Why do we have ear wax? Earwax is a normal product of our ears. It is a mixture of cerumen (wax), oil, sweat, and dead skin cells that is produced in the outer 1/3 of the ear canal. Although many consider ear wax to be a nuisance, it serves two important purposes: it lubricates the ear canal and acts as an antibacterial agent.

There are two types of earwax: wet and dry. Wet wax is common in Western Europe, and dry wax is more common in Asia. Researchers have identified at least one gene (the ATP-binding cassette CII gene), that determines the type of ear wax we produce. Individuals vary greatly in the amount and consistency of wax produced, which affects their predisposition to the canal becoming plugged. Some are rather prolific “wax producers,” and others remain relatively wax-free with little maintenance.

So how much wax should we have? Too little earwax increases the risk of infection; however, too much wax can also increase chance of infection and cause hearing problems. So you want just enough. Two populations are known to have a high incidence of excessive/impacted cerumen: individuals with mental retardation and the elderly.

What can go wrong?

  1. Wax can occlude the ear canal, causing hearing impairment, and a feeling of fullness. This is called an “impaction”.
  2. Wax can trap bacteria in the ear, causing an infection. Symptoms are typically pain and hearing loss.
  3. It can obscure vision when the doctor looks in your ears, possibly hiding a dangerous process (such as cholesteatoma – a erosive cyst of the eardrum).
  4. Wax can cause hearing aids to malfunction.

How do you know if there is an excessive build-up of wax?

If your ear(s) feel plugged or itchy, but there is no pain, you may have a wax problem. There may also be hearing loss in the affected ear. If this is the case, see a physician – either your internist or an ENT doctor.

What is the best way to remove earwax? There are several different methods to remove ear wax, including: ear drops, irrigation with water, or with instruments and suction.

It is okay to use a cotton tipped applicator only to clean the very outside of the ear, however, one should never put the applicator, or anything else for that matter, into the ear canal. Follow the old adage, “don’t put anything smaller than your elbow into your ear.”

Over the counter drops that help remove wax are largely water, oil and peroxide solutions (e.g. Debrox). These drops are generally safe to use, as long as one does not have a perforation of the eardrum. These drops can effectively remove small to moderate amounts of wax, but are generally ineffective in more severe impactions.

Irrigation is a technique where a stream of water is used to flush the wax out of the canal. While irrigation is an accepted method, it has many disadvantages compared to ear wax removal under direct vision. Irrigation is can be quite painful, and may cause infections, vertigo and perforations of the eardrum. It should never be performed if you have a hole in the eardrum.

What about ear candling? These hollow candles are placed into the ear canal and ignited. Although the intent is to create negative pressure which draws wax from the ear, ear candles have been scientifically proven to be ineffective, and carry the obvious risk of burning the ear canal. Studies show that these candles can even deposit debris, wax and soot into the canal causing greater problems than wax build-up.

The best method to remove earwax is by a physician using a microscope to directly visualize and remove the wax. This is done only by an ear specialist called an “otologist”, or an ENT physician. Under direct microscopic vision, wax is removed with a cerumen spoon, suction, or both. It can be safely performed on all individuals, including those with eardrum problems.

Recommendations for Optimal Aural (Ear) Hygeine

First, realize that wax isn’t all that bad. It keeps your ear from becoming dry and itchy, and helps to prevent infection.

It is generally safe to put a few drops of clean baby oil or olive oil into the ear on a regular basis. Another recommendation is an over-the-counter drop such as Debrox on occasions when the ear feels slightly plugged with wax.  Warning: DO NOT use drops of any kind if the eardrum is not intact.

We recommend regular cleanings by a physician using microscopic vision and following these guidelines:

  • No wax – do nothing.
  • Small amount wax – do nothing unless it is obscuring visualization of the eardrum.
  • Moderate amount of wax – take it out with instruments and suction using a microscope. Recheck in 6 months.
  • Large amounts of hard wax – take out as much as can be easily removed with microscope. Have the person use drops and return in a few days to a week for further cleaning. Recheck in 3 months.

Ear wax exists for good reason, but too much can be a problem. It is best to have your ears examined regularly by a physician. If wax build-up is a problem, see an ENT doctor to have the wax removed in the most effective manner possible.

Dr. Kato is the founder of The Ear Institute in Palm Desert. Her top priority is improving the quality of life of her patients. Dr. Kato can be reached at: 760-565-3900.

Resources: 1) Fairey A, Freer CB, Machin D. Ear wax and otitis media in children. Br Med J. Clin Res Ed 1985:291:387-8 2) Okuda I, Bingham B, Stoney P, Hawke M. The Organic Composition of Earwax. J Otolaryngol. 1991 Jun 20(3):212-5. 3) Petrakis NL. Earmarks of Art History: Cerumen and Medieval Art. Am. J. Otol 21:5-8, 2000; 4) Roeser, R. J. and B. B. Ballachanda (1997). “Physiology, pathophysiology, and anthropology/epidemiology of human earcanal secretions.” J Am Acad Audiol 8(6): 391-400.5) Yoshiura, K., A. Kinoshita, T. Ishida, et al. (2006). “A SNP in the ABCC11 gene is the determinant of human earwax type.” Nat Genet 38(3): 324-30.

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Comments (26)

  • I have been feeling strange movement in my ear. Occasionally there is a very mild earache. I have had absolutely no wax in my ears for months and my ears are itchy. they feel blocked at times and I have a terrible nasal drip. is it connected?

  • Shirley Whiteman

    My ear wax here lately is sticky like glue,whats wrong?

    • Dear Ms. Whiteman,

      There is likely nothing wrong with your wax. The consistency of the wax varies from person to person, and is genetically determined.

      • My 12 year old son has the sticky kind. What do I put on a Q-tip to get this cleaned? I only use the Q-tip on the outside and not push it inside his canal.

  • I have impacted ear wax in my ear and I have a hole in my ear drum. Will the Debrox help this condition?

    • Dear Ms. Titi,

      You should NOT be putting debrox into your ear if you have a hole in the drum. You should have it cleaned by an ENT physician (not a primary care office, where they will likely irrigate the canal – another practice that is not recommended if you have a hole in the eardrum.)

  • My husband has had ear pain for 3 weeks now, the doctor told him his ear to clean cause there is no ear wax in his ear at all. He getting pulseating pain in his ear. I cant find anything about some have no wax in ear. The doctor out here said put sweet oil in ear but no affect. I dont know what to do.

  • my ear keeps getting stuck together and then i cant hear anything the n i pull on my ear or something and it unclogs i was going to try a home remedy and stop using q tips what do you think

    • Lauren Del Sarto

      An ear, nose and throat doctor will be able to tell if you have something in your ear (such as wax) and remove it as necessary. We strongly recommend seeing a professional.

      Thank you for reading.

      Lauren Del Sarto

    • Your symptoms are consistent with possible ear wax. You could begin by seeing your primary care physician, or an ENT physician for diagnosis.

    • Hi did you sort the ear problem as I have the same condition thanks julie

  • I have a really bad earache in both of my ears and I keep losing hearing in my right ear. My ears are also very sensitive to sound. I have been to my GP and they said it was just earwax but I am not convised.What advise can you give . Thanks

    • Lauren Del Sarto

      We would recommend that you see an ear nose and throat specialist to determine the cause.
      Thank you for reading Desert Health.

      Lauren Del Sarto

  • my 11 yr old son just told me his left ear inside all the way down the side of his jaw feels sticky. he says when he trys to wash it , it just feels more sticky. when he turns his head it feels worse, what could it be?

    • You son’s symptoms could be consistent with wax, or an ear infection. I recommend that you see an ENT specialist.

  • I Hv a perforated eardrum , a hole in the ear. I had a cholestrum n had surgery 15 yrs ago very successful. Hwr, I always Hv my ear cleaned out every three months, but on aug 5th when I had it cleaned out he moved something. Said he had to get the scab off. Since then I had vertigo for 6 wks. I’m free of the vertigo by doing exercises, I was told by my ENT dr that I need to put baby oil 4-6 drops in my ear 3x week . I am very nervous abt that afraid the vertigo will come back . What is yr opinion?

    • It is possible that the cleaning could have moved a prosthesis that is connected to the inner ear. The vertigo is concerning. I recommend that you see not just an ENT specialist, but an Otologist if possible. An otologist is an ENT that specializes specifically in complex disorders of the ear.

  • I have sticky ear, one day water just got in it and now it’s super sticky, and it smells.plus sticky wax and water keeps coming out slowly.

    • Lauren Del Sarto

      We recommend you visit a health care practitioner to have the wax removed and identify the source of the smell.

      Thank you for reading!

      Lauren Del Sarto

  • I’ve had problems with ear wax for the last year now. Sometimes I wake up and the lobe of my ear will literally be sticking to my ear due to ear wax. I put some hydrogen peroxide in my ear but it didn’t really seem to work to be honest. It feels very thick and gunky. It’s also very wet and just barely takes on a solid form. I also seem to get very minor short headaches from time to time. I’ve absolutely had it up to here with this stuff. I’ve done everything.

    • Lauren Del Sarto

      Have you seen a doctor for this condition? They have technology and medication that can address the issue. We highly recommend you seek professional care.

      Thank you for reading Desert Health ~

      Lauren Del Sarto

  • I accidentally put debrox in my ear that has a perforated ear drum! I have an appointment in a week to see my ENT, but it’s extremely painful and I can’t even touch my ear I can’t hear out of either ears now everything is extremely muffled. What type of damage could I have caused to my ear?

  • So my left ear is swollen on the inside and I have wax hardened in thin sheets that get stuck to my skin sometimes some blood gets drawn and sometimes I wake up to my whole inner ear covered in a casing of thin skin like ear wax help please

  • You may have a condition called chronic otitis externa. This is a relatively common problem. The best person to help address and correct this problem is an ENT physician.


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