Hearing Health

Impacted Earwax

What is impacted earwax?

Earwax is a waxy, yellowish substance that lines the inside of your ear canal. The ear canal is the tube that runs from your outer ear to your eardrum. The wax helps protect your canal from water, infection, injury, and foreign bodies. But too much wax buildup can cause problems. This buildup is called impacted earwax.

Special glands in your ear make secretions that combine with dead skin cells to form earwax. The earwax travels with slowly growing cells of your skin. Over time, the earwax moves from the inner part of your ear canal to the entrance of the canal. Jaw movement also helps the earwax move through the canal.

Some things can cause problems with this normal process. Any type of blockage in the canal can cause a problem. Some people also may make too much earwax. This causes it to build up in the ear canal. The earwax may not totally block your ear canal. Most people have just a little buildup of earwax, which doesn’t cause any symptoms at all.

Impacted earwax is very common. As you get older, earwax tends to become harder and less mobile. Older adults are more likely to have problems with too much earwax. It can cause symptoms like hearing loss. It can also prevent a proper exam of the ear.

What causes impacted earwax?

Earwax buildup happens when your ear makes earwax faster than your body can remove it. This can happen with a number of health conditions, such as:

  • Bony blockage (osteoma or exostoses)
  • Infectious disease, like swimmer’s ear (external otitis)
  • Skin disease (like eczema)
  • Autoimmune disease (like lupus)
  • Narrowed ear canal (from birth, chronic inflammation, or injury)
  • Making too much earwax due to injury
  • Making too much earwax due to water collecting in the ear canal

Some of these conditions cause a physical blockage. Others cause more earwax to be made. In some cases, the cause of impacted earwax is not known.

Objects placed in your ear can also lead to impacted earwax, especially if done repeatedly. This is more likely in children and young people who have no other problems with their ear canals. For example, if you use cotton swabs to remove earwax, you may push the wax deeper into your canal. Over time, this may cause complete blockage. Hearing aids, swimming plugs, and swim molds can have a similar effect with repeated use.

Who is at risk for impacted earwax?

You may be at increased risk if you have a health condition that can cause increased earwax buildup, like eczema. You may also increase your risk if you keep putting objects in your ear, like a hearing aid. Older adults and people with thinking (cognitive) problems also have an increased risk.

What are the symptoms of impacted earwax?

Earwax usually does not cause any symptoms, unless it builds up a lot. These are the most common symptoms of impacted earwax:

  • Hearing loss
  • Earache
  • Sense of ear fullness
  • Itching in the ear
  • Dizziness
  • Ringing in the ears
  • Cough

You might have only 1 or 2 of these symptoms. They often happen slowly.

The symptoms of impacted earwax may look like other health conditions or problems. Always see your healthcare provider for more information.

How is impacted earwax diagnosed?

Your healthcare provider can diagnose impacted earwax by taking your medical history and giving you a physical exam. This might include some simple hearing tests. Your provider should easily see the wax when looking at your ear through a device called an otoscope.

Your provider might diagnose you with impacted earwax even if you don’t have any symptoms. For example, you might need an ear exam for another reason. If you have so much earwax that your provider can’t see into your ear canal, he or she might diagnose you with impacted earwax.

How is impacted earwax treated?

Your healthcare provider will figure out the best treatment plan for you based on:

  • How old you are
  • Your overall health and medical history
  • How sick you are
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your opinion or preference

If you have symptoms of impacted earwax, your provider will likely recommend some kind of treatment. If you don’t have any symptoms, your provider will likely not recommend treatment, unless you need an ear exam for other reasons. Often, the earwax goes away on its own with time. In rare cases, removing earwax can cause providers. Providers may recommend removal for people who can’t talk about their symptoms, like young children.

Treatment options include:

  • Medicines dropped into the ear canal, to soften the earwax and slowly break it down
  • Irrigation of the ear canal with water in your provider’s office
  • Manual removal, using special tools in your provider’s office

Your healthcare provider might recommend one of these options, partly based on your other health conditions. You might need a combination of these methods for the best removal.

Providers don't recommend using other home methods of earwax removal (like ear candling and ear vacuum kits). Studies have shown these methods don’t work well.

What are the complications of impacted earwax?

Impacted earwax itself does not usually cause problems. But in rare cases, some treatments for earwax removal cause the following complications:

  • Swimmer’s ear (otitis external)
  • Earache
  • Short-term (temporary) hearing loss
  • Dizziness
  • Retention of water in the canal
  • Eardrum hole (perforation)
  • Ringing in the ears
  • Bleeding from the ear

Different removal methods have different risks for these complications. Your own risk depends on your other health conditions. For example, people with diabetes may have a greater risk for swimmer’s ear. Talk with your healthcare provider about the risks that most apply to you.

Can impacted earwax be prevented?

You may not be able to prevent impacted earwax if you have certain medical conditions that make it more likely to have earwax buildup, such as eczema. But if you don’t have these types of medical conditions, you might be able to prevent repeated episodes. Using a topical agent once a week may help. You may also need to plan for a regular ear cleaning every 6 months or so. Healthcare providers recommend not using cotton swabs. They often push the earwax farther back down your ear canal.

 

When should I call my healthcare provider?

Call your healthcare provider if you have severe symptoms after your earwax removal, such as bleeding from your ears or significant ear pain.

Key points

  • Earwax is a normal substance that helps protect the inside of your ear canal.
  • When too much earwax builds up (gets impacted), it can cause symptoms like temporary hearing loss.
  • Earwax buildup is more common in older adults.
  • Certain medical conditions increase the likelihood of impacted earwax.
  • You might need special drops to help remove your earwax, or you might need an office procedure to remove it. Never try to remove your own earwax manually.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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