Earwax: Why it Builds Up and How to Remove It

Excess earwax can be caused by skin conditions like eczema or when the ear canal is irritated by things like earbuds or hearing aids. The buildup of earwax may also occur as you get older when earwax is generally drier and harder, or simply because your ear canal is narrow. Improper cleaning can also cause earwax to become impacted (jammed) in the ear canal.

When earwax is impacted, it can cause itchiness, coughing, dizziness, ringing in the ear, and a significant loss of hearing. You may be able to remove the earwax at home, but you may be better served to see a healthcare provider if there is any discomfort or hearing loss.

Learn why you may suddenly have so much earwax, ways you can safely remove it, and when it is time to see a healthcare provider.

Function and Types of Earwax

Earwax is a waxy substance comprised of secretions in the ear canal. These include substances called cerumen (secreted by specialized sweat glands known as ceruminous glands) and sebum (a skin oil secreted throughout the body by sebaceous glands).

Ear wax protects the outer ear canal from dirt, insects, bacteria, and other harmful agents. It also repels water and keeps the ear canal moist and free from dryness and cracking.

Earwax also has antibacterial and antifungal properties. Studies show that a healthy amount of earwax may decrease your risk for ear infections like otitis externa.

What Causes Excessive Earwax?

Typically the body removes earwax through the action of chewing or talking. Jaw movement causes the earwax to move from your inner ear towards your outer ear.

However, certain conditions can cause the excess production of earwax and/or the impaction of earwax in the ears. Chief among them is the type of earwax you have.

These include:

• Wet earwax: This is the typical type of earwax that has a higher lipid (fat) content.
• Dry earwax: This is a type with a lower lipid content due to a reduced number of ceruminous glands.

Dry earwax can be problematic as it is less able to cling to the walls of the ear canal. Instead, it may start to clump as sebum glues it together with dead skin and debris.

Other causes and risk factors for earwax overproduction and impaction include:

• Genetics: Eastern Asian people are genetically predisposed to dry earwax.
• Older age: Sweat gland and sebaceous gland production tend to slow with age, increasing the likelihood of dry earwax. Hair in the ear canal also tends to become coarser, trapping earwax.
• Younger age: Babies and small children have shorter and narrower ear canals, increasing their vulnerability to impaction.
• Abnormal ear anatomy: This includes benign bony growths such as osteomas that can block the movement of wax from the ear.
• Improper ear cleaning: Using objects like cotton swabs can push earwax further into the ear canal, increasing the risk of impaction (and possibly damaging the ear canal or eardrum).
• Hearing devices: Over time, objects like earbuds and hearing aids block the migration of earwax from the ear canal, leading to impaction.
• Skin conditions: Eczema is an inflammatory condition that can cause increased earwax production. It also causes the shedding of skin cells that can mingle with earwax.
• Hidradenitis suppurativa: This is a condition that causes inflammation of the sebaceous glands, leading to skin infection, skin dryness, and dry earwax.
• Stress: Anxiety, fear, and stress are linked to increased earwax production due to the release of the stress hormone cortisol which stimulates sweat glands.

Some people produce more earwax than others for no apparent reason, referred to as idiopathic cerumen overproduction. In cases like these, earwax buildup tends to be recurrent.

Excess Earwax Symptoms

Earwax blockage can cause the following symptoms:

• Earache
• Hearing loss
• Feeling like your ears are plugged
• Ear itchiness
• Persistent cough
• Tinnitus (ringing in the ears)
• Dizziness

Removing Excess Earwax

About 12 million people get treated for excess earwax every year in the United States.

There are several ways to remove earwax at home, including over-the-counter ear drops containing mineral oil, glycerin, hydrogen peroxide, and saline (salt) solution. Rinsing of the ear canal can be done with a rubber bulb syringe purchased at most drug stores.

However, if you have pain or significant hearing loss, you should contact a healthcare provider. Similarly, if your child has excess earwax, see a pediatrician rather than trying to remove it yourself.

Earwax should only be removed if you have symptoms. The three methods of earwax removal by a healthcare provider include:

• Cerumenolytic agents: These ear drops, often containing carbamide peroxide, soften earwax so that it can be easily washed out of the ear canal.
• Ear irrigation: This involves squirting liquid in the ear canal to gently flush out earwax and debris.
• Manual extraction: This is typically done by an ear, nose, and throat (ENT) specialist using a lighted scope and specialized tools.

If left untreated, excessive earwax can cause impaction symptoms to worsen. These include hearing loss, ear pain, dizziness, and tinnitus. A buildup of earwax can also make it difficult to see inside it ear during a physical examination, which can lead to the misdiagnosis of a middle ear problem

Risks of Earwax Removal

Removal of earwax is relatively safe if performed with a healthcare provider. However, rare complications may occur, including:

• Allergic reactions (in response to certain cerumenolytic agents)
• Earache
• Bleeding
• Ear infection
• Ear pain
• Temporary hearing loss
• Ruptured eardrum
• Dizziness or vertigo (spinning sensations)
  
• Tinnitus
  

Preventing Earwax Buildup

The following measures may help prevent the buildup of earwax. However, you should speak with your healthcare provider before trying them, especially if you have a history of ear problems:

• Dip a cotton ball in mineral oil and place it in the outer ear canal for 10 to 20 minutes per week.
• Avoid wearing earplugs or hearing aids for eight or more hours at night.
• If you tend to have frequent earwax buildup, consider having a routine ear cleaning done by a healthcare provider every six to 12 months.

Summary

Earwax is a protective substance in the middle ear. Excessive earwax may be caused by the shape of a person's ear, genetics, stress, inserted devices, and hairy ear canal hair. Older adults are also more likely to have larger amounts of earwax.

Symptoms of excess earwax may include a cough, hearing loss, ear pain, itchiness, or tinnitus. To treat earwax impaction, it's best to see a healthcare provider. They may use ear irrigation, cerumenolytic ear drops, or manual extraction tools to remove the earwax safely.