Most people think earwax is dirt that needs cleaning. But your ears make it for a reason - to trap dust, protect your eardrum, and keep bacteria out. The problem isn’t earwax itself. It’s when it builds up and hardens, blocking your ear canal. That’s called earwax impaction. And it’s more common than you think.
What Exactly Is Earwax Impaction?
Earwax, or cerumen, is a natural substance made by glands in your outer ear canal. It’s usually soft, yellowish, and moves out on its own as you talk, chew, or shower. But sometimes, it gets stuck. When it builds up so much that it blocks your ear canal and causes symptoms, that’s impaction. According to the American Academy of Family Physicians, about 6% of adults have earwax impaction. That number jumps to 12% for people over 65 and hits 30% in those with developmental disabilities. It’s not rare. And it’s not caused by being dirty. It’s often caused by trying to clean your ears.How Do You Know You Have It?
You won’t always feel it. But if you start noticing any of these signs, it might be more than just a little wax:- Hearing loss - sounds seem muffled, like you’re underwater
- Earache or pressure - a dull, constant ache that doesn’t go away
- Feeling like your ear is full - even when you’re not sick
- Ringing in your ears (tinnitus)
- Dizziness or balance issues
- Itching inside the ear
- A strange smell or drainage from the ear
Why Cotton Swabs Make It Worse
This is the biggest mistake most people make. You stick a cotton swab in your ear to clean it. But instead of removing wax, you push it deeper. The NHS says 60-70% of earwax impactions are caused by cotton swabs. That’s not a coincidence. That’s a pattern. Your ear canal is shaped like a tube with a narrow end near the eardrum. Swabs don’t reach the wax - they jam it tighter. Worse, they can scratch the skin, cause infections, or even puncture the eardrum. A 2023 Reddit analysis of 687 threads showed that 74% of people who used swabs felt worse within 48 hours. Over 20% ended up in urgent care. Even if you’re gentle, you’re still interfering with a system that works. Your ears clean themselves. Wax naturally migrates out. You don’t need to help.
Who’s at Higher Risk?
Some people are more likely to get impacted wax. That doesn’t mean they’re doing something wrong - their bodies just work differently.- People who wear hearing aids - 35-40% of users develop impaction because the device blocks wax from exiting
- Older adults - earwax gets drier with age, and the canal narrows, making buildup more likely
- People with lots of ear hair - hair traps wax and slows its natural movement
- Those with oddly shaped ear canals - some are narrower or curved, making wax harder to clear
- People who use earplugs or headphones often - same issue as hearing aids
How Doctors Diagnose It
You can’t diagnose this yourself. You need to see a professional. A doctor uses a tool called an otoscope - a small light with a magnifying lens - to look inside your ear. That’s it. The American Academy of Otolaryngology says this method is 98.7% accurate. But here’s the key: they don’t treat wax just because it’s there. They treat it only if it’s blocking your view of the eardrum AND you have symptoms. About 30-40% of people have wax visible on exam but feel fine. That’s not impaction. That’s normal. Sometimes, what feels like wax is something else. About 22% of people who think they have earwax impaction actually have an ear infection, a skin growth, or even a jaw joint problem. That’s why self-diagnosis is risky.Safe Ways to Remove It
There are three proven methods. And only one should be done at home.1. Softening at Home (First Step)
If you suspect mild impaction, try softening the wax first. Use a few drops of olive oil, almond oil (if you’re not allergic), or mineral oil. Lie on your side, put 2-3 drops in your ear, stay like that for 5-10 minutes, then sit up. Repeat 3-4 times a day for 3-5 days. This doesn’t remove wax - it loosens it. Then, gently wipe the outer ear with a damp cloth. Don’t stick anything inside. The NHS recommends this as a first-line approach. Studies show it works in about 58% of cases. You can also use over-the-counter drops like Debrox or Murine. These contain carbamide peroxide. They bubble slightly and break down wax. They’re 65% effective after 4 days. But don’t use them if you have a history of ear surgery, a perforated eardrum, or tubes in your ears.2. Professional Removal
If home methods don’t work, or if you have symptoms, see a doctor. Three professional methods are used:- Manual removal - a doctor uses tiny tools like curettes or forceps to gently scoop out the wax. This is 92% effective in one visit.
- Ear irrigation - warm water or saline is gently flushed into the ear. It’s 85% effective, but not safe for people with past eardrum damage or infections.
- Microsuction - a small vacuum removes wax under direct vision. This is the gold standard. It’s 96% effective, has almost no side effects, and is safe even for people with ear surgery history.
3. What NOT to Do
Some methods are dangerous. And they’re still popular.- Ear candling - lit candles inserted into the ear. The FDA has banned these as misbranded devices. They don’t work. They burn skin, cause wax burns, and can rupture eardrums. Between 2018 and 2022, over 12,500 injuries were reported.
- Home suction devices - those little vacuum tools sold online. They’re not medical-grade. They can damage your ear canal or eardrum.
- Q-tips, bobby pins, paper clips - anything smaller than your elbow. That’s the rule.
What Happens After Removal?
Most people feel better right away. Hearing improves. The pressure disappears. The ringing stops. One study found 89% of patients said their hearing was “immediate and clear” after professional removal. If you have recurring impaction, your doctor might recommend monthly oil drops or regular checkups. Some people need to see an ENT every 6-12 months. That’s normal. It’s not a failure. It’s just how your body works.When to See a Doctor
Don’t wait. If you have:- Sudden hearing loss
- Severe pain or dizziness
- Drainage, blood, or foul odor from the ear
- A history of ear surgery or perforated eardrum
- Diabetes or a weakened immune system
The Bottom Line
Earwax isn’t the enemy. Trying to clean it out is. Your ears are designed to take care of themselves. If you feel blocked, start with oil drops. Give it a few days. If nothing changes, or if you’re in pain, don’t guess. See a professional. Most cases are solved in one visit. No surgery. No drugs. Just a quick, safe removal. And then - you forget about earwax until next time. Because that’s how it’s supposed to be.Can earwax cause permanent hearing loss?
No, earwax impaction doesn’t cause permanent hearing loss. It causes temporary, conductive hearing loss - meaning sound can’t reach the eardrum properly. Once the wax is removed, hearing usually returns to normal. But if left untreated for months, especially in older adults, it can lead to chronic ear infections or damage to the ear canal, which might affect hearing long-term. That’s why timely removal matters.
Is it safe to use hydrogen peroxide for earwax?
Hydrogen peroxide can help soften wax, but it’s not the best choice. It’s about 52% effective, and 15% of users report burning, itching, or irritation. It can also dry out the skin inside the ear, making future buildup worse. For most people, olive oil or mineral oil is safer and just as effective. Avoid it if you have a perforated eardrum or ear tubes.
Why does my ear feel clogged after using ear drops?
That’s normal. The drops soften the wax, making it swell and temporarily block the canal more. It’s not getting worse - it’s breaking down. Wait 2-3 days, then try gentle irrigation or see a doctor. Don’t panic if you feel more blocked at first. It’s part of the process.
Can children get earwax impaction?
Yes, especially toddlers and kids who use earbuds or hearing aids. But they’re less likely to use cotton swabs, so impaction is often due to anatomy or genetics. Never try to remove wax from a child’s ear at home. Always see a pediatrician or ENT. Their ear canals are smaller and more delicate.
How often should I get my ears checked for wax buildup?
If you’re healthy and don’t have symptoms, you don’t need routine checks. But if you wear hearing aids, have a history of impaction, or are over 65, get checked once a year. Some people need it every 6 months. Your doctor will tell you based on your history. Don’t wait until you’re in pain.
