Earwax build-up


Earwax build-up (or cerumen impaction) occurs when excessive earwax accumulates in the ear canal and may lead to a blockage. This can cause decreased hearing, pain, itching, infection, and a feeling of fullness in the ear. Earwax normally migrates outward in the ear canal and is removed naturally with cleaning, movement of the jaw, and other activities. However, certain factors, such as using Q-Tips or other objects to clean the ears, can cause the wax to become impacted in the ear. Treatment usually involves softening the wax with oils or using manual removal techniques to remove the impact.


The most common symptoms of earwax build-up are feeling of fullness or pressure in the ear, decreased hearing, ringing in the ears (tinnitus), dizziness, itchiness, and a general feeling of discomfort. Other symptoms may include pain, a bad smell coming from the ears, or drainage from the ears.


The most common causes of earwax build-up are narrowed ear canals, production of too much ear wax, injury to the ear canal, use of certain hearing aids or ear plugs, or excessive cleaning of the ear. Other causes include having a narrow ear canal due to genetics, inflammation or infection, hair or skin growths in the ear canal, or a foreign body in the ear canal.

Risk factors

The primary risk factor for earwax build-up is over-cleaning or over-insertion of items such as cotton swabs or hair pins into the ears. Other risk factors include a narrow ear canal, a buildup of hair or skin cell debris, skin conditions such as eczema, or having a family history of earwax blockage. Additionally, some medications can increase the production of earwax, leading to a higher risk of blockage.


Earwax build-up can be diagnosed by a physical examination. The doctor will use a lighted instrument called an otoscope to examine the ear canal and look for any blockage of wax or other signs of infection. Other diagnostic tests such as an audiogram or a tympanogram may also be conducted if required.


The various subtypes of Earwax build-up include:

  • Dry Earwax: This type of earwax is dry, crumbly, and can easily flake off.
  • Wet Earwax: This type of earwax is gooey, sticky and can be difficult to remove.
  • Soft Earwax: This type of earwax is wet but not sticky and can easily flake off.
  • Hard Earwax: This type of earwax is dry, hard and difficult to remove.
  • Impacted Earwax: This type of earwax is very hard and difficult to remove from the ear canal and may require medical treatment.


The most common treatments for earwax build-up include home remedies such as gently irrigating the ear with warm water, using over-the-counter ear wax softening drops, or using a bulb syringe to flush out the wax. If these treatments are unsuccessful, a doctor may need to use special tools such as a curette, or suction, to remove the earwax.


There are a few simple steps to reduce the risk of earwax build-up:

  1. Use ear drops that contain hydrogen peroxide to soften the wax, making it easier to remove.
  2. Use cotton swabs only to clean the outer ear and avoid inserting them into the ear canal.
  3. Be careful when using hearing aids and make sure to remove them regularly and clean them properly.
  4. Schedule regular visits to an ENT to check for any wax build-up and to have it removed, if needed.
  5. Avoid putting any objects such as keys or hairpins in your ears.
  6. Use mild soap and water directly into the ear to help clean the outer ear.
  7. Consider using a professional ear wax removal service to have the earwax professionally and safely removed.

Gender differences?

Yes, there are gender-specific differences in both the presentation and management of Earwax build-up. For example, women tend to have more wax build-up in their ear canals due to the narrower and more curved shape of their ear canals. This can make it more difficult to remove the wax buildup, so women may require additional or more frequent earwax removal treatments or a larger volume of water infused during the treatment. Additionally, women may be more likely to experience hearing loss or pain due to earwax buildup, as their narrower ear canals are more prone to blockage. Therefore, women may need to be monitored more closely or require more aggressive treatment to reduce their risk of hearing loss or pain due to earwax buildup.


Nutrition plays an important role in the management of earwax build-up. Eating a healthy diet filled with fruits, vegetables, and whole grains can help support a healthy immune system, which can help prevent excess earwax from forming. Additionally, foods rich in essential fatty acids, such as salmon and other fish, can help keep the ears lubricated and reduce the chances of earwax buildup. Nutrients, such as Vitamin A, Vitamin E and Zinc are also beneficial in promoting healthy ear wax production. Ensuring a balanced intake of these vitamins and minerals can help keep the ears healthy and prevent any buildup.

Physical Activity

Regular physical activity can help prevent earwax build-up by promoting circulation and ensuring proper drainage of the ear canal. Exercise helps to move excess moisture away from the ear and can help to loosen any built-up wax, which can then be gently removed. Additionally, physical activity helps boost the immune system and can help protect the ears from infection or other illnesses, which can reduce the risk of earwax blockage and buildup.

Further Reading

  1. https://my.clevelandclinic.org/health/diseases/14428-ear-wax-buildup–blockage
  2. https://www.nhs.uk/conditions/earwax-build-up/
  3. https://www.healthline.com/health/earwax-buildup
  4. https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/earwax-build-up
  5. https://www.webmd.com/a-to-z-guides/ear-wax

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