Earwax Buildup: What's Normal, What's Not, and When to Get It Checked

Almost everyone deals with earwax at some point, whether it is a mild itch, a feeling of fullness, or hearing that suddenly sounds muffled. It is one of the most common reasons patients call an ENT office, and the good news is that it is usually simple to treat once it is properly evaluated.

The tricky part is that a lot of the advice people grow up with, like using a cotton swab or trying an ear candle, can actually make the problem worse. This article covers what earwax is for, what causes it to build up, how to tell if you have impaction, and what to do about it safely.

What Earwax Is For

Earwax, or cerumen, is made by glands in the outer part of the ear canal. It is not a sign of poor hygiene. It actually protects the ear by trapping dust and debris, moisturizing the skin of the canal, and creating a mildly acidic environment that helps keep bacteria and fungus from growing. In most people, the ear canal clears itself gradually. Old wax moves outward over time, helped along by jaw movement from talking and chewing, and it usually falls out or gets washed away without you noticing.

Why Earwax Builds Up or Becomes Impacted

For some people, that natural self-cleaning process does not keep up, and wax accumulates faster than it clears. Common reasons include:

• Narrow or unusually curvy ear canals, which make it harder for wax to work its way out
• Naturally hairy ear canals, which can trap wax
• Regular use of hearing aids, earbuds, or earplugs, which can block the canal and push wax back in
• Getting older, since earwax tends to become drier and harder to clear with age
• Cotton swabs, bobby pins, or anything else inserted into the ear canal, which push wax deeper rather than removing it

Over time, this trapped wax can harden and pack against the eardrum. That is called cerumen impaction, and it is what usually brings people in to see us.

Signs of Earwax Impaction

Impacted earwax can cause a range of symptoms, and they do not always show up in just one ear. Common ones include:

• A blocked or full feeling in the ear
• Muffled or reduced hearing
• Itching in the ear canal
• Ringing or buzzing (tinnitus)
• Mild dizziness or a feeling of imbalance
• Odor or discharge from the ear
• Ear discomfort or a mild ache

These symptoms can overlap with other ear conditions, so it is worth having a clinician take a look rather than assuming it is always wax.

Why Cotton Swabs and Ear Candling Are a Bad Idea

It is worth repeating: cotton swabs do not remove earwax from where the problem actually is. They mostly clean the outer part of the canal while pushing the rest of the wax further in, closer to the eardrum. Used repeatedly, this can pack wax into a hard plug and, in rare cases, injure the eardrum itself.

Ear candling, where a hollow candle is placed in the ear and lit on the other end, is not an effective way to remove wax. It does not create the suction it claims to, and it carries a real risk of dripping hot wax into the ear canal or burning the ear or face. We do not recommend it.

What Is Safe to Try at Home

For mild, occasional buildup, over-the-counter softening drops (mineral oil, glycerin, or saline-based ear drops) can help loosen wax so it clears on its own. Follow the instructions on the package and give it a few days. If the blocked feeling does not improve, or if it gets worse, stop and have it checked rather than trying to dig it out yourself.

Home softening drops are not right for everyone. See the section below on who should avoid home treatment entirely.

When to See an ENT

Make an appointment if you notice any of the following:

• Blocked hearing or fullness that does not improve after a few days of home softening drops
• Sudden or significant hearing loss
• Ear pain, drainage, or bleeding
• Dizziness along with ear symptoms
• Wax buildup that keeps coming back

What Earwax Removal in Our Office Involves

In-office cerumen removal is quick and, for most patients, painless. We use a microscope to see the ear canal and eardrum clearly, which lets us remove wax precisely and safely. Depending on the situation, we may use gentle irrigation (rinsing the canal with warm water), a small curette to lift wax out directly, or suction. Most visits take just a few minutes, and many patients notice improved hearing right away.

Who Should Never Attempt Home Removal

Some patients should skip home remedies altogether and come straight in. This includes anyone with:

• A perforated or previously perforated eardrum
• Ear tubes
• A history of ear surgery
• Diabetes
• Blood thinner medications
• A weakened immune system

For these patients, irrigation and softening drops carry a higher risk of infection or injury, and removal should be done under direct visualization by a clinician.

ENT Specialists has treated ear conditions since 1966 and sees patients at our Brockton, Dedham, Plainville, and Taunton offices. If earwax buildup is affecting your hearing or comfort, we can take a look and remove it safely, usually in a single visit.