What is earwax?
Earwax, or cerumen, is a natural substance produced by glands in the ear canal. It serves several important functions:
Functions of Earwax:
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Protection: It acts as a barrier, preventing dust, dirt, and small particles from entering and damaging the ear canal or eardrum.
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Lubrication: Earwax helps to keep the skin inside the ear canal soft and prevents it from becoming dry or irritated.
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Antimicrobial Properties: It contains enzymes and other compounds that help prevent bacterial and fungal infections.
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Composition of Earwax:
Earwax is made up of:
Secretions from sebaceous (oil) and ceruminous (sweat) glands in the ear canal.
Dead skin cells, hair, and other debris.
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Two Primary Types of Earwax:
There are two primary types of earwax, determined by genetics:
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Wet Earwax: Typically sticky and yellow or brown. Common in people of African and European descent.
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Dry Earwax: Flaky and light-colored. Common in people of East Asian and Indigenous American descent.
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How can I tell if I have too much earwax and need it removed?
​Earwax Removal:
In most cases, earwax moves naturally out of the ear canal during chewing or talking. However, some people experience earwax impaction, where excess buildup can cause symptoms like:
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Hearing loss
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What is conductive hearing loss?
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Conductive hearing loss happens when sound waves are blocked from traveling through the outer or middle ear to reach the inner ear.
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Excess earwax can cause hearing loss because it creates a physical blockage in the ear canal, preventing sound waves from reaching the eardrum. This type of hearing loss is called conductive hearing loss, as it disrupts the normal conduction of sound. Once the wax is removed, hearing usually returns to normal.
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Tinnitus
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What is Tinnitus?
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Tinnitus is hearing noises that don’t originate from an external source. Tinnitus often manifests as ringing, buzzing, whooshing, or other phantom noises that are not caused by external sounds. Earwax buildup can cause tinnitus by creating pressure in the ear canal, blocking sound waves, or irritating the ear canal lining. This pressure or blockage alters sound signals, leading to ringing or buzzing. Removing the buildup typically resolves the issue, but self-removal can cause harm. Seek medical care if you experience fever, persistent earache, drainage, or foul odor.
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Vertigo
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What is vertigo?
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Vertigo is a sensation of spinning or dizziness, often described as feeling like you or your surroundings are moving or rotating, even when you are still. It is not a condition itself but a symptom of an underlying issue, typically related to the inner ear, brain, or sensory pathways involved in balance.
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Impaction can sometimes interfere with balance, leading to dizziness or a spinning sensation.
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Earache (also known as otalgia)
Persistent or intermittent pain in the ear due to pressure from the wax.
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Feeling of Fullness
A sensation of blockage or fullness in the ear.
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Itching
Irritation or itchiness inside the ear canal caused by wax buildup.
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Discharge
A watery or waxy discharge may occur if the impaction irritates the ear canal.
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Odor
A noticeable smell from the ear if wax has trapped bacteria or debris.
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Coughing
Stimulation of the vagus nerve in the ear canal can trigger a reflex cough.​
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Infections
Excess wax can trap moisture and bacteria, increasing the risk of outer ear infections (otitis externa).
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If necessary, earwax can be safely removed by using ear drops (olive oil is always safe to use), irrigation, or professional cleaning by a healthcare provider. Avoid using cotton swabs inside the ear canal, as this can push the wax further in and cause damage.​
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Book you earwax removal appointment now!
What Are the Different Types of Earwax and Their Treatment Options?
​​No Earwax Buildup
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A clean ear canal with no significant wax accumulation
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Occluding Wax
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Fully occluding earwax that blocks the ear canal
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Partial Occluding
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Earwax partially blocking the ear canal but still allowing some passage of sound
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Fully Occluding
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A complete blockage of the ear canal by compacted wax
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Keratin build-up in the ear canal (Keratosis Obturans)
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A condition involving a plug of dead skin due to failed epithelial migration. It is hard to remove, resembles normal wax, and may require an ENT referral due to possible erosion into the external auditory meatus (EAM)
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Foreign Bodies
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Presence of objects in the ear canal. Removal methods depend on the type of object, often requiring manual instruments
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Book your earwax removal appointment now!
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Relevant pictures
Who has higher risks of earwax build-up?
Risk Factors for Earwax Buildup:
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Being under 5 or over 65 years old
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Abnormal ear canals (e.g., too bendy, too narrow, or too hairy)
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Learning difficulties or speech problems
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Skin conditions affecting the ear canals
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Genetic factors
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Overzealous cleaning with fingertips or cotton buds
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Working in dusty or dirty environments
Can I use shop-brought products to remove earwax myself?
Products like Hopi ear candles, home irrigation kits, screw tools, probes, and cotton buds can all harm your ears and are not effective in removing earwax. Please let a qualified professionals help you.
How can I clean my earwax then?
Medical olive oil is a safe method for keeping earwax soft. If the amount of earwax is not excessive, it can effectively help keep your ears clean. For those with earwax buildup issues, applying olive oil once a week can be a suitable long-term routine.
Is it normal to feel a blocked sensation after using olive oil?
Yes, it is relatively common to feel a blocked sensation in the ears after using olive oil. This can happen for several reasons:
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Oil Coverage: When olive oil is introduced into the ear canal, it can coat the wax or the ear canal itself, making the ear feel more "full" or blocked temporarily.
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Wax Softening: Olive oil is often used to soften earwax, which may expand slightly as it absorbs the oil, contributing to the sensation of blockage.
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Oil Residue: Some of the oil might remain in the ear canal, creating a sensation similar to having water in the ear.
When to Be Concerned
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Prolonged Blockage: If the blocked sensation persists for more than a day or two, it may indicate that the wax has shifted and is now fully obstructing the ear canal.
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Pain or Discomfort: If you experience pain, itching, or discharge, it could indicate an infection or irritation.
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Hearing Loss: If the blockage significantly affects your hearing or doesn't improve, it may require professional intervention.
What You Can Do
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Lie on Your Side: After applying olive oil, lie on your side for a few minutes to allow the oil to work, and then tilt your head to let any excess oil drain out.
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Ear Cleaning: Avoid using cotton swabs to remove wax, as this can push it further into the ear canal.
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Consult a Professional: If the blocked sensation persists, see a healthcare provider for an evaluation. They can safely remove any wax buildup.
Can I use sodium bicarbonate or hydrogen peroxide ear drops instead of olive oil before the removal?
Short answer: NO.
Sodium bicarbonate is generally unsuitable for earwax removal because it crystallises the earwax, making it harder to extract. It is only used in rare cases when the ear canal is fully blocked, and the earwax is resistant to other methods, including multiple microsuctions (though this is uncommon). In fact, some clinicians may refuse to perform the removal if you have only used sodium bicarbonate beforehand.
Hydrogen peroxide, which is essentially bleach, can cause irritation in the ear despite being considered relatively safe by some. Additionally, since it bleaches the earwax, it can make it difficult to distinguish between earwax and potential pus.
Before attempting removal, it’s best to only soften the earwax to facilitate extraction. For this purpose, medical-grade olive or almond oil, specifically formulated for earwax softening, is recommended.