Earwax: care and safe removal

What is earwax?

Earwax, or cerumen, is a natural mixture of secretions, shed skin and small hairs produced in the outer part of the ear canal. It protects and lubricates the thin canal skin, traps dust and small particles, repels water and helps maintain an environment that limits the growth of some bacteria and fungi. A healthy ear normally moves wax outward by itself through jaw movement and skin migration.

When does earwax cause problems?

Wax can build up when it is pushed inward, when the canal is narrow or unusually shaped, with ageing or skin conditions, or when hearing aids and earplugs interfere with natural clearance. Symptoms can include reduced hearing, pressure or fullness, itching, tinnitus, discomfort and sometimes cough. These symptoms can have other causes, so examination is useful when the diagnosis is uncertain.

Safe self-care

Do not insert cotton buds, hairpins, ear candles or other objects into the canal. They can push wax deeper, damage the skin or perforate the eardrum. Clean only the outside of the ear with a cloth.

Wax-softening drops may help, but ask a pharmacist or clinician first if you have ear pain, discharge, a known or possible eardrum perforation, grommets, previous ear surgery, recurrent infections or significant skin disease. Stop and seek advice if drops cause pain or dizziness.

Professional removal

A trained clinician can remove impacted wax with microsuction, a small instrument or irrigation, depending on the ear and local service. Irrigation is not suitable for everyone, particularly with a perforated eardrum, grommet, some previous ear operations or active infection. The clinician should examine the ear and select the safest method.

Seek prompt medical advice for sudden hearing loss, severe pain, bleeding, pus or watery discharge, marked dizziness, or symptoms after inserting an object. Routine earwax does not need removal when it causes no symptoms and does not prevent necessary examination.