The Ins and Outs of Safe Earwax Removal

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.

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.