Earwax

Earwax (cerumen) is a substance produced by the glands in the ear canal.

Earwax helps protect against ear infections and probably has other functions as well. Normally, the earwax eventually moves out of the canal, often along with skin cells that are shed. However, as a person ages, earwax and the skin become drier, causing the earwax to stick to the canal. As a result, earwax can accumulate, eventually becoming hard, thick, and firmly plugged. Seborrheic dermatitis of the scalp (dandruff) and around the ears, which is common among older people, makes earwax plugs especially likely. Earwax accumulation does not reflect poor personal hygiene.

Symptoms and Diagnosis

If an earwax plug blocks the ear canal or presses against the eardrum, ringing of the ears (tinnitus) or a feeling of fullness may develop. Hearing loss may also occur. If a person does not already have hearing loss caused by something else, the hearing loss caused by earwax plugging usually is barely noticeable. However, many older people, even before they have accumulated an earwax plug, already have lost a small degree of hearing without noticing it. For them, earwax plugs, which worsen hearing only a little bit, can make hearing loss obvious.

A doctor diagnoses earwax accumulation by examining the ear with a viewing tube (otoscope).

Treatment

Sometimes earwax can be softened or dissolved at home with hydrogen peroxide, mineral oil, or baby oil. Alternatively, a nonprescription oil preparation specifically designed to soften and dissolve earwax can be used. Whichever softening liquid is used, several drops should be put in the ear canal and retained there for about 15 minutes by tilting the head to one side. After 15 minutes, the ear is gently rinsed with tap water—for example, in the bathtub or shower. Alternatively, a rubber bulb syringe, available without a prescription, can be used to gently flush the ear with tap water. To remove large amounts of earwax, the person may need to repeat this procedure several times. If earwax remains, a doctor usually can remove it with a small instrument or by flushing the ear with pressurized water.

A person can sometimes prevent accumulation of hard earwax by using softening liquids about once or twice a week as described above. Allowing warm water to flow into the ears while bathing or showering may also help.

Attempting self-treatment by sticking an object (even soft cotton-tipped swabs) into the ear canal can pierce (perforate) the eardrum or cause infection or bleeding. Health care practitioners, however, can usually safely use cleaning tools in the ear canal, often with the aid of an otoscope.