Q&A: Ear Wax

Question: Ryan, what is earwax and what’s its purpose?

Answer: Earwax (medically known as cerumen) is a waxy substance that everyone has in their ears. The sebaceous and ceruminous glands inside your ear work together to make earwax. Earwax is vital for your ear health. It acts as a waterproof lining for your ear canal, traps dirt and dust, protects against bacterial and fungal infections, and prevents your ears from drying out. Earwax is made out of cholesterol, fatty acids, alcohol esters, squalene, and keratin.

Question: What are symptoms of excessive earwax build-up and how do I know if I have it?

Answer: Decreased hearing, ear fullness, pressure or irritation and ear discomfort are common symptoms of cerumen impaction. Earwax buildup may occasionally present as ear pain. Cerumen impaction is identified by visual inspection of the ear canal with an ear scope called an otoscope. Obstruction due to ear canal disease, narrowing of the ear canal, overproduction of wax, or the failure of wax to migrate to the ear opening are other reasons cerumen impaction can occur.

Question: What color is earwax?

Answer: Health earwax ranges in color and may be off-white, yellow, orange, dark or light brown. You should check in with your healthcare provider if you have earwax that’s green (could mean you have an infection), black (often seen in people with impacted earwax), and brown with dark streaks (may indicate you have an injury in your ear canal). If you have runny discharge in your ear, it could also mean you could have a ruptured eardrum. 

Question: Can earwax build-up negatively impact my hearing?

Answer: Wax build-up usually causes no symptoms, but in some cases, if wax gets impacted it can lead to hearing loss, ear fullness, itching or pain. It can also cause dizziness, vertigo, cough or ringing in the ear (tinnitus). Decreased hearing is often the most common symptom of wax build-up.

Question: What are the treatment options for earwax removal?

Answer: Your ears naturally self-clean and your body gets rid of it on a regular basis. In fact, if your ears are functioning properly, you should leave your earwax alone. Don’t use cotton swabs or Q Tips, hairpins or similar objects to remove earwax. Avoid ear candling or vacuum kits, as these may lead to ear canal trauma or burns.

Question: Should I clean my ears, myself?

Answer: Many people think they know how to clean their ears. But actually, the practices that many people use for ear cleaning simply push earwax further into the canal. Cleaning wax out of ears should be done very carefully. Your hearing can be temporarily or permanently damaged. In addition, the symptoms of earwax buildup may also indicate another medical issue. For this reason, it is recommended you see a qualified medical professional about earwax buildup. An ear lavage, also known as ear irrigation or ear flush, is a safe method of earwax removal when performed by a healthcare professional. A healthcare professional may use a rubber bulb syringe filled with warm water, or a triggered squirt bottle and cannula to flush out the ear. They may also use a water pick for this purpose. Other providers may use a curved instrument to scrape the wax out, or a small vacuum to suck it out.

Question: How do I prevent getting earwax build-up?

Answer: For those who get recurrent wax build up, use an ear wax softening drop three times a week to soften the wax and aid in the normal elimination mechanisms. Patients with chronic impaction should be referred to an ear specialist (ENT), and so should people with perforated ear drums, history of ear surgery, ear discharge, necrotic tissue, or persistence of ear complaints after wax removal.