Understanding earwax impaction

What is earwax impaction?

Our ears naturally produce a substance called earwax, or cerumen, which is typically wax-like and brownish in color. This is a normal bodily process that helps clean the ear canal by trapping everyday debris and preventing dirt from reaching the sensitive inner parts of the ear. The amount of earwax produced varies among individuals—most people have a normal level, while some experience excessive production, which can lead to cerumen impaction. Earwax impaction occurs when this natural substance builds up beyond the normal amount.

Though not considered a life-threatening condition, earwax impaction can lead to several uncomfortable complications. Fortunately, it is often a preventable and manageable health issue.

Causes of earwax build-up

Environmental factors: During windy seasons, pollen and dust particles in the air can easily enter the ear. In response, the body activates its natural defense mechanism by producing more earwax to trap these particles and prevent them from reaching the inner, more sensitive parts of the ear.

Anatomical Structure: Certain biological factors can contribute to excessive earwax production. Individuals with narrower ear canals are at a higher risk of earwax impaction because the restricted space limits the natural movement of wax, increasing the likelihood of buildup and blockage.

Use of ear-invasive items: Frequent insertion of objects into the ear canal—such as earbuds, cotton swabs, earplugs, or even hearing aids—can disrupt the ear’s natural cleaning process and aggravate wax production. This interference often leads to increased buildup and a higher risk of impaction.

Other conditions: Certain skin disorders, such as eczema or psoriasis, can increase the risk of earwax buildup. Flaking skin within the ear canal stimulates the wax glands to produce more earwax in an effort to remove the accumulating debris. Additionally, uncontrolled stress is another significant factor contributing to excessive earwax production. Stress disrupts the body’s natural balance and triggers the release of cortisol, a hormone that can cause the ear glands to overproduce wax.

Common Symptoms and Complications of Earwax Buildup

• Persistent ringing in the ear (tinnitus)

• A feeling of fullness or blockage in the ear

• Gradual hearing loss or impairment

• Ear pain or discomfort

• Itching inside the ear canal

• Dizziness or loss of balance (vertigo)

• Ear discharge or an unpleasant odor

Earwax safe removal tips and treatment

Ear cleaning: It is essential to practice safe and gentle ear-cleaning methods. Avoid inserting any objects into the ear canal, as this can push wax deeper and cause damage. Instead, clean only the outer ear using a soft cloth, and refrain from using earbuds or cotton swabs inside the ear.

Wax dissolving medication: there are several over the counter (OTC) products available that can help dissolve earwax buildup inside the ear. For individuals prone to excessive earwax production, these solutions can be used once a week as part of a maintenance routine to dissolve hardening earwax and prevent impaction.

Ear Irrigation: In cases where earwax buildup leads to blockage and reduced hearing, ear irrigation can be an effective solution. Traditionally, this procedure was performed by healthcare professionals at clinics using a warm, sterile liquid to flush the ear. Today, ear irrigation kits are widely available at most pharmacies, allowing for home treatment when used with strict adherence to safety guidelines.

Microsuction method: This non-invasive procedure is performed by qualified audiology professionals in their consulting rooms. Using a suction device in combination with an otoscope or a miniature camera, the clinician obtains a clear view of the ear canal while safely suctioning out the accumulated wax.

When to see a doctor?

Earwax impaction is generally treatable; however, it can sometimes indicate a more serious underlying condition. Therefore, it is essential to seek medical attention if symptoms persist or worsen.

When to See a Doctor:

• Presence of blood coming from the ear (otorrhagia)

• Severe or worsening ear pain

• Pus-like discharge oozing from the ear (otorrhea)

• Sudden and complete hearing loss in one ear or both

• Suspected foreign object lodged inside the ear

  
  

Though earwax impaction is a common condition that can significantly affect hearing and overall ear health, it is often overlooked. Timely intervention through safe and effective methods, such as proper cleaning, use of emulsifying earwax medications, ear irrigations and micro-suctioning, can help prevent complications like infections, discomfort, and hearing loss.

References

Merkley, MG. (2024). Why do I have excessive earwax? Available at: https://www.goodrx.com/health-topic/ear/why-do-i-have-excessive-earwax (Accessed on: 03/12/2025)

Mangal, R. (2025). Can Stress Affect Your Ear Health? Available at: https://suctionears.com.au/can-stress-affect-your-ear-health/ (Accessed on: 03/12/2025)

Ama, M. (2025). What Causes An Increase In Ear Wax Production? Available at: https://advancedhealthline.com/what-causes-an-increase-in-ear-wax-production.html (Accessed on: 03/12/2025)

Cleveland Clinic. (2025). Earwax Blockage. Available at: https://my.clevelandclinic.org/health/diseases/14428-ear-wax-buildup--blockage (Accessed on: 03/12/2025)

Abbie, C. (2024). Excessive Ear Wax Buildup: Causes and Solutions. Available at: https://www.hooverentaudiology.com/excessive-ear-wax-buildup-causes-and-solutions/ (Accessed on: 03/12/2025)

Michaudet, C., Malaty, J. (2018). Cerumen Impaction: Diagnosis and Management. Available at: https://www.aafp.org/pubs/afp/issues/2018/1015/p525.html (Accessed on: 04/12/2025)

Adams, E. (2022). EM@3AM: Cerumen Impaction. Available at: https://www.emdocs.net/em3am-cerumen-impaction/ (Accessed on: 04/12/2025)

Yetman, D. (2021). What is Microsuction for Earwax Removal? Available at: https://www.healthline.com/health/microsuction (Accessed on: 04/12/2025)

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