What is earwax and why do we need it?
Earwax is a mixture of secretions from glands in the outer part of the ear canal, dead skin cells and tiny hairs. It lubricates the canal, traps dust and microbes and has mild antibacterial properties. Under normal conditions, jaw movement helps push it slowly towards the opening of the ear, where it dries and falls out or is washed away. Ear cleaning is not needed beyond wiping the outer ear with a cloth.
Symptoms of a wax blockage
- Muffled or reduced hearing, usually in one ear.
- A feeling of fullness or pressure.
- Ringing or buzzing in the ear (tinnitus).
- Itching or mild discomfort; occasionally a cough from irritation of the nerve in the ear canal.
- Dizziness or earache, less often.
- Symptoms can appear suddenly after showering or swimming, when wax swells.
- Not everyone with wax has symptoms. Wax only needs removal if it causes problems or blocks the view of the eardrum.
Why wax builds up
- Using cotton buds, hairpins or fingers, which push wax deeper.
- Wearing hearing aids, earbuds or earplugs for long periods.
- A narrow or curved ear canal or hairy canals.
- Skin conditions such as eczema.
- Older age: wax becomes drier and harder.
- Overproduction of wax, which varies between people.
- Learning disabilities or dementia can make wax problems more frequent.
Safe home treatment: softening drops
Ear drops soften the wax so it can leave on its own. The AAO-HNSF guideline lists water, saline, hydrogen peroxide, oil-based and cerumenolytic (wax-dissolving) drops as options, with no clear evidence that one is best. A practical routine:
- Lie on your side with the affected ear up.
- Put 2–3 drops of olive oil or an over-the-counter wax-softening drop in the ear, as directed.
- Stay in position for 5–10 minutes, then sit up; clean the outside with a tissue.
- Repeat 2–3 times a day for 3–5 days.
- The wax may fall out by itself or may soften enough to be washed out.
- Do not use these drops if you suspect a perforated eardrum or have an ear infection.
Professional removal
- Irrigation (syringing): a stream of warm water is gently directed into the canal. Not suitable for people with a perforation, ear tubes, previous ear surgery, or a history of infection.
- Microsuction: a clinician uses a small suction device under a microscope or headlight; widely used by ENT services and considered very safe and effective.
- Manual removal with curette or forceps under direct vision.
- Pharmacies in many countries offer wax removal; check the practitioner is trained. In Spain, ear cleaning is available at ENT clinics.
- In our practice we examine the ear canal and eardrum, then remove wax safely.
What to avoid
- Cotton buds: they push wax in and can scratch or perforate the eardrum.
- Ear candles: they do not remove wax, and cause burns and blockages. Health authorities advise against them.
- Hairpins, keys, pencils or fingers.
- Home irrigation kits or high-pressure devices without training; they can perforate the eardrum.
- Hydrogen peroxide in strong concentrations or repeated irrigation without advice.
- Leaving symptoms for months without checking: a blocked ear may not be wax.
Hearing aid and earbud users
People who wear hearing aids or earplugs regularly are more prone to wax build-up, and wax can block the device. Have your ears checked by a professional every 3–6 months, clean hearing aids as instructed and give the ears time to “breathe” without devices when possible. Excess wax can also reduce the benefit of hearing aids, so address it before blaming the device.
When to see a doctor
- Hearing loss or fullness lasting more than a week despite drops.
- Ear pain, discharge, fever or bleeding.
- Dizziness or tinnitus that is new or persistent.
- A perforated eardrum, ear tubes or previous ear surgery.
- Sudden hearing loss (urgent).
- Frequent wax build-up: a clinician can advise a routine.
- See also clogged ears.
Three common situations
Muffled hearing in one ear after a swim: wax swells when wet; try drops for 3–5 days and see a clinician if not clear.
Hearing aid user with repeated blockages: arrange a regular ear check and gentle removal.
Child with itching and no pain: avoid cotton buds; see a doctor to examine the ear.
Key points to remember
Earwax is normal. Treat it only when it blocks the ear, use softening drops, avoid cotton buds and candles, and ask a trained professional to remove it if needed. See a doctor for pain, discharge, sudden hearing loss or if you suspect a perforated eardrum.
This guide is for general information and does not replace an assessment by your own doctor or ENT specialist.
Questions about earwax blockage
These answers are general information and do not replace an examination or individual medical advice.
How do I know if my ear is blocked with wax?
Typical signs are muffled hearing, fullness, itching or ringing, often in one ear. A clinician can confirm by looking in the ear.
Is olive oil safe for ear wax?
It is commonly used to soften wax and is generally safe, unless you have a perforated eardrum, ear tubes or an infection.
Should I clean my ears with cotton buds?
No. They push wax deeper and can injure the canal and eardrum. Clean only the outer ear with a cloth.
Do ear candles work?
No. They do not remove wax and can cause burns and blockages.
How often should I have my ears cleaned?
Only when they cause symptoms or block the view of the eardrum. People with hearing aids may need checks every few months.
What is microsuction?
A safe method in which a clinician removes wax with a small suction device while viewing the canal.
Sources
- NHS · Earwax build-up
- AAO-HNSF · Clinical practice guideline: Cerumen impaction (update), 2017
- MedlinePlus · Ear wax
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.