In this article:
- Earwax, or cerumen, is secreted inside your ear canals and forms a sticky, protective covering over the delicate inner lining of the ear canal.
- When there is excessive production of earwax, your ear is unable to clear it fast enough, leading to a blockage of the outer ear canal.
- Earwax buildup can lead to temporary loss of hearing, earache, itchiness, foul odor, and discharge from the ear.
- People who use cotton swabs or hearing aids are more prone to earwax accumulation/impaction than those who do not.
- Invasive ear cleaning techniques such as ear candling and the aggressive insertion of cotton swabs can damage your inner ear and eardrum and push the wax deeper.
What Is Earwax?
The ear canal is lined with sebaceous and ceruminous glands that produce a greasy, viscous substance called cerumen, more commonly known as earwax.
This oily secretion forms a protective covering over the delicate skin of the inner ear to keep it safe from external threats.
The sticky wax lining your ear cavity traps the invading germs, dust, and other irritants while keeping the ear canal well lubricated.
Earwax is vital for the health of your ears, but it can be a problem if it is secreted in excess amounts or accumulates over time.
Why Does Earwax Accumulate?
Your ear is a self-cleaning organ that gradually but systematically eliminates the old earwax. A failure to do so can result in wax buildup, which can compromise your hearing or cause other ear problems.
Earwax naturally migrates from the back of the ear canal toward the ear opening. The constant jaw motions while talking, chewing, and yawning further assist this forward movement.
Earwax serves as a medium for carrying dead skin cells and dust out of the ear as well. Once the mixture of earwax, epithelium cells, and other grime reaches the ear opening, it dries up, turns flaky, and falls out of the ear on its own.
Any disruption in this natural migratory process can lead to the progressive buildup of cerumen within the ear canal. The wax along with the debris and skin cells gets impacted over time. This means it becomes a dry, hardened consolidated mass blocking the ear canal.
Similarly, an overproduction of cerumen can overwhelm the self-cleaning mechanism of the ear, and the excess wax can get jammed within the ear canal to form a blockage.
Earwax buildup or blockage can make you hard of hearing for as long as it persists. (1)
Causes of Earwax Buildup/Blockage
The following factors can lead to the buildup and impaction of cerumen, resulting in an ear blockage:
- Certain ear infections such as swimmer’s ear can cause a narrowing of the outer ear canal due to inflammation and pave the way for earwax accumulation.
- Dermatological conditions such as eczema are characterized by hardened wax secretions and dry, flaky skin, both of which can contribute to excessive cerumen accumulation.
- Autoimmune conditions such as lupus can also lead to excess earwax buildup.
- Some trauma or blockage within the ear canal can also trigger an overproduction of cerumen, eventually resulting in a blockage.
- Unnecessary ear cleaning by inserting your fingers, cotton swabs, or other invasive tools into your ear canal can push the wax deeper into the ear and lodge it against the eardrum.
- People tend to produce drier and harder earwax as they get older. This earwax is relatively harder to expel because it does not move easily and is, therefore, more likely to cause a blockage.
- Some people, such as those of East Asian descent, produce a less fluid form of cerumen that is more likely to clump and form a blockage.
Signs and Symptoms of Earwax Buildup
Some of the signs and symptoms of the accumulation of excessive earwax include:
- A feeling of blockage or fullness in the ear
- Tinnitus or ringing in the ear
- A foul smell coming from the ear
- An uneasy sensation inside the ear
- Hearing problems, including temporary deafness (2)
- Itchiness in the ear
- Ear discharge
- Vertigo (dizziness)
How Is Earwax Blockage Diagnosed?
To diagnose an ear blockage, your ENT doctor or otologist will first review your medical history and then take a look inside your ear cavity using a medical tool called an otoscope.
This cylindrical device is fitted with a small flashlight and a magnifying lens that help the doctor examine the inside of your ear and detect signs of impacted cerumen.
In some cases, the extent of impaction is so severe that it clogs the entire ear canal such that the doctor is unable to see through it.
Another method to diagnose earwax buildup involves pulling the pinna, or the outermost part of the visible ear, to see if the patient is able to hear better or not.
This is known as Banji’s test. If the patient registers a momentary increase in sound perception when the pinna is pulled, the impaired hearing may be attributed to wax impaction.
The logic behind this examination is pulling the ear makes room for the sound to travel through the ear canal that is congested with earwax. If there is no improvement in sound perception following the pull, the impaired hearing may be due to something other than cerumen impaction. (3)
Medical Treatment for Earwax Blockage
The standard treatment options for earwax removal include:
- Ear drops: Hydrogen peroxide or enzyme-containing ear drops can be administered daily for a few days to dissolve the impacted earwax.
As the hardened wax acquires a more fluid-like consistency, it moves more easily out of the ear canal. You can use over-the-counter (OTC) ear drops for this purpose.
- Ear irrigation: Another commonly used preliminary treatment for the removal of cerumen buildup is ear irrigation.
As the name suggests, this process involves flushing your ear canal with a controlled, pressurized flow of warm water to dislodge and expel the impacted/excess earwax.
Although ear irrigation can be done using a metal syringe, an electronic ear irrigator is a safer and medically preferred option. This device comes with variable pressure control, which helps ensure that syringing can be initiated at the minimum pressure to avoid damaging the delicate inner ear. (4)
The water used for ear irrigation should be the same temperature as your body, neither too cold nor too hot. (4)
- Microsuction: Microsuction is a slightly discomforting but largely painless medical procedure that requires the patient to stay very still as the earwax is suctioned out of the cavity.
The doctor may also use a small device such as a curette or a cerumen spoon to manually remove the impacted wax, usually when all the other methods have failed. This procedure can be quite noisy and can temporarily alter your sound perception.
It is essential that you always consult your doctor before trying any OTC or self-treatment for earwax removal. The inside of your ear is extremely fragile and can get easily and irreparably damaged if the procedure is not done properly.
Your doctor will examine your ear to determine the extent of cerumen impaction before deciding upon the appropriate treatment with the least associated risks or side effects.
Also, the possibility of an ear infection or a pierced or perforated eardrum has to be ruled out before proceeding with any of these treatments.
Home Remedies for Earwax Buildup
1. Preventive Self-Care Tips to Avoid Earwax Buildup
You cannot regulate the production of earwax or change the width and shape of your ear canal.
However, preventive self-care measures can help reduce the incidence of wax buildup:
- If you are prone to earwax buildup, you must follow up with your ENT/otologist for regular ear cleaning to prevent future ear blockages.
- Your ear is more than equipped to clean itself. Needless poking and digging with sharp, invasive ear cleaning tools only irritate your sensitive inner lining and force the earwax further into the cavity.
Only gently wipe the outer ear from time to time to remove the debris, wax, and flaky skin.
- Apply a small amount of moisturizing lotion on the outer visible part of the ear to soothe dry, flaky, and sensitive skin.
This basic skincare can help prevent future blockages, provided that you do not use copious amounts of the product or put it inside the ear cavity. (9)
Inflammatory skin conditions such as eczema can also make your skin increasingly dry and flaky. The skin debris can in turn trickle down into your ear and cause a blockage.
Therefore it is necessary to manage any such underlying dermatological issue to prevent ear clogging.
- Do not spray water or any liquid inside your ear with force as it can damage the inner ear and eardrums, and the water pressure can force the earwax deeper into the ear canal.
- Before putting any cleaning solution in your ear, it is important to check its temperature. Using hot liquids to loosen the consolidated earwax can burn the skin inside the ear or perforate the eardrum, increasing the risk of ear infection.
- Never put cold water in your ear to flush out the excess earwax as it can cause dizziness.
- Not getting enough omega-3 fatty acids, zinc, and magnesium through your diet may lead to an overproduction, accumulation, and impaction of earwax.
Consume a wholesome, well-balanced diet with a special focus on foods that are rich in these vital nutrients.
2.1 Liquids to Remove and Soften Earwax
Several ear cleaning solutions can help break down consolidated earwax and thereby facilitate its natural expulsion out of the ear canal.
a. Oil-based compounds
Certain oils can be safely used as ear drops to soften impacted earwax and ease its expulsion out of the ear canal. These lubricating agents not only dilute the consistency of the consolidated wax, but some of these products also exhibit antiseptic properties that can help fight bacteria, fungi, and other infection-causing germs. (6)
Oils to use:
- Baby oil
- Almond oil
- Coconut oil
- Mineral oil
- Olive oil
How to use:
- Slightly warm the oil of your choice, but make sure it is not too hot before you put it in your ear.
- Tilt your head to one side and use a dropper to administer 3-4 drops of the warm oil into the clogged ear.
- Let the oil sit in your ear cavity for about 10-20 minutes so that it gets completely absorbed and subsequently loosens the earwax.
- After the wait time, tilt your head sideways and allow the downward push of gravity to force the wax toward the ear opening.
- Use cotton swabs or tissue to remove the softened wax from the rim of the ear canal, but do not dig too deep or too forcefully.
Note: This remedy is not suitable for people with an active ear infection or a perforated eardrum, as it can worsen the ear damage.
b. Water-based compounds
Baking soda, or sodium bicarbonate, may work as a diluting agent to break up impacted earwax to aid its natural expulsion.
You can make your own ear cleaning solution by mixing baking soda and regular water in a 1:10 ratio. This means that the solution should contain 10% baking soda. (7)
How to use:
- Mix 1 part baking soda and 10 parts regular or saline water.
- Tilt your head sideways and put several drops of this solution in the affected ear using an ear dropper.
- Let the solution settle for 10-20 minutes and then use a rubber-bulb syringe to gently flush warm water into the ear.
- The stream of water will move the wax toward the ear opening, after which you can use a tissue or soft cloth to wipe it off.
You can also use regular warm water or salt water for this purpose if you do not have baking soda at hand.
Note: Using a baking soda solution to clear out excess or impacted earwax is not recommended if you have a perforated eardrum or an active ear infection. Moreover, people who are using any other ear drop or are allergic to any ear drops should exercise extra precaution when using this remedy to avoid any ear damage or complications.
c. Other compounds
# Hydrogen peroxide
Hydrogen peroxide is an effervescent liquid that can be used to clear out small ear blockages caused by cerumen impaction or overproduction. (8)
How to use:
- Take equal parts of 3% hydrogen peroxide and water and mix them well to make a solution.
- Transfer the solution to an ear dropper and squeeze a few drops into the affected ear while tilting your head sideways.
- Wait for 10–20 minutes until the solution dilutes the hardened wax, and then use a cotton swab to gently clean the ear canal opening.
Note: Never use undiluted hydrogen peroxide to clean your ear. Hydrogen peroxide is a potent liquid that must be optimally diluted in water to avoid any damage to the delicate inner lining of the ear as well as the eardrum.
Glycerin is a mild lubricating agent that can be safely used to dissolve impacted earwax.
How to use:
- Fill an ear dropper with glycerin.
- Tilt the affected ear toward the sky and put 3-4 drops of glycerin into the affected ear.
- Close the opening of your ear with a cotton ball and then return your head to its normal position.
- Do not remove the cotton ball for at least a few hours, after which you can gently flush warm water in your ear to expel the softened wax.
# Vinegar and rubbing alcohol
A mixture of vinegar and rubbing alcohol has been successfully used for earwax removal for ages.
Besides dissolving and eliminating the earwax buildup, both of these ingredients provide additional benefits to remedy an ear blockage.
Alcohol is an effective drying agent that evaporates at a low temperature and has antimicrobial properties.
Vinegar is also credited with antimicrobial properties that can help reduce the risk of ear infections and can return the acid balance of the ear canal to a normal level.
How to use:
- Mix equal parts of white vinegar and rubbing alcohol in a bowl to make a solution.
- Use an ear dropper or drench a cotton ball in the solution.
- Tilt your head sideways such that the affected ear is facing the sky.
- Use the ear dropper or squeeze the cotton ball to dribble 2-3 drops of this solution into the ear. Allow the liquid to remain in the ear canal for 10-20 minutes.
- Turn the affected ear downward to allow the excess liquid to drain out. You may use a cotton swab to gently remove the earwax from the ear canal opening.
Note: This remedy is not meant for people with a perforated eardrum or active ear infection.
These home remedies carry a lot of anecdotal merits but lack direct scientific support. For any therapy to work, it must be done properly or else it can give rise to adverse side effects. The need for caution is even more important when you are treating something as delicate as the human ear.
So, to avoid any undue complications or potential ear damage, it is essential that you consult your ear doctor before attempting any of these remedies.
Your doctor will assess the extent of earwax accumulation and other relevant factors such as the state of your eardrum and the presence of any active infection before giving his green light.
If your condition does not improve or gets worse after this first-line, doctor-approved home treatment, you must seek immediate medical care to avoid any irreversible ear damage or hearing loss.
2.2 Ear Irrigation with Warm Water (After Softening the Earwax)
You can use any of the above-listed softening agents for a few days to adequately loosen and dislodge the impacted earwax, and then use ear irrigation to gently flush it out of the ear canal.
The controlled, pressurized flow of water helps direct the softened wax toward the opening of the ear from where it may naturally drain out or may be removed using a cotton swab, tissue, or soft, clean cloth.
- Tilt the outer ear toward the sky.
- Straighten your ear canal by stretching the pinna, or external flap of the ear, up and back.
- Use a rubber-bulb syringe to gently squirt warm water into your affected ear.
- Lastly, tilt the treated ear downward to let the water drain out.
Note: Using extreme water pressure or hot water for ear irrigation can damage or erode the sensitive lining of the inner ear and puncture your eardrum. So, do not try this method unless you are completely sure about the proper technique.
Seek your doctor’s help in this regard or let him conduct it for you. Water flossers such as the Waterpik release a high-pressure water stream that can damage your ears and therefore are not considered safe for regular home use.
Moreover, ear irrigation is not recommended for people with poorly controlled diabetes or a compromised immune system as they run the risk of contracting an outer-ear infection after this procedure.
It may take several rounds of wax softening and ear irrigation for the excess earwax to fall out such that the blockage clears completely.
In some cases, the wax-dissolving agents may only soften the superficial layer of the wax. If that happens, the loosened wax will move deeper into the ear canal and may get compressed against the eardrum. If you fail to register any relief even after a few treatments, see your doctor. (5)
Potentially Dangerous Home Remedies to Avoid
The ears are delicate organs and extra care must be observed when dealing with ear problems. Stay away from complications by avoiding the following remedies when dealing with earwax blockage.
Putting anything in your ear: Aggressive ear cleaning with sharp, invasive tools or even q-tips can compromise the structural integrity of the skin of the ear canal and can push the wax deeper toward the eardrum.
It may seem like a good idea to manually pull out the excess cerumen using a bobby pin, key, cotton swab, or any penetrative tool, but doing so can be counterproductive.
When you forcefully insert these cleaning tools in your ear cavity, they rub against the delicate inner lining and can leave it severely irritated or damaged.
Moreover, this kind of rigorous cleaning can strip away the natural oils inside the ear canal, introduce bacterial infections into the cavity, or rupture your eardrum.
Ear candling: Another alternative treatment for earwax removal that may be more damaging than helpful is ear candling. This method involves igniting a hollow cone-shaped ear candle and holding its flame over the affected ear.
The heat travels into the ear and dilutes the impacted wax. However, there is a significant risk of injury as the molten wax from the candle can drip into your ear and cause burns as well as further obstruction by adding to your earwax.
The following risk factors can make you increasingly predisposed to developing an earwax-induced blockage:
- Certain anatomical features such as a narrow or underdeveloped ear canal can make one prone to earwax buildup.
- This condition is more common in people with a history of impacted earwax and recurrent ear infections.
- People with excessive hair growth in the ear canals have a higher likelihood of developing earwax blockages.
- People tend to secrete harder and drier earwax as they get older, which is then more prone to impaction.
- Some people develop harmless bony protrusions in the external ear canal called osteomata, which can disrupt the self-cleaning mechanism of the ear.
- The regular use of earplugs, music earplugs, or even hearing aids can push the earwax further into the ear canal, leading to blockage.
Earwax blockage due to cerumen accumulation/impaction can lead to the following complications if it is not treated properly or if it escalates to a serious degree:
- Ruptured eardrum
- Middle-ear infection
- Outer-ear infection such as swimmer’s ear
- Vertigo characterized by dizziness and disorientation, typically when the earwax gets pushed against the eardrum or tympanic membrane
- Persistent tinnitus marked by a ringing or buzzing sound in your ear
Ears and Air Travel
It is common to experience a feeling of fullness or blockage in the ears when you are on board a flight, especially when making a landing.
This is largely due to a rapid change in atmospheric pressure, which the ears find hard to equalize. An air pocket forms in the middle ear that is increasingly sensitive to such air pressure fluctuations.
There are some easy ways to get rid of clogged ears caused by a difference in air pressure. The wax accumulation in your ears, however, may exert additional pressure and exacerbate your discomfort or pain.
When to See a Doctor
Your ear is a fragile organ that requires meticulous, gentle-handed care when there is blockage caused by an earwax buildup/impaction.
If you experience any unexplained ear pain, discomfort, a problem with your hearing function or any symptom that may indicate cerumen accumulation, visit your ENT or otologist for a proper checkup.
You should rely on your doctor to suggest the safest and most appropriate treatment for your particular case instead of treating the condition yourself.
If your symptoms persist even after 3-5 days of the prescribed treatment, please consult your doctor.
Prompt medical assistance is particularly warranted if you experience any of the following symptoms:
- Persistently high fever
- Constant nausea
- Severe vertigo that can disrupt your body balance to such a degree that it becomes difficult for you to walk
- Sudden loss of hearing
- Yellow or green pus-like discharge from the ear canal
- Acute ear pain or bleeding after inserting an ear cleaning object into the affected ear canal
What you may ask your doctor:
- What can I do about earwax impaction/blockage?
- What role does my age, gender, genes, or dietary intake play in the development of this problem?
- Is it safe to go swimming while I have an earwax-induced blockage?
- What can I do to prevent a buildup of earwax in the future?
- How frequently should the earwax be cleared out of the ears?
What your doctor may ask you:
- How long have your symptoms persisted?
- Have you experienced any discharge from your ears?
- Have you experienced any unexplained ear pain or hearing problems in the past?
- Do your ear symptoms come and go, or are they continuous?
- Have you tried any medical treatment or medication for earache/earwax blockage in the past?
Earwax or cerumen in normal amounts is important for keeping your ears healthy. This oily secretion helps to lubricate the ear canal and forms a shield over the delicate inner lining.
However, excessive amounts of earwax can build up over time and cause a blockage.
Deep cleaning your ears is not required unless there is enough earwax buildup to cause symptoms such as earache or hearing problems.
There are some self-care measures and home therapies that may assist with the expulsion of excess earwax, but one should refer to an ear specialist before starting self-treatment.