vacuum seal and the earwax will adhere to the candle.

However, ear candling is NOT a recommended treatment for earwax blockage. Ear candles are not a safe option of wax removal as they may result in serious injury. Since users are instructed to insert the 10- to 15-inch-long, cone-shaped, hollow candles, typically made of wax-impregnated cloth, into the ear canal and light the exposed end, some of the most common injuries are burns, obstruction of the ear canal with wax of the candle, or perforation of the membrane that separates the ear canal and the middle ear (see Figure 1 – Ear Anatomy above).

• Research has found that ear candling doesn’t work, and it may result in injury, such as burns, ear canal obstructions and even perforations.
• Research also shows that ear candling does NOT create a vacuum to suck earwax from the ear. Any wax left on the ear candle is from the candle itself, not earwax. Some risks of the ear candling process are the following:
  • Burns to the ear canal
  • Ear blockage from candling wax
  • Hole in eardrum
  • Ear infection

The U.S. Food and Drug Administration ² became concerned about the safety issues with ear candles after receiving reports of patient injury caused by the ear candling procedure. There are no controlled studies or other scientific evidence that support the safety and effectiveness of these devices for any of the purported claims or intended uses as contained in the labeling.

Based on the growing concern associated with the manufacture, marketing, and use of ear candles, the U.S. Food and Drug Administration has undertaken several successful regulatory actions, including product seizures and injunctions, since 1996. These actions were based, in part, upon violations of the Food, Drug, and Cosmetic Act that pose an imminent danger to health.

Talk to your doctor before trying any alternative remedies for removing earwax.

Ear wax blockage home remedy

If your eardrum doesn’t contain a tube or have a hole in it, these self-care measures may help you remove excess earwax that’s blocking your ear canal:

• Soften the wax. Use an eyedropper to apply a few drops of baby oil, mineral oil, glycerin or hydrogen peroxide in your ear canal.
• Use body-temperature water (cooler or warmer water may cause brief but severe dizziness or vertigo). After a day or two, when the wax is softened, use a rubber-bulb syringe to gently squirt warm water into your ear canal. Tilt your head and pull your outer ear up and back to straighten your ear canal. When finished irrigating, tip your head to the side to let the water drain out.
• Dry your ear canal. When finished, gently dry your outer ear with a towel or hand-held dryer.

To avoid damaging your ear or causing an infection:

• Never irrigate the ear if the eardrum may have a hole in it.
• Do not irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik).

You may need to repeat this wax-softening and irrigation procedure a few times before the excess earwax falls out. However, the softening agents may only loosen the outer layer of the wax and cause it to lodge deeper in the ear canal or against the eardrum. If your symptoms don’t improve after a few treatments, see your doctor.

Earwax removal kits available in stores also can be effective at removing wax buildup. Ask your doctor for advice on how to properly select and use alternative earwax removal methods.

1. Earwax and Care. http://www.entnet.org/content/earwax-and-care[↩]
2. Don’t Get Burned: Stay Away From Ear Candles. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm200277.htm[↩]