Earwax, also called cerumen, is made by the body to protect the ears. The ear wax has both lubricating and antibacterial properties. Untreated buildup can lead to hearing loss, irritation, pain in the ear, dizziness, ringing in the ears and other problems. 

 

What is earwax?

Earwax, known medically as cerumen, is a naturally occurring sticky substance in the outer ear. Earwax contains oil and sweat mixed with dirt and dead skin cells.

Earwax can become a problem when it accumulates in the ear canal and becomes impacted. This can cause hearing loss and infection of the ear canal.

People have earwax because it is a natural lubricant for their eardrums.

Why do people have earwax?

Earwax is natural and helpful

It’s hard to believe something so unappealing can be so important to your ears’ good health, yet being sticky and smelly is exactly why a normal amount of ear wax is beneficial. Consider these attributes:

  • Earwax is a natural barrier that prevents dirt and bacteria from entering the innermost parts of your ears. Because it is sticky, it collects microscopic debris that finds its way into your ear canal, much like fly paper traps insects. Without this defensive barrier, your inner ear would be at risk.
  • It acts as a moisturizer and protective coating for your ear canal. Without earwax, your outer ear might be itchy and flaky, which puts it at greater risk for becoming irritated and infected.
  • It acts as an insect repellant. The smell of earwax keeps bugs away, while the stickiness traps those that accidentally venture inside. (Yep, bugs and plenty of other things can get stuck inside your ear.)

Why cleaning your ears is not necessary?

“An overly clean ear can be an unhealthy ear,” according to an in-depth article on the harms of earwax cleaning by researcher and hearing instrument specialist, Max Stanley Chartrand, PhD. Anytime someone tries to clean their ear by inserting a finger or small object into their ears, they risk wedging earwax back into the skin, where it can harden and become problematic, even affecting your hearing, he explains.

Temporary hearing loss and tinnitus

Ear infections and earwax impactions increase the volume of your own voice, so people with these problems may speak very softly. The impacted wax can also press upon the vagus nerve, triggering a chronic reflexive cough. Lastly, Chartrand explains, it can also make the eardrum spasm, leading to ringing in the ears that sounds like a roaring or buzzing sound.

If you suspect impacted earwax? Proceed with caution

Even though earwax has its benefits, blockages can occur, particularly if you tend to have dry, hard earwax. If you develop a sensation of stuffiness in your ears, feel like your voice  or hearing loss and suspect earwax is the culprit:

  • Ask a doctor for help if you have ear tubes (used to treat chronic middle ear infections) or if you have any ear pain. Earwax buildup is not painful.
  • Regularly clean your hearing aids or any other devices you put in your ears.
  • Do not clean ears with a cotton swab, hairpin or any sharp instrument in an attempt to remove wax yourself. This can push the wax deeper into the ear canal where it is unable to be sloughed off naturally, or you could even puncture your eardrum.
  • Do not try ear candling. Besides having no proven benefits, ear candling can cause burns, wax blockage, punctured eardrums and serious injury. Instead, follow general rules for keeping ears clean (see below).
  • Consider professional cleaning (in some cases): Some hearing care providers offer professional cleaning using tools like the Earigator. This is not necessary nor a good idea for most people, but it’s easy for doctors to look in the ears using an otoscope to check for impacted earwax.

how to not use and use earbuds  How not to use and use earbuds

Your earwax says a lot about you

Although most everyone’s ears produce earwax, that’s where the similarity ends. Its composition varies from person to person, depending on their ethnicity, environment, age and diet.

Two types of earwax

There are two primary types of earwax—wet and dry:

  • Wet cerumen is more common in Caucasians and Africans
  • Dry cerumen is more common among Native Americans, Pacific Islanders and Asians

Normal earwax colors

Even the color of your cerumen can say a lot about you:

  • Dark brown or black colored earwax is typically older, so its color comes from the dirt and bacteria it has trapped. Adults tend to have darker, harder earwax.
  • Dark brown earwax that is tinged with red may signal a bleeding injury.
  • Light brown, orange or yellow earwax is healthy and normal. Children tend to have softer, lighter-colored earwax.
  • White, flaky earwax indicates you lack a body-odor producing chemical. Dark-colored, sticky earwax indicates you should probably use deodorant.
types of earwax

 

What are the symptoms of earwax buildup and blockage?

Symptoms of this condition include:
  • A feeling of fullness in the ear.
  • Pain in the ear.
  • Difficulty hearing, which may continue to worsen.
  • Ringing in the ear (tinnitus).
  • A feeling of itchiness in the ear.
  • Discharge or odor coming from the ear.
  • Dizziness.
More serious symptoms could mean you’ve developed an infection. Watch for:
  • Serious pain
  • Drainage from the ear canal
  • Itching
  • Odor coming from the ear
  • Fever

Diabetes and earwax

Interestingly, the pH of earwax in people with diabetes tends to be less acidic, according to practice guidelines published by the American Association of Family Physicians. This makes it less protective against germs, meaning people with diabetes should take extra care with their ears because they are at higher risk of ear infections.

Do I have too much earwax?

Usually, the body knows exactly how much earwax to produce. As long as you maintain a healthy diet, have good hygiene and move your jaw (think chewing and talking), your ears will naturally expel excess earwax, dirt and debris without any intervention.

The more you remove, the more your body will make

When you make a habit of removing earwax, that sends a signal to your body to make more, creating an excess which can interfere with hearing, put you at greater risk for developing ear infections and other complications.

Earwax super-producers

Stress and fear can also accelerate earwax production. Others who have a tendency to produce too much earwax include those:

  • with a lot of hair in their ear canals.
  • who suffer from chronic ear infections.
  • who have abnormally-formed ear canals or osteomata, which is extra bone tissue,
  • who are elderly, have certain skin conditions or certain learning disabilities.

How to clean your ears

While your ears are self-cleaning, there are a few things you can do to keep them clean and free of excess debris:

  • Wash your ears using a warm, soapy wash cloth. Letting warm water from your daily shower run over (but not in) your ears every so often is probably enough to soften and loosen excess earwax.
  • If you wear hearing aids, make sure you clean them properly.
  • If you’re older than 60, have your hearing evaluated periodically by a hearing healthcare professional. Ask your family physician for a referral, or search our online directory to find hearing clinics near you. Besides advising you on your hearing health, they will be able to detect excess cerumen and may safely remove it.
  • See a doctor immediately if your home treatments don’t help or if you experience sudden hearing loss, pain or bleeding.
ear wax

How doctors remove earwax?

If you’ve had wax buildup issues in the past, your doctor may refer you to an ear, nose, and throat doctor. This specialist can check for underlying issues that might be causing the black earwax.

Your doctor may use these treatments to remove excess earwax:

  • Removal. Your doctor can remove earwax with a small, spoon-shaped tool called a curette. The tool is designed to scrape the wax out of your ear canal without compacting any more in the ear.
  • Irrigation or ear syringing.. If you’ve not tried irrigation, your doctor may try this treatment technique. They may also use a water pick, which produces a more forceful water stream than a rubber syringe.
  • Suction. A small vacuum-like suction tool can gently remove excess earwax.

This involves putting water, saline, or wax-dissolving drops into the ear canal. About a half hour later, the ears are irrigated and the wax is removed.

Although there are at-home kits, it’s always a good idea to be extra careful and have a physician do it. An otolaryngologist can also manually remove the earwax.

When to call a doctor?

Overall, earwax is normal and can vary in its appearance and texture. If you notice earwax that is markedly different than what you’ve seen before, it’s always good to call your doctor and check to see if there’s anything you should be on the lookout for.

If you’re experiencing symptoms of earwax buildup and at-home remedies have not been successful, your doctor might need to manually and safely remove the earwax.

 

Reference
  • Cha Y. Neurotology & Ear Disorders. In: Amthor FR, Theibert AB, Standaert DG, Roberson ED. eds. Essentials of Modern Neuroscience. McGraw-Hill;
  • Horton GA, Simpson MTW, Beyea MM, Beyea JA. Cerumen management: an updated clinical review and evidence-based approach for primary care physicians. J Prim Care Community Healthr. 2020;11:215013272090418.
  • Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary. Otolaryngology–Head and Neck Surgery. 2017;156(1):14-29. doi:10.1177/0194599816678832
  • Diagnosis and Management of Cerumen Impaction,otolaryngology–Head and Neck Surgery, September 2008
  • Earwax Help: Why We Have Earwax and How to Remove Safely, Healthyhearing.com