What Is Earwax (Cerumen) Impaction?
Key takeaways:
Earwax is an important substance that helps protect your ear canal.
Earwax blockage can occur from using headphones, hearing aids, or inserting cotton swabs in your ears.
Removing excess earwax may require softening drops, flushing, or manual removal.
We all have earwax, and some have more than others. But what is this substance that can be sticky and sometimes dry? Just like mucus helps protect the inside of our nose, earwax protects our ear canals, keeping them healthy and free from irritation and infection.
It can be tempting to clean your own ears with cotton swabs when you have earwax buildup. But it turns out the cotton swabs can make the issue worse.
Keep reading to learn why earwax is important (and totally natural), and what you can do if you think you may have too much.
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What is earwax, and what does it do?
Earwax, or cerumen, is a substance produced by special glands in the ear canal. It’s the reason that dust, bacteria, and even insects can’t travel farther into the ear canal without getting trapped. The oily wax also keeps the ear canal from becoming dried out or irritated by water.
You may be wondering about your earwax? Does it look “normal”? It turns out that earwax comes in many different colors. It can vary from yellow to orange, brown, black, or gray. All these colors can be normal. Earwax may also be sticky or dry, depending on your genetics.
What is earwax impaction?
Chewing and moving your jaw allows earwax to move toward the opening of the ear canal. The earwax will eventually dry, flake, and fall out. But sometimes, earwax doesn’t make it all the way out and builds up in the ear canal. The extra wax may harden and block the ear canal. This is called cerumen impaction.
What causes an earwax blockage?
If you have an earwax blockage in your ears, there might be a simple explanation. A few reasons for this include:
Cleaning methods — like with cotton swabs — can push earwax farther into the ear canal.
Earwax that becomes drier as you get older can more readily get stuck.
Extra hair in your ear canal can trap the earwax.
Hearing aids can block earwax.
Genetic traits can make wax either stickier or drier.
Different shapes of the ear canal can trap earwax.
You also may be someone who produces a lot of earwax. And there’s nothing wrong with this. The truth is, some people just make more wax than others.
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What are the symptoms of impacted earwax?
Often an earwax buildup causes no symptoms at all. But in some cases, impacted earwax can cause symptoms such as:
Ear pain
Ears that feel clogged or full
Itching in the ear
Drainage or a bad smell from the ear
Loss of hearing
Ringing in the ears (tinnitus)
Keep in mind that other ear disorders can cause these symptoms, too — like an outer ear infection or Meniere’s disease, a condition that causes ear pain, vertigo, tinnitus, and hearing loss. That’s why healthcare providers always start with an ear examination to look for earwax when a person has symptoms related to their ears or hearing.
How is impacted earwax treated?
If you’re diagnosed with earwax impaction, your healthcare provider can help you decide the best way to treat it. We’ll discuss commonly used, effective treatment options below.
Cerumenolytic agents (earwax softeners)
Cerumenolytic agents are liquids or medications that can break up or dissolve earwax. Often, you need to use these ear drops for several days in a row before the wax buildup is soft enough to be removed.
Common earwax softening drops available over the counter include:
Almond oil
Carbamide peroxide
Docusate sodium
Hydrogen peroxide, 3%
Mineral oil
Saline solution
Irrigation
Irrigation of the ears is usually done with warm water or a mixture of water and hydrogen peroxide. Different types of bulbs and syringes are used to flush out your ear canal with these solutions. Before trying to flush or irrigate the earwax, you can use a cerumenolytic agent to help with removal.
Manual removal
When irrigation and drops aren’t enough, your healthcare provider will use special instruments to scoop or pull out the earwax. Because of the risk of injuring the ear canal and eardrum, only a healthcare professional should do this.
Sometimes you can treat impacted earwax at home, but make sure to talk to your healthcare provider first. Some treatments can be irritating and damage your ears if not done properly.
One more thing, don’t try “ear candles” at home. These haven’t been proven to help with earwax removal. You can also burn your face and ear or even puncture your eardrum in the process.
What are the long-term risks of not treating impacted earwax?
For most people, earwax impaction isn’t dangerous. But there are a few issues that can arise:
Temporary hearing loss
More permanent hearing loss can occur in children with earwax impaction
Difficulty looking into your ear, making it harder for your healthcare provider to diagnose other ear issues
Otitis externa, an outer ear infection
How do you prevent earwax impactions?
The best way to prevent earwax impactions is by properly caring for your ears. Your ears are self-cleaning, and you shouldn’t need to do much to keep them clean. Avoid sticking anything into your ear to clean it. This includes cotton swabs. When you push cotton swabs into the ear canal, the wax is pushed deeper down and can get stuck. All you need is a soft cloth to clean around the ear.
Talk to your healthcare provider to see if you would benefit from using over-the-counter cerumenolytic drops to soften hard earwax. If you wear hearing aids, have your ears checked regularly by your healthcare provider (every 3 to 6 months).
The bottom line
Ears are self-cleaning and don’t usually need much care to keep them clean. Earwax protects your ears, but an excess of it can cause a blockage in your ear canal. This blockage can lead to symptoms like hearing loss or ear pain. Speak with your healthcare provider to decide the best way to remove excess earwax from your ears.
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References
ENThealth.org. (2018). Earwax (cerumen impaction). American Academy of Otolaryngology-Head and Neck Surgery Foundation.
Horton, G. A., et al. (2020). Cerumen management: An updated clinical review and evidence-based approach for primary care physicians. Journal of Primary Care & Community Health.
Matsunaga, E. (1962). The dimorphism in human normal cerumen. Annals of Human Genetics.
McCarter, D. F., et al. (2007). Cerumen impaction. American Family Physician.
MedlinePlus. (2022). Ear wax. National Library of Medicine.
Michaudet, C., et al. (2018). Cerumen impaction: Diagnosis and management. American Family Physician.
National Center for Advancing Translational Sciences. (2016). Ménière's disease. U.S. Department of Health & Human Services.
Olusanya, B. O. (2003). Hearing impairment in children with impacted cerumen. Annals of Tropical Paediatrics.
Sevy, J. O., et al. (2021). Cerumen impaction removal. StatPearls.
