Impacted earwax, also known as cerumen impaction, is a condition where earwax accumulates in the ear canal to an extent that it causes symptoms or blocks the passage of sound into the ear. Earwax, or cerumen, is a natural substance produced by glands in the outer part of the ear canal. It plays a crucial role in the ear’s self-cleaning process, protecting the ear by trapping dust, microorganisms, and other foreign particles. However, problems arise when there is an excessive buildup, leading to impaction. This article delves into the causes, symptoms, diagnosis, treatment, and prevention of impacted earwax, shedding light on this common yet often misunderstood condition.

Understanding Earwax and Its Functions

Earwax is composed of keratin (from shed skin cells), fatty acids, alcohols, squalene, and cholesterol. The composition and consistency of earwax can vary based on ethnicity, diet, age, and other factors. There are two primary types of earwax: wet and dry. The type of earwax an individual has is determined genetically.

The primary functions of earwax include lubricating the ear canal, providing protection against bacteria, fungi, insects, and water, and aiding in the cleaning and removal of dead skin cells from the ear canal.

Causes of Impacted Earwax

Impacted earwax can result from several factors, including:

Excessive Production: Some individuals naturally produce more earwax, increasing the risk of impaction.
Narrow or Irregular Ear Canals: Anatomical variations can hinder the natural exit of earwax.
Frequent Use of Earplugs or Hearing Aids: These devices can push earwax deeper into the ear canal.
Age: The consistency of earwax changes with age, becoming harder and more likely to form a blockage.
Improper Ear Cleaning: Using cotton swabs or other objects to clean the ear can push wax deeper into the canal, leading to impaction.

Symptoms of Impacted Earwax

The accumulation of earwax can lead to various symptoms, including:

Hearing Loss: Partial or full hearing loss in the affected ear is common.
Earache: Pain or discomfort in the ear may occur.
Tinnitus: Some people may experience ringing or buzzing sounds in the ear.
Fullness or Pressure: A sensation of fullness or pressure in the ear is often reported.
Dizziness: In some cases, impacted earwax can lead to vertigo or dizziness.
Cough: The stimulation of the vagus nerve by impacted wax can sometimes trigger a cough.

Consequences of Digging Earwax the Wrong Way

Risks of Using Improper Tools

When it comes to earwax removal, many people resort to using everyday items like cotton swabs, hairpins, or even keys. While it might seem like a quick fix, this practice can cause significant harm. One of the most common mistakes is pushing earwax deeper into the ear canal, which can lead to impacted earwax — a condition where earwax accumulates and hardens, blocking the ear canal. Impacted earwax can cause symptoms ranging from mild discomfort to severe pain, ringing in the ears (tinnitus), dizziness, and even temporary hearing loss.

Potential for Infection and Injury

Moreover, the delicate skin inside the ear canal can be easily scratched or injured by these foreign objects, increasing the risk of infections. Infections can occur when bacteria or fungi enter the tiny cuts or abrasions caused by improper cleaning. This can lead to otitis externa, also known as swimmer’s ear, which is an inflammation of the outer ear canal that can be painful and require medical treatment.

Severe Complications: Eardrum Perforation

In severe cases, the use of inappropriate tools can cause perforation of the eardrum. The eardrum is a thin membrane that separates the outer ear from the middle ear, and any perforation can lead to serious complications, including chronic ear infections, persistent hearing loss, and in some cases, the need for surgical intervention. Therefore, understanding the risks associated with improper earwax removal is crucial for protecting your ear health.

The Right Way to Remove Earwax

Understanding the Role of Earwax

Maintaining ear health begins with understanding that earwax, or cerumen, plays an essential role in protecting your ears. It traps dust, debris, and microorganisms, preventing them from reaching the deeper parts of your ear. Typically, earwax will naturally migrate out of the ear canal on its own, aided by jaw movements such as chewing and talking.

Safe Home Practices

If you feel the need to clean your ears, it’s important to do so with caution. Never insert objects into the ear canal, as this can lead to complications. Instead, focus on cleaning the outer part of your ear. A warm, damp cloth can be used to gently wipe away any excess earwax visible at the opening of the ear canal.

For those who experience an uncomfortable buildup of earwax, over-the-counter ear drops can help soften the wax, making it easier for it to exit the ear naturally. These drops typically contain ingredients like hydrogen peroxide or carbamide peroxide, which help to break down the wax. However, it’s essential to use these products as directed and consult with a healthcare professional if you’re unsure about their use, especially if you have a history of ear problems or experience symptoms like ear pain, hearing loss, or discharge.

Professional Earwax Removal Services in Singapore

Expertise at Aglow ENT Centre

For those experiencing persistent earwax problems or who prefer a safer, more reliable method of removal, professional earwax removal services are highly recommended. At Aglow ENT Centre, our experienced ENT specialist is able to safely remove impacted earwax without causing harm to the ear canal or eardrum.

The Procedure Explained

A thorough examination of the ear would be conducted using an otoscope, allowing us to assess the extent of the wax buildup and determine the most appropriate removal method. Depending on the situation, we may use microsuction, a gentle and precise technique that uses a tiny vacuum to remove earwax, or specialised instruments designed to extract wax without damaging the sensitive structures within the ear.

Ensuring Your Ear Health

In cases where earwax is particularly hard or impacted, we may recommend ear drops to soften the wax before removal. Our goal is not only to remove the earwax but also to ensure that your ear health is maintained, minimising the risk of infections or other complications.

Whether you’re experiencing symptoms like discomfort, hearing loss, or simply wish to maintain good ear hygiene, our professional earwax removal services provide peace of mind and effective results. At Aglow ENT Centre, we are committed to delivering personalised care that prioritises your ear health and overall well-being.

In some cases, if the object is not visible or if there is concern about damage to the ear structures, additional tests such as a tympanometry (to assess the functioning of the middle ear) or an audiogram (to test hearing) might be conducted.

Methods of Earwax Removal

Earwax removal is a critical aspect of maintaining ear health, but it must be approached with care to avoid causing harm. Various methods are available, each with its own set of benefits and risks. Understanding these techniques can help you choose the safest and most effective approach.

Natural Migration: The safest and most recommended method for earwax removal is to allow it to exit the ear naturally. Earwax is produced by glands in the ear canal and usually makes its way out of the ear on its own. As you chew, speak, and move your jaw, the earwax is gradually pushed from the ear canal to the ear opening, where it can be wiped away. This process usually requires no intervention and is the best way to maintain ear health.
Microscopic Clearance: Microscopic removal is a professional earwax removal technique performed by ENT specialists. It involves using a small, gentle vacuum to suction out earwax under direct observation with a microscope. This method is effective and safe, as it allows the specialist to see exactly what they are doing, minimising the risk of injury to the ear canal or eardrum. Microsuction is often recommended for those with impacted earwax or when other methods have failed.
Another method performed during the microscopic clearance is manual removal, where specialised tools such as curettes or tiny forceps are used to extract earwax. This technique requires skill and precision, as it involves working very close to the eardrum. It is typically used when earwax is hard or impacted, and other methods like irrigation are unsuitable. This method is not recommended for self-care due to the risk of pushing the wax deeper or injuring the ear.
Ear Drops: Over-the-counter ear drops are a popular and accessible method for softening earwax, making it easier for it to naturally exit the ear. These drops often contain ingredients like hydrogen peroxide, carbamide peroxide, or saline, which help to break down and dissolve earwax. Ear drops are usually safe for most people but should be used as directed. It’s important to consult with a healthcare provider before use if you have ear pain, discharge, or a history of ear problems.

Home Remedies for Earwax Buildup/ Home Remedies and Prevention Tips

While professional care is sometimes necessary, many people can manage earwax buildup safely at home with the right techniques. Understanding how to prevent excessive earwax accumulation and how to address it when it does occur can help you maintain healthy ears.

Avoid Inserting Objects into the Ear: One of the most critical prevention tips is to avoid inserting objects like cotton swabs, hairpins, or fingers into the ear canal. These items can push earwax deeper into the canal, leading to impaction and potential damage. Instead, focus on cleaning only the outer ear with a damp cloth, gently wiping away any wax that has migrated to the surface.
Use Warm Oil for Softening Earwax: A common home remedy for softening earwax involves using warm oil. Olive oil, baby oil, or mineral oil can be gently warmed (to body temperature) and placed into the ear with a dropper. The oil softens the earwax, making it easier for the wax to naturally work its way out of the ear. After applying the oil, lie on your side for a few minutes to allow the oil to penetrate, then wipe away any excess oil and earwax that may emerge.
Stay Hydrated: Hydration is essential for overall health, including ear health. Drinking plenty of water helps keep the body’s secretions, including earwax, at the right consistency. When you are well-hydrated, earwax is less likely to become too dry or hard, which can reduce the risk of impaction.
Steam Inhalation: Steam inhalation can help to loosen earwax, making it easier for it to naturally exit the ear. You can create steam by taking a hot shower or using a bowl of hot water. Simply cover your head with a towel and lean over the bowl, inhaling the steam. This method not only helps with earwax but can also benefit the sinuses, which are closely connected to ear health.
Regular Ear Check-ups: Even if you are able to successfully remove your earwax at home, regular check-ups with a healthcare provider are important, especially if you’re prone to excessive wax buildup or have pre-existing ear conditions. During a check-up, your doctor can inspect your ears, remove any excess wax if necessary, and provide advice tailored to your specific needs.
Consider Ear Drops for Maintenance: For those prone to earwax buildup, using ear drops periodically as a preventive measure can help keep the wax soft and reduce the likelihood of impaction. However, this should be done under the guidance of a healthcare provider, particularly if you have sensitive ears or any history of ear problems.
Avoid Over-Cleaning: It’s important to remember that earwax is beneficial and protective. Over-cleaning can strip the ear canal of this natural defence, leading to dryness, irritation, and even increased earwax production as the body tries to compensate. Therefore, aim for a balance — clean the outer ear regularly, but leave the ear canal to take care of itself unless there is a specific issue that needs to be addressed.

By following these home remedies and prevention tips, you can manage earwax buildup effectively and safely, ensuring that your ears stay healthy without the need for frequent medical interventions.

Prevention

Preventing impacted earwax involves adopting safe ear-cleaning practices and avoiding the overuse of earplugs and hearing aids when possible. Individuals prone to earwax buildup might consider regular check-ups with a healthcare provider to manage the condition proactively.

Conclusion

Impacted earwax is a prevalent issue that can lead to discomfort and hearing disturbances. Understanding its causes, symptoms, and treatment options is essential for effective management. By adhering to proper ear care practices and seeking professional assistance when necessary, individuals can prevent the complications associated with impacted earwax and maintain optimal ear health.

Frequently Asked Questions

Is it worth getting earwax removed?

Yes, getting earwax removed is definitely worth it, especially if you’re experiencing symptoms like hearing loss, discomfort, itching, or a feeling of fullness in the ear. While earwax is a natural substance that protects your ears by trapping dust and debris, too much of it can lead to problems such as ear infections or impacted earwax, which can be painful and affect your hearing. Professional earwax removal ensures that the wax is removed safely and effectively, reducing the risk of complications and helping to maintain your overall ear health.

Is earwax removal painful?

Earwax removal is generally not painful, especially when performed by a healthcare professional. Most methods, such as microsuction, are designed to be safe and comfortable. You might experience a sensation of pressure or slight discomfort during the procedure, but it shouldn’t be painful. If you’re using at-home remedies like ear drops, you might feel a slight fizzing or bubbling sensation as the wax softens, but this is usually mild. If you experience pain during earwax removal, it’s important to stop and consult a healthcare provider, as this could indicate an underlying issue.

How to tell if you need earwax removal?

You may need earwax removal if you notice symptoms such as hearing loss, a feeling of fullness or blockage in your ear, ringing in the ear (tinnitus), dizziness, or discomfort in the ear. Sometimes, earwax buildup can also cause itching or discharge from the ear. If you’re frequently cleaning your ears but still experience these symptoms, it’s likely that the earwax has become impacted and needs professional removal. It’s always a good idea to consult with a healthcare provider if you’re unsure, as they can examine your ears and determine the best course of action.

Will deep earwax eventually come out?

Deep earwax may eventually work its way out of the ear naturally, as the ear is designed to self-clean. However, if the earwax is deeply impacted, it might not come out on its own and could even worsen over time. Jaw movements, like chewing and talking, help to push earwax outward, but in some cases, the wax can become too hard or trapped to be expelled naturally. If deep earwax is causing symptoms or discomfort, it’s best to seek professional removal rather than waiting for it to come out on its own.

What happens if you push earwax too deep into your ear?

Pushing earwax too deep into your ear can lead to a number of problems, including impacted earwax, which can cause pain, hearing loss, and a sensation of fullness in the ear. Additionally, pushing earwax deeper can damage the sensitive skin of the ear canal or even perforate the eardrum, leading to infections and more serious complications. If you suspect you’ve pushed earwax too deep, it’s important to avoid further attempts at cleaning and seek professional help to safely remove the wax and prevent any damage.

What softens earwax fast?

To soften earwax quickly, you can use over-the-counter ear drops that contain ingredients like hydrogen peroxide or carbamide peroxide. These drops work by breaking down the wax and making it easier for it to naturally exit the ear. Another effective method is to use warm oil, such as olive oil or baby oil, which can be gently applied into the ear with a dropper. Let the oil sit in the ear for a few minutes while lying on your side, then wipe away any excess. Both methods can help soften earwax fast and facilitate its removal, but it’s important to follow instructions carefully and consult a healthcare provider if you have any concerns.

Medical Teaching

Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.