Earwax

What is earwax?

Earwax in ear canal

Earwax is a build-up of dead cells, hair, foreign material such as dust, and cerumen. Cerumen is the natural wax produced by glands in the ear. It forms a protective coating of the skin in the ear canal. Small amounts are made all the time. Flakes or crusts of earwax break off and fall out of the ear from time to time.

The quantity of earwax made varies greatly from person to person. Some people form plugs of earwax in their ear canal. This may cause a feeling of fullness and dulled hearing. It can feel uncomfortable. A hard plug of earwax can also sometimes cause 'ringing in the ear' (tinnitus) or occasionally even a mild type of dizziness (vertigo).

A clinician can look into the ear canal and confirm that a plug of earwax has formed. A plug of earwax is not a serious problem but can be a nuisance. Earwax only needs to be removed if it is causing symptoms such as reduced hearing. Earwax may also need to be removed for fitting of a hearing aid, or if the eardrum needs to be examined.

Note: do not try to clean the ear canal with cotton wool buds, etc. This can make things worse as earwax can be pushed deeper inside. It may also cause an ear infection or even damage the eardrum itself. It is best to let the ear clean itself.

Ear drops

Ear drops, which can be bought from pharmacist, will often clear a plug of earwax without the need for any more treatment. For example, olive oil, almond oil, sodium bicarbonate, and sodium chloride ear drops are commonly used for this purpose.

The drops should be kept at room temperature before using them. (Let the bottle stand in the room for about half an hour.) Pour a few drops into the affected ear. Lie with the affected ear uppermost when putting in drops. Stay like this for 2-3 minutes to allow the drops to soak into the earwax.

The earwax is softened and it often breaks up if you put drops in 2-3 times a day for 3-7 days. Flakes or crusts of earwax often fall out bit by bit.

Ear microsuction

Microsuction is considered to be one of the safest ways of removing ear wax. A trained practitioner uses a microscope to look into the ear as the wax is suctioned away without using water. This is available on the NHS in some GP surgeries and in ear, nose and throat departments at hospitals. It is also available in many private clinics across the UK.

Ear irrigation (syringing)

Ear irrigation was a traditional method of removing ear wax. Ear irrigation involves lukewarm water being squirted into the ear canal which dislodges the wax plug which then falls out with the water. Although ear irrigation was mostly successful and painless there were complications associated with it in some instances (for example, damage to the eardrum, inflammation or infection). Ear irrigation is rarely offered any longer by GP surgeries, due to these risks and the fact that it is not part of the NHS contract.

Some people are troubled by repeated build-up of earwax and require earwax removal every so often. In this situation, to prevent earwax building up and forming a plug, some doctors recommend using ear drops regularly - for example, olive oil ear drops. Some people also buy a bulb syringe to use at home to perform their own irrigation.

However, there is no clear research evidence on this issue. For example, it is not clear how often the drops should be used and different doctors advise different things - from daily, to once a fortnight. It is also not clear if regular use of ear drops does actually prevent earwax from building up. However, people troubled by build-up of earwax may wish to try using ear drops on a regular basis to see if this prevents the problem.