The Ins and Outs of Safe Earwax Removal
Safely removing the gunk will help you feel and hear better
It may be something icky that you’d rather not think about, but earwax is a perfectly normal bodily secretion and a fact of life. Knowing how to control that gunk will allow you to hear better and prevent infections, earaches and more.
What earwax is and why we have it
So what, exactly, is this stuff? Well, earwax — the medical term is cerumen — is a waxy oil secreted by the tiny sebaceous and sweat glands that line the walls of the outer ear canal. A small amount of earwax regularly migrates from deep in the ear canal to the outside of the ear — acting as a kind of conveyor belt — carrying a lot of bad stuff along with it. “These secretions keep a flow going away from the eardrum toward the opening of the ear, catching dead skin cells, tiny hairs that line the ear canal and other types of microscopic debris along the way,” explains Mark Vaughan, M.D., a family physician and medical director at Auburn Medical Group in Auburn, California. Eventually, when the waxy mixture reaches the outside of the ear, it typically flakes off. Jaw movements, such as talking and chewing, help move things along.
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Earwax on its own isn’t bad. “When ears are making the right amount of wax, it’s actually the sign of a healthy ear,” says Anh Nguyen-Huynh, M.D., an ENT-otolaryngologist affiliated with Cleveland Clinic. Indeed, earwax acts as a protective lubricant that coats the ear canal, repelling water and preventing the skin from drying out. That waxy component is slightly acidic, so it “creates an unfriendly environment” for the bacteria and fungus that tend to develop in the moist, dark environment of the inner ear, says Yu-Lan Mary Ying, M.D., an otolaryngologist–head and neck surgeon affiliated with Rutgers New Jersey Medical School in Newark. In fact, the wax of diabetic people is less acidic, making them more vulnerable to ear infections.
Not all earwax is the same. People of African or European descent, for example, have wax that’s moist and gooey, while most Asians have dry, flaky earwax.
Why too much earwax can be a problem
Some people are more prone to producing excessive earwax. A waxy buildup is particularly common in older adults. According to the American Academy of Otolaryngology (AAO), approximately 1 in 20 adults experience a buildup of earwax.
“One factor has to do with the effects that aging has on our glands — including the salivary glands in our mouth, the mucus glands in our nose and throat, and the glands in our ears — whose secretions can change in consistency,” says Isaac Namdar, M.D., associate professor in the department of otolaryngology at Mount Sinai West Hospital. As we age, the secretions change in consistency. Earwax becomes drier and harder and migrates more slowly out of the canal, causing dead skin particles to collect. Certain conditions that produce dry, flaking skin, such as eczema, can also make it harder for the wax to exit.
What’s more, “it could be that the process of sloughing it off becomes more sluggish with age,” says Nguyen-Huynh. “Also, one of the things I notice in older patients is that many of them — men in particular — have a copious amount of hair growing in the ear canal, which could impede the movement of skin and ear wax. And in some, the outer ear canal becomes narrower and less firm with age, which can make it easy for wax to get trapped.”
Those who wear hearing aids or earbuds regularly are at risk, too, since the devices can potentially block the outward flow of earwax. What’s more, Ying says, that wax may damage your hearing aid, creating muffled sound amplification or an annoying whistling or squeaking sound called feedback, or even causing the device not to fit. Hearing aids may also become damaged if the wax gets into the vents and receivers. Try to clean your device daily, and have it checked out by your doctor every few months, to be sure it’s in good working order.
While a little excess earwax is merely a nuisance, an abundance of wax can accumulate in the ear canal over time and create a blockage. That big clump of earwax, called impacted cerumen, is hard to remove, especially if it is hard and dry. This may lead to difficulty hearing, a stopped-up feeling of fullness in the ear, ringing in the ear (called tinnitus) or pain. “If the whole ear canal is occluded by wax,” says Ying, “it can press against the eardrum, leading to problems with the middle ear physiology, and may even cause dizziness,” which can increase your risk of falling.
How to keep earwax under control
“People think earwax is dirty and needs to be cleaned,” says Nguyen-Huynh. “But our ears are like self-cleaning ovens, designed to get rid of undesirable stuff.” Unless earwax is creating a problem, she says, no action is necessary.
For small amounts, you may want to give your ears a gentle cleansing each day. The best approach: After washing your face or stepping out of a steamy shower, cover one finger with a damp washcloth and wipe the nooks and crannies around of your outer ear. “De-clogging the most external exit will help with that natural migration,” Ying says.
People who tend to produce an abundance of earwax may try using a softening agent — such as mineral oil, baby oil or 3 percent hydrogen peroxide — to help the wax leave the ear or to remove it more easily. Using an eyedropper, apply a drop or two into your ear, tilting your head so that the opening of the ear is pointing up toward the ceiling. Stay in that position for a minute or two to let the fluid flow down to the waxy buildup. Then tilt your head in the opposite direction to let the fluid to drain, along with the wax that has broken loose. Sometimes, a few squirts of warm water, gently squeezed from a rubber bulb syringe into the ear, may be needed to dislodge loosened wax. This routine may need to be repeated before the excess wax breaks free.
Or try an over-the-counter product to loosen small amounts of wax. These products may contain an oil-based solution or hydrogen peroxide. (Ying recommends the Debrox Earwax Removal Kit.) Some include a bulb syringe that you squeeze to flush your ear with warm water, if needed.
Do's and Don’ts of At-Home Earwax Removal
- Use a damp washcloth to wipe the outer portion of the ear each day
- Try a drop or two of a softening agent, like baby oil or mineral oil, to remove wax
- Consider an over-the-counter product containing oil or hydrogen peroxide to loosen wax
- Insert cotton swabs, fingers or other implements into the ear canal
- Irrigate your ears with water if you have a damaged eardrum or middle ear infection
- Treat a wax blockage at home; visit your health care provider for symptoms like hearing loss, ringing or ear fullness
Irrigation, however, isn’t always appropriate, particularly if you have a damaged eardrum or a middle ear infection. A hole in the eardrum may allow fluid to be flushed deeper into the ear canal. If it doesn’t come out, it can create a moist environment, and that can lead to an outer ear infection. And if you’re not careful, irrigation can cause an eardrum perforation. “You’re doing it blind,” says Ying. “You think, Let me go in a little bit deeper, but you have no way to gauge that.” What’s more, if you’re softening the plugged-up wax but not dissolving or removing it, the fluid can turn all of that into a wall of mud that can plug up your ears even more.
It might be tempting to poke a cotton swab, bobby pin, pencil or finger into your ear to get the gunk out, but don’t go digging. Yes, it’ll remove some of the wax, but it may also push the rest deeper into the ear canal. There’s also a risk of injuring the eardrum. “You might look at your Q-tip and think, Look at this stuff I got out of my ear,” says Vaughan, who has seen plenty of this “pushy” behavior in his practice. “But that’s actually wax you got from the sides of the ear canal, after you’ve pushed most of the wax further inside the ear canal.” A tip from Nguyen-Huynh: When you put a cotton swab inside the ear and hear the sound of the tip rustling those tiny hairs, that means you’re in a place you should not be.
When to get medical help
If these measures don’t clear out the bad stuff, see your health care provider to remove a blockage. It’s not uncommon to have a buildup after using cotton swabs because the “tip tends to plow earwax was deeper,” Nguyen-Huynh says. Do that over time and you will build up a big clump of wax, called an impacted cerumen, which is difficult to remove, especially if it is hard and dry.
If the buildup is fairly close to the opening of the ear canal, a general practitioner can do the job. In fact, earwax removal is one of the most common otolaryngological procedures performed in a primary care setting. If the ear is impacted with a hard, stubborn chunk of wax that’s really lodged in there, it may be time to bring out the big guns — namely, an ear, nose and throat doctor (that is, an otolaryngologist) — for a closer look. Otolaryngologists have an arsenal of precise tools at their disposal to go deep without harming the delicate eardrum.
“First and foremost is being able to visualize what is going on in there,” says Namdar. “We have the endoscope to let us look inside the ear canal to see exactly how much wax you have, the texture of the wax, and then decide the best instrument to use to remove it.” There are various techniques doctors employ to remove impacted wax. One involves using a curette, a slender instrument designed to fit into the narrow ear canal that has a curved tip to scrape or scoop out wax. Another method Ying uses involves dilating the ear canal with a speculum, then using suction to dislodge the wax.
A clean ear canal can make a world of difference. One study found that 35 percent of hospitalized patients over age 65 had impacted earwax and 75 percent of those had improved hearing after it was removed. Some experts estimate that removing an earwax plug can improve hearing by 10 decibels. (The difference between whispering and normal conversation is around 20 decibels.) And if earwax is causing tinnitus, getting it removed may very well resolve the problem.
Better hearing might not be the only benefit to maintaining a clean ear canal. There may be a link between earwax blockage and brainpower. In a small 2014 study, Japanese researchers found significant improvements in hearing — as well as in cognitive ability — among elderly patients with memory disorders after impacted earwax was removed from their ears.“There may also be an improvement in your balance,” Vaughan says. “Some patients actually feel as though their lives have changed.”
Editor’s note: This story was originally published on April 7, 2020. It’s been updated to include additional guidance on proper earwax removal.
Barbara Stepko is a longtime health and lifestyle writer, and former editor at Women’s Health and InStyle. Her work has appeared in The Wall Street Journal, Parade and other national magazines.