Earwax, known medically as cerumen, is a waxy substance produced by special glands in the outer part of the ear canal. It serves important protective and self-cleaning functions for the delicate structures of the ear. Earwax traps dirt, dust, and other debris before it can reach and potentially damage the eardrum. It also has antibacterial properties that may help prevent ear infections.
Normally, earwax works its way out of the ear canal naturally through jaw motion and shedding of the outer layer of skin in the canal. However, sometimes earwax can build up and harden, causing a blockage in the ear canal. Excessive earwax is one of the most common causes of temporary hearing loss.
An accumulation of earwax can lead to frustrating symptoms like muffled hearing, ear pain, ringing, and dizziness. Being able to recognize the signs of a potential earwax blockage is important, so that appropriate treatment can be sought.
Symptoms of Earwax Blockage
The most common symptoms associated with earwax impaction include:
- Feeling that the ear is plugged or full. This is often described as a sensation that the ear needs to “pop” or release pressure.
- Partial loss of hearing or sounds seeming muted and muffled. This may only affect one ear if the blockage is only present on one side.
- Ringing, buzzing, or roaring sounds in the ear (tinnitus)
- Ear pain, which may be dull and mild or sharp, depending on the extent of the blockage. Pain typically gets worse when chewing food.
- Vertigo or dizziness, especially when changing positions or bending over.
- A feeling of itchiness or irritation inside the ear canal. There may be an urge to scratch at the ear.
- Coughing fits as the body tries to clear the sensation of blockage in the ear. Coughing is often worse at night.
- Difficulty with balance, clumsiness, or problems with coordination on the side with the blocked ear.
Causes of Earwax Buildup
While most people produce some earwax every day, an accumulation can occur for various reasons:
- Overproduction of earwax. Some people simply produce more cerumen than average. Earwax thickness and consistency can also vary between individuals.
- Pushing wax deeper into the ear. Attempts to clean the ear with items like cotton swabs can inadvertently push the wax deeper into the canal, causing impaction against the eardrum.
- Growths or bends in the ear canal. Benign growths like osteomas or excess hair in the canal, as well as fixed bends in the anatomy can create places where earwax collects and builds up.
- Aging. As individuals grow older, earwax often becomes drier and harder. The ear canal also tends to produce less natural oils, allowing wax to stick to the canal walls.
Risk Factors for Earwax Blockage
Certain factors place individuals at increased risk for problematic earwax buildup:
- Age. Earwax blockages are most common in older adults over age 65.
- Use of hearing aids or earplugs. By placing an object into the ear canal, wax can be pushed inward. Hearing aids and earplugs should be cleaned routinely.
- Ear deformities or hairy canals. Anatomical abnormalities like narrow ear canals or excessive hair make it easier for wax impaction to occur.
- Prior history of earwax blockage or impaction. Once a blockage has occurred, the probability of recurrence is higher.
- Active ear infection or eczema in the ear canal. Inflammation makes the canal more sensitive and prone to blockages.
When to See a Doctor
In most cases, over-the-counter earwax removal products can be tried at home first. However, if symptoms like hearing loss, pain, and dizziness persist after several days, it is best to see a doctor. Some signs that warrant prompt medical evaluation include:
- Visible wax obstruction deep in the ear canal
- Significant wax buildup against the eardrum
- Presence of blood or pus coming from the ear
- Sudden deafness or acute severe pain
- Vertigo, balance problems, or ringing in just one ear
- History of prior ear surgery, injury, or irradiation of the head/neck
- Presence of ear tubes or perforated eardrum
Treatment Options for Earwax Blockage
Several methods are available for removing excess earwax:
Ear drops – Drops like carbamide peroxide or glycerin can soften and break up earwax. This helps facilitate natural wax expulsion from jaw motion and skin shedding. Drops may need to be used for several days prior to irrigation or manual removal.
Ear irrigation – Flushing the ear canal with warm water is an effective way to flush out soften wax. This is typically performed by a doctor, using specialized equipment to prevent complications like infection.
Manual removal – Using suction, microforceps, or curette, a doctor can directly remove wax under visualization. Local anesthetic eardrops are applied first for comfort.
Do not attempt to manually remove earwax yourself using items like bobby pins or keys, as this risks damaging the ear canal and eardrum. Use of cotton swabs should also be avoided, as they typically push wax deeper into the canal. Home irrigators do carry a risk of complications.
Preventing Earwax Buildup
To help avoid excessive earwax, steps like using over-the-counter ear drops prior to hearing aid or earplug use can keep the ear canals clean and lubricated. If prone to repeated buildup, regular follow up with a doctor every 6 to 12 months allows for monitoring and maintenance.
Earwax blockage is a common cause of temporary hearing loss and other ear symptoms like pain, itching, and ringing. While earwax serves a purpose in protecting the ears from damage, excessive buildup can become problematic. Risk factors like older age and use of hearing aids can increase the chances of impaction occurring. Seeking medical treatment at the first signs of symptoms can remove troublesome wax and prevent complications. With the proper precautions, earwax blockages can often be avoided.