Cerumen Impaction - Ear Wax and Removal

So your partner has started to say, "Honey, why don't you answer me?" when you have never had a hearing problem before in your life. Either you have selective inattention (when you just choose to ignore someone), or you may have wax buildup in your ear(s). Do you turn your head to hear so you can hear with the better ear? Does your ear feel plugged? Is it itching? You may be developing a cerumen impaction or earwax blockage.

Cleaning Wax Out of the Ear Canal

Some Ear Wax is Good - Too Much Can Be Bad

Some people make a little bit of earwax (cerumen), while others produce a lot of it. For those who produce a lot of it, if it is concerning, ask your immediate family members (your parents and your brothers and sisters) if they have the same problem: It tends to run in families.

For some reason, people are very bothered by the mere thought of having earwax in their ears and try to remove every little bit of it. But earwax serves a purpose. Some earwax is a good thing. It is there to clear out debris like bacteria, dirt, and insects from your inner ears. It protects the ear canal's sensitive surface and has antibacterial properties. As most folks know, those Q-tips are only supposed to be used on the outer part of the ear. Many people know the expression, "Don't put anything smaller than your elbow into your ear."

Some people do make a lot of earwax or have narrow winding ear canals so it is hard for the earwax to get out on its own. In an effort to remove it with Q-Tips and various solutions, the wax gets pushed further and further into the ear canal. Occasionally, earbuds or earplugs contribute to pushing earwax further into the canal as well. Sometimes, when a person tries to clean out their own ears, some of the ear solution gets trapped behind the wax. Hearing becomes impaired, and the wax can become irritating. When a lot of wax gets stuck in the ear, this is called cerumen impaction (you would never believe how much wax can get stuck inside the ear!).

By the way, are you one of those folks digging around with Bobby pins and Q-tips who become obsessed with the wax in your ears? Just stop. You can actually cause inflammation and infection in the ear canal that way. Your ear canals are tender and can be scratched easily.  It is important to understand the correct process for cerumen impaction- earwax and removal.

​There are several ways to remove cerumen. The safest way is with irrigation (as long as you do not have a perforated eardrum or ear tubes). The following offers various solutions:​​​

How to Remove Earwax

1) Mix your own ear drops with 1/2 hydrogen peroxide and 1/2 WARM water. Put a few drops in your ear and lie on your side with that ear up for about 10 minutes. Use the rest of the WARM solution in a bulb syringe to gently squirt in your ear as you stand over the sink. If you do not see cerumen coming out, you may need to repeat the process. This can take a while because some cerumen gets old, hard, and thick.

2) You can do the same with Debrox (popular ear drops). Put a few (5) drops in your ear, lie on your side (as above), and irrigate with WARM water. Repeat twice a day for up to four days. If the cerumen does not come out or you develop worsening symptoms, see a healthcare provider.

3) Ear wax removal kits - over the counter. Follow instructions.

If you develop pain while doing this, stop and see a healthcare provider to have it checked.

Sometimes, there is infection and/or irritation in the canal (otitis externa/swimmers ear) or a middle ear infection behind the eardrum (otitis media).

Notes:

• Occasionally, the fluid you instill gets stuck behind the wax and causes more irritation

  
  

• If you get dizzy while irrigating, stop. You can try again, but be sure to use a warm solution. but if this continues, see your healthcare provider. 

  
  

• Don't try to scrape this out or use a Q-Tip. It should drip out.

  
  

If all else fails, you may need to see a clinician to have the wax removed and then practice prevention (which is not Q-Tips). If you are reasonably sure it is a wax problem, use an ear wax softener before going. Be aware that many insurance companies DO NOT cover this procedure unless you have other ear symptoms, such as pain. It needs to be "medically necessary".

Q&A

Ear Candling (coning) -

Some folks disagree with me, but most sources warn against this method. This is dangerous and often doesn’t work -- don’t do it. The idea is that you place the unlit end of a lit, hollow candle into your ear, and that draws out the wax. But several things can go wrong: It can push earwax deeper in, candle wax can get inside your ear, it can puncture your eardrum, or it can rupture or burn your ear canal, face, scalp, or hair. See your doctor if you think you have a problem with earwax. There are better ways to remove earwax!