Earwax build-up and removal

Earwax is naturally produced by the body to protect the inside of your ear from water and infection.

The amount of earwax produced varies from person to person. Usually, earwax moves slowly from the inside to the outside of your ear, where it is washed. Sometimes the wax builds up and forms a plug which blocks the ear. In some cases, the wax plug falls out by itself without any treatment. At other times, the build-up needs treatment.

What causes the build-up of ear wax?

The build-up of earwax is a common problem that can happen at any age. Some people naturally produce a lot of wax or produce hard and dry wax which is more prone to build-up. Other factors that can increase the chance of wax build-up include:

  • having hairy or narrow ear canals 
  • being elderly, as earwax becomes drier with age
  • bony growths in the outer part of the ear canal.

Inserting objects into your ear canal, such as cotton buds, ear plugs or hearing aids can also cause wax blockage.

What are the symptoms of earwax build-up?

The build-up of ear wax in your ear can cause:

  • discomfort or pain in the ear
  • a feeling of fullness or a blocked feeling in your ear
  • problems hearing
  • ringing, humming or buzzing in the ear (tinnitus)
  • dizziness (vertigo).

How is wax build-up treated?

When faced with blocked ears many people try to clean out the blockage by inserting cotton wool buds into their ears. However, this can make things worse as the wax is often pushed deeper inside. 

Rather than reaching for the cotton buds, consider the following treatment options: 

Ear drops

You can soften the wax by using olive oil, baby oil or ear drops such as Waxsol or Cerumol which can be bought from your pharmacy. Place a few drops in your ear each day for 3 to 7 days to soften and loosen the wax, so that it falls out naturally. Read more about how to apply ear drops.

Syringing or ear irrigation

Ear syringing is commonly used to remove wax build-up. It is usually performed by a nurse or doctor. 

Warm water is squirted into your ear which weakens and dislodges the wax. The wax flows out of the ear with the water.

  • Ear syringing isn't usually painful, but it can be quite uncomfortable and can make you feel dizzy. 
  • To be effective, you must have used ear drops or olive oil drops for at least 5 days before ear syringing.
  • There is a small risk of infection or damage to your ear canal or a perforated eardrum (a hole in the eardrum).

Ear syringing is not suitable for everybody, for example, if you have a hole in the eardrum (perforation), have had ear surgery in the past or have a weakened immune system. 

Microsuction

This is a quick and painless procedure where a small device is used to suck the earwax out of your ear. Compared with syringing, there is less risk of damage to the ear and it does not always need softening drops first. You may feel some discomfort, tickling or dizziness during microsuction. This procedure is only available at specialist ear care clinics. 

Aural toilet (manual removal)

Here the wax is removed manually using a thin instrument with a small hoop at one end. It is used to clean your ear and scrape out the earwax.

Avoid ear candles

The use ear candles is not advised. They have no proven benefit in the removal of earwax and can cause serious injury.

How can wax build-up be prevented?

Some people are naturally prone to wax building up in their ears and may need frequent treatment to remove it when it becomes a problem.

Regular use of olive oil drops (2 to 3 drops in each ear once per week) may reduce the build up of wax. This can be particularly useful if you use hearing aids or ear plugs. 

Learn more

The following links provide further information on earwax. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Earwax Ear Nurse Specialist Group (NZ)
Earwax build-up NHS Choices (UK)
Earwax BetterHealth (Australia)
Earwax and care  AAO-HNSF (US)

References

Earwax management Australian Family Physician, October 2015