Ear wax
Ear impaction; Cerumen impaction; Ear blockage; Hearing loss - ear wax
The ear canal is lined with hair follicles. The ear canal also has glands that produce a waxy oil called cerumen. The wax will most often make its way to the opening of the ear. There it will fall out or be removed by washing.
Wax can build up and block the ear canal. Wax blockage is one of the most common causes of hearing loss.
The ear canal is lined with hair follicles and glands that produce a waxy oil called cerumen. 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.
The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.
The external structures of the ear may aid in diagnosing some conditions by the presence or absence of normal landmarks and abnormal features including earlobe creases, preauricular pits, and preauricular tags.
Causes
Ear wax protects the ear by:
- Trapping and preventing dust, bacteria, and other germs and small objects from entering and damaging the ear
- Protecting the delicate skin of the ear canal from getting irritated when water is in the canal
In some people, the glands produce more wax than can be easily removed from the ear. This extra wax may harden in the ear canal and block the ear, causing an impaction. When you try to clean the ear, you may instead push wax deeper and block the ear canal. For this reason, health care providers recommend against trying to reach into your own ear to clean it.
Symptoms
Treatment
Most cases of ear wax blockage can be treated at home. The following remedies can be used to soften wax in the ear:
- Baby oil
- Commercial ear drops
- Glycerin
- Mineral oil
- Water
Another method is to wash out the wax.
- Use body-temperature water (cooler water may cause brief but severe dizziness or vertigo).
- Hold your head upright and straighten the ear canal by holding the outside ear and gently pulling upward.
- Use a syringe (you can buy one at the store) to gently direct a small stream of water against the ear canal wall next to the wax plug.
- Tip your head to allow the water to drain. You may need to repeat irrigation several times.
Ask your health care provider before doing it on your own.
To avoid damaging your ear or causing an infection:
- Never irrigate or use drops to soften the wax in the ear if the eardrum may have a hole in it or you have had recent ear surgery.
- Do not irrigate the ear with a jet irrigator designed for cleaning teeth.
After the wax is removed, dry the ear thoroughly. You may use a few drops of alcohol in the ear or a hair dryer set on low to help dry the ear.
You may clean the outer ear canal by using a cloth or paper tissue wrapped around your finger. Mineral oil can be used to moisturize the ear and prevent the wax from drying.
Do not clean your ears too often or too hard. Ear wax also helps protect your ears. Never try to clean the ear by putting any object, such as a cotton swab, into the ear canal.
If you cannot remove the wax plug or you have discomfort, consult a health care provider, who may remove the wax by:
- Repeating the irrigation attempts
- Suctioning the ear canal
- Using a small device called a curette
- Using a microscope to help
The body naturally makes ear wax to coat, protect, and lubricate the lining of the ear canal. How do you get rid of extra ear wax? I'm Dr. Alan Greene with a few tips. Speaking of tips, one of the most common things people do is take a cotton swab and try to get the ear wax out that way. That works pretty well, but there are a couple of serious problems with it. One is if you happen to stumble you could actually hurt oneself with a ruptured eardrum with it. But the bigger problem is that whenever you put something in the ear like that and rub around, you're moving the hair cells inside the ear and stimulating the body to make more wax. So it actually perpetuates the problem. It gets out what's there, but it makes you have more very soon thereafter. Now the way the body is normally setup, the wax that's there is gradually moved out by the hair cells and it becomes and gets into this part of the ear. So, the best way in general to deal with your wax is stick nothing inside the ear canal. Just take a clean washcloth and clean the outer part of the ear that you can just easily reach with your finger. Every now and then though ear wax will build up where you do need to do something extra. That can happen if you've been sick or if the humidity changes or something irritating gets in there. Some people are genetically predisposed to it. But in that case, the best solution is usually to get ear wax drops. You get them over the counter both in brands and generic form. And the way they work is they melt the ear wax and make it easier to come out. So, you tilt your head to the side you put 5 or 10 drops in there. And you want to leave the drops in for a couple of minutes so you either need to keep your head tilted or you can put a cotton ball in and go about your work and then come back later to get rid of the wax and the drops. The way you get rid of it - you take a bulb syringe and you fill it with warm water by squeezing the air out first, dipping it in water, picking it up, and then just gently flush with the warm water. That'll help the drops come out, help some of that melted wax to come out. And then to get rid of that extra water in there, you tilt your head to the side, the other side down, and gently move your ear around in a circle like this and you should get the extra water drops out as well. You can do that a couple times a day for about 4 days and usually that'll take care of even a pretty serious ear wax build-up.
Outlook (Prognosis)
The ear may become blocked with wax again in the future. Hearing loss is often temporary. In most cases, hearing returns completely after the blockage is removed. Hearing aid users should have their ear canal checked for excess wax every 3 to 6 months.
Rarely, trying to remove ear wax may cause an infection in the ear canal. This can also damage the eardrum.
When to Contact a Medical Professional
See your provider if your ears are blocked with wax and you are unable to remove the wax.
Also call if you have an ear wax blockage and you develop new symptoms, such as:
- Drainage from the ear
- Ear pain
- Fever
- Hearing loss that continues after you clean the wax
References
Riviello RJ. Otolaryngologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 63.
Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical practice guideline (update): earwax (cerumen impaction). Otolaryngol Head Neck Surg. 2017;156(1_suppl):S1-S29. PMID: 28045591
Whitaker M. Office-based procedures in otology. In: Myers EN, Snyderman CH, eds. Operative Otolaryngology Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 125.
Version Info
Last reviewed on: 5/30/2022
Reviewed by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
