What is earwax?
Earwax (cerumen) 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. A hard plug of earwax can also sometimes cause tinnitus ('ringing in the ear') or even mild vertigo (a type of dizziness).
A doctor or nurse can look into the ear canal and confirm a plug of earwax has formed. A plug of earwax is not a serious problem, more a nuisance. You only need to remove earwax if it is causing symptoms such as dulled hearing. Earwax may also need to be removed for fitting of a hearing aid, or if a doctor or nurse needs to examine your middle ear.
Note: do not try to clean the ear canal with cotton wool buds, etc. This can make things worse as you will push some earwax deeper inside. It may also cause an ear infection. So, let the ear 'clean itself'.
What can I do if earwax builds up and causes symptoms?
Ear drops alone will often clear a plug of earwax. You can buy drops from pharmacies. For example, olive oil ear drops are commonly advised for this purpose. Warm the drops to 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 irrigation (which used to be called ear syringing)
This may be needed if ear drops do not work. Irrigating the ear with water will usually clear plugs of earwax. But, it often only works if the plug of earwax has been softened. Therefore, use ear drops (such as olive oil ear drops) to soften wax 2-3 times a day for 3-5 days prior to irrigation. Ear irrigation is usually painless. Lukewarm water is squirted into the ear canal. This is usually done by a machine that squirts water at the right pressure. This dislodges the softened plug which then falls out with the water.
Note: the old-fashioned big ear syringes have largely been replaced by modern irrigation machines. This is because the machines can deliver the squirt of water at the correct pressure. There is no risk of there being too much pressure applied which may harm ( a problem with the old-fashioned syringes).
Some people feel dizzy after ear irrigation, but this quickly settles. Some people develop an inflammation in the ear canal following ear irrigation. This causes itch and discomfort, but can be treated with ear drops. Rarely, ear irrigation can cause damage to the ear or eardrum.
Therefore, see a doctor or nurse after ear irrigation if you develop any ear pain, troublesome itch in the ear, discharge from the ear, or swelling of the tissues around the ear canal (which may indicate infection).
Ear irrigation may not be advised if you have certain ear problems. In particular, if you:
- Have had complications following this procedure in the past.
- Have had ear surgery in the past (apart from grommets that have come out at least 18 months previously and you have been discharged from the hospital ear department).
- Have a cleft palate (even if it has been repaired).
- Have an ear infection or have had an ear infection in the previous six weeks.
- Have recurring infections of the ear canal (recurring otitis externa).
- Have, or have had, a perforated ear drum.
If ear irrigation does not work, or is not advised, you may be referred to an ear specialist for removal of troublesome earwax.
Can I prevent a build-up of earwax?
Some people are troubled by repeated build-up of earwax and require ear irrigation 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.
However, there is no clear research evidence to guide on this issue. For example, it is not clear how often the drops should be used. 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, if you are troubled by regular plugs of earwax, you may wish to try using ear drops on a regular basis to see if this prevents the problem.