Earwax (pī taringa) is naturally produced by your body to protect the inside of your ear from dust and infection.
Earwax is normal. Earwax not causing symptoms or blocking your ear canal should be left alone.
Usually, earwax moves slowly from the inside to the outside of your ear, where it falls out.
Sometimes the wax builds up and forms a plug that blocks your ear. In some cases, the wax plug falls out by itself without any treatment.
At other times, the build-up needs treatment. This includes drops or syringing, microsuction or manual removal by your healthcare professional.
Using cotton wool buds or ear candles is not recommended.
What is ear wax?
Ear wax is a waxy secretion made by your ear canal. It helps to clean your ear and prevent infections. It does this by being sticky and trapping dust. The muscles of the ear help the wax to move out of the ear. It is usually yellow or brown in colour.
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What causes the build-up of ear wax?
Some people naturally produce a lot of wax or produce hard and dry wax that is more likely to build-up. Other factors affecting wax build-up include:
having hairy or narrow ear canals
being an older adult, as earwax becomes drier with age
bony growths in the outer part of your ear canal
working in dusty environments
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, itching or pain in your ear
a feeling of fullness or a blocked feeling in your ear
hearing problems, eg, mild deafness
ringing, humming or buzzing in your ear (tinnitus)
Many people try to clean out earwax blockage with cotton wool buds. This is not recommended as the wax is often pushed deeper inside and you risk injuring your ear canal. Also avoid ear candles as they have no proven benefit in the removal of earwax and can cause serious injury.
Instead, use one of following treatment options:
You can do this treatment yourself.
You can buy ear drops (eg, Waxsol) from your pharmacy to soften the wax. Read the full instructions on the packaging.
Alternatively you can use olive, canola or baby oil. Use 2–3 drops in your ear 3–4 times a day and do this for 3–5 days.
Warm water is squirted into your ear to weaken and dislodge the wax. The wax flows out of your ear with the water. Your doctor or nurse can do it, or you can do it at home using a special treatment kit (eg, Audiclean) from your pharmacy.
A small device is used to suck the earwax out of your ear or alternatively a thin instrument with a small hoop at one end is used to remove the wax. These procedures are generally only available from specialist audiology (ear) services, although some branches of Hearing NZ offer them.
If you have earwax building up in your ear canal, it can be tempting to reach for a cotton-wool bud. But before you do, check out the answers to these frequently asked questions.
Do you need to treat your ears to prevent build-up of earwax?
Prevention is best for certain groups of people, but not everyone needs it. You may need to if you are an older adult, wear hearing aids or have a history of excessive earwax. Talk to your doctor to work out whether you should have preventative treatment.
How often should I remove wax from my ears?
There is no standard procedure for preventing earwax build-up, and for most people, nothing needs to be done unless too much wax develops. Ask your healthcare provider if there is anything special that you should do to prevent or reduce build-up of earwax.
What will happen if I just leave my ears alone and don’t clean them?
Most people don’t need a regular schedule to prevent earwax build-up, although some do occasionally.
Do cotton-wool buds remove wax from the ear?
Cotton-wool buds can remove some wax, but they often simply push the wax deeper into your ear. They may worsen an impaction (earwax blockage) or injure your ear canal. They are not recommended.
Does it hurt to have earwax removed?
The procedures used to remove earwax should not cause any pain. If the procedure involves liquid, it may feel funny but should not hurt.
If earwax is removed, will my hearing get better?
If your ear canal is completely or almost completely blocked by earwax, removing the wax will allow your hearing to return to the level it was before the blockage.
The guideline includes the following recommendations:
Clinicians should explain proper ear hygiene to prevent cerumen impaction when patients have an accumulation of cerumen.
Clinicians should diagnose cerumen impaction when an accumulation of cerumen, as seen on otoscopy, is associated with symptoms, prevents needed assessment of the ear, or both.
Clinicians should assess the patient with cerumen impaction by history and/or physical examination for factors that modify management, such as ≥1 of the following: anticoagulant therapy, immunocompromised state, diabetes mellitus, prior radiation therapy to the head and neck, ear canal stenosis, exostoses, and nonintact tympanic membrane.
Clinicians should not routinely treat cerumen in patients who are asymptomatic and whose ears can be adequately examined.
Clinicians should identify patients with obstructing cerumen in the ear canal who may not be able to express symptoms (young children and cognitively impaired children and adults), and they should promptly evaluate the need for intervention.
Clinicians should routinely perform otoscopy to screen for cerumen in patients with hearing aids during a healthcare encounter.
Clinicians should treat, or refer to a clinician who can treat, the patient with cerumen impaction with an appropriate intervention, which may include ≥1 of the following: cerumenolytic agents, irrigation, or manual removal requiring instrumentation.
Clinicians should recommend against ear candling for treating or preventing cerumen impaction.
Clinicians should assess patients at the conclusion of in-office treatment of cerumen impaction and document the resolution of impaction. If the impaction is not resolved, the clinician should use additional treatment. If full or partial symptoms persist despite resolution of impaction, the clinician should evaluate the patient for alternative diagnoses.
Finally, if initial management is unsuccessful, clinicians should refer patients with persistent cerumen impaction to clinicians who have specialised equipment and training to clean and evaluate ear canals and tympanic membranes.