Earwax Blockage

What is an earwax blockage?

An earwax blockage (called cerumen impaction) happens when natural earwax builds up in the ear canal. Over time, the buildup can block sound from reaching your eardrum.

Sounds become dull, faint, or simply less loud. You can also get dizzy or have ear pain. The blockage may get better on its own or a doctor may need to remove the wax safely.

Most common symptoms

Sometimes earwax blockage doesn’t cause any issues but typical symptoms of earwax blockage include:  

• Hearing loss on the side with the blockage. Sounds are dull, faint, or less loud.
• Dizziness
• Ringing in your ears
• Loss of balance

You also might have an ear infection. Signs include fever, ear pain, hearing loss and an uncomfortable feeling of fullness in your ear.

Causes of earwax blockage

Your ear naturally makes wax to help lubricate the ear canal and prevent infection. In the majority of people, the ear is self-cleaning—meaning wax makes its way out on its own. If something keeps this from happening, it can cause wax to build up.

Ears that are clogged from water or air pressure may be cleared quickly. But earwax buildup from infection can take up to a week to clear up.

How do you remove impacted ear wax?

Usually, a wax buildup will fall out on its own, but you may need help removing the blockage. If there aren’t any signs of infection, your doctor might tell you to just give it time. But if you feel your hearing is getting worse on one side, or if you have a fever, see your doctor within 24 hours for an exam.

Don’t try to manually remove the wax yourself with home remedies. Some patients use cotton swabs or do ear candling. These can cause trauma to the ear canal. And cotton swabs can push a small portion of the wax further down into the ear canal.

If treatment is needed, see your doctor, who will try one of these approaches:

• Use a special ear pick to remove the wax.
• Use suction with either visualization from a hand-held instrument or a large microscope.
• Wash out your ear (irrigate) using a water pick or a rubber bulb syringe.

Ear drops

The doctor might also recommend over-the-counter or prescription ear drops. These break up and dissolve the buildup of earwax over time (up to a week or longer). Some people need to use drops once a week or month to keep earwax from building up.

Talk to your doctor before using drops if you have a broken eardrum, or you have had ear surgery, have a fever, or notice there is something coming out of your ear (like drainage or blood).

To use the drops, tilt your head all the way to the side (or lay on your side) with the problem ear facing up. Put drops in according to package directions, then stay still for 5 minutes.

Over-the-counter and prescription options include:

• Carbamide peroxide (Debrox, Auro, or Auraphene-B)
• Triethanolamine polypeptide (Cerumenex)
• Docusate sodium (Waxsol)
• Hydrogen peroxide
• Cerumol
• Earex

Risk factors

• Using cotton swabs to clean your ears. Instead of pulling wax out of your ear canal, this pushes it in, creating blockage.
• Wearing hearing aids. These can block the normal movement of earwax out of the ear.
• Using ear plugs regularly. Similar to what can happen from hearing aids, these can push earwax back into your ear, causing a buildup.
• Having an ear malformation (such as a misshapen or narrow ear canal). This can keep wax from draining like it normally would.

Earwax blockage in children

Earwax blockage is very common in children. Your child may not notice the hearing loss. But if they don’t answer when you call them, or keep turning their head to one side to hear better, these are signs of a hearing problem. Make an appointment with the pediatrician.

Follow up

Most of the time, no follow up is needed after the blockage is gone. If your doctor chooses the “watch and wait” route, or if the removal was incomplete, you’ll probably need to go back for another check-up in 1 to 2 weeks. You may need to follow up if it happens again.

Preventative tips

• Don’t use cotton swabs to clean out your ear canal.
• Do not put foreign objects in your ear. Items such as hearing aids or headphones, when used properly, generally should not cause a problem.