Patient education: Ear wax impaction (The Basics)

What is ear wax impaction? — Ear wax impaction is when ear wax builds up enough to cause symptoms. Normally, ear wax helps to protect the insides of the ears and prevents injury or infection (figure 1). But having too much ear wax can cause symptoms like trouble hearing and sometimes pain. The medical term for ear wax is "cerumen."

Young children and older adults are more likely than others to have ear wax impaction.

What causes ear wax impaction? — Several different things can cause ear wax impaction:

●Diseases that affect the ear – Some health problems can affect the shape of the inside of the ear, and make it hard for wax to move out. For example, skin problems that cause skin cells to shed a lot can lead to wax build-up in the ears.

●A narrow ear canal (figure 2) – In some people, the ear canals are narrower than in others. These people might be more likely to have ear wax impaction. A person's ear canal can become narrower after an ear injury or after severe or multiple ear infections.

●Changes in ear wax and lining due to aging – As people get older, their ear wax gets harder and thicker. This makes it more difficult for the wax to move out of the ear as it normally should.

●Ear-cleaning habits – Some people try to clean their ears using cotton swabs (Q-Tips) or other tools. This can actually push the wax deeper into the ear instead of getting it out. Over time, this can cause ear wax impaction.

●Making too much ear wax – Some people make more ear wax than others. This can happen when water gets trapped in the ear, or when the ear is injured. But some people just have a lot of ear wax for no obvious reason.

What are the symptoms of ear wax impaction? — The symptoms include:

●Trouble hearing

●Pain in the ear

●Feeling like the ear is blocked or plugged

●Hearing a ringing noise in the ear

These symptoms can happen in 1 or both ears.

Should I see a doctor or nurse? — Yes. If you or your child have any of these symptoms, see a doctor or nurse. They can check the insides of the ears to figure out if the symptoms are caused by ear wax impaction or another problem, such as an ear infection.

Should I clean my (or my child's) ears at home? — No. The insides of the ears do not usually need to be cleaned. Sticking anything into the ears can push the wax in deeper and cause impaction.

"Ear candling" involves lighting 1 end of a hollow candle, and putting the other end in the ear. Ear candling is not recommended for ear wax removal. It does not remove ear wax and can even cause ear injuries and burns.

How is ear wax impaction treated? — There are several treatments to remove impacted ear wax. Doctors and nurses offer these treatments only to people who have bothersome symptoms. They do not recommend treatments for removing ear wax in people who have no symptoms, even if they have ear wax impaction.

In some cases, doctors and nurses will remove ear wax in people whose ears are impacted and who aren't able to let others know if they have symptoms or not. This can include young children, and people who are confused or have trouble communicating, including some older adults.

There are several different ways to remove ear wax:

●Ear drops – Special ear drops can soften ear wax and help it to drain out. Ear drops are not usually safe for people with an ear infection or damage to the eardrum.

●Rinsing – In some cases, a doctor or nurse can remove impacted ear wax by squirting water (or another liquid) into the ear to rinse it out.

●Special tools – A doctor or nurse might use a special tool to remove ear wax. There are different types of tools that can do this safely. These include small sticks, hooks, and spoons. There are also tools that use suction to pull the wax out.

More on this topic

Patient education: Ear infections (otitis media) in children (The Basics)
Patient education: Outer ear infection (The Basics)
Patient education: Age-related hearing loss (presbycusis) (The Basics)
Patient education: Tinnitus (ringing in the ears) (The Basics)

Patient education: Ear infections (otitis media) in children (Beyond the Basics)
Patient education: External otitis (including swimmer's ear) (Beyond the Basics)
Patient education: Tinnitus (ringing in the ears) (Beyond the Basics)