Earwax

The outer ear canal is lined with hair follicles and glands that produce a wax called cerumen. These hairs and wax protect the eardrum by trapping dust and other foreign material. Earwax also moistens the ear canal, keeping it from becoming dry and irritated.

Causes/associated factors
The amount and quality of wax produced in the ear differs from person to person. Some people have moist, sticky wax. Others have dry, crumbly wax.
Normally, the ear canal is self-cleaning. The wax gradually moves to the outer opening of the ear, where it rolls out on its own or can be wiped away. Sometimes the wax clumps together and blocks the ear canal. This condition is called impacted cerumen. It's the most common cause of hearing loss for people of all ages. Earwax buildup is especially common in older adults.

Inserting swabs or other articles into the ear can cause impacted cerumen. Rather than cleaning the ear, the swab may actually push the wax toward the eardrum.

Other factors that may lead to a wax buildup include:

water in the ear that causes the wax to swell
exposure to dust or dirt
excessive wax production
earplugs or hearing aids that hamper the natural wax removal process

Signs/symptoms
If you have a wax blockage, your ear may feel plugged. Other symptoms include sudden or progressive hearing loss over a few weeks or months, an earache or ringing in your ear. Some people describe pressure or fullness in the ear that can be accompanied by dizziness.

Diagnosis
Your doctor will make a diagnosis based on your symptoms, medical history and an ear exam with an instrument called an otoscope.

Treatment
Treatment is typically unnecessary unless your ear canal is blocked or your hearing is noticeably affected. If your eardrum is intact (no holes from surgery or other conditions, for example) and you're otherwise healthy, you may want to try an over-the-counter earwax removal kit. Follow the instructions on the package carefully. Keep in mind that it may take about 30 minutes to soften the wax.
If you're not able to remove the wax or you suspect that your eardrum is damaged, consult your doctor. Because the removal attempt may cause temporary redness of the eardrum, remind the doctor you used an earwax removal kit at home.

Depending on the situation, your doctor may remove the wax manually with a small instrument or suction device. If your eardrum isn't damaged, the doctor may try to flush the wax out of your ear with body temperature water.

If you have a lot of wax or it's tightly impacted, the doctor may use eardrops to help soften the wax before irrigation. The eardrops may need to be used for two to three days before ear irrigation, and sometimes it takes more than one attempt to remove the wax.


Complications
The eardrum and ear canal are fragile and easily injured. You can cause an ear infection or damage your eardrum by trying to remove the wax yourself. You may also develop an ear infection if a blockage keeps the canal from draining normally.

Pregnancy-specific information
Earwax buildup isn't considered a pregnancy-related condition. Discuss any specific concerns with your health care provider.

Senior-specific information
Again, earwax buildup is common in older adults.

Prevention
When possible, avoid dusty air. If you work in a dusty environment, try to cover your ears. (Earplugs may help, but they can also push the wax deeper into your ear canal.)
Clean your ears by holding a washcloth over your index finger without letting the finger enter the ear canal itself. Don't remove earwax with swabs, bobby pins, paper clips or other objects. Remember, they may pack the wax against the eardrum and damage the drum or canal.

If you have frequent wax blockages, ask your doctor how to keep the wax soft and prevent wax buildups. If your ears are otherwise healthy, your doctor may recommend over-the-counter softening drops or products such as mineral oil, baby oil or glycerin.