What helps if earwax builds up?

The amount of earwax that is produced varies from person to person and has nothing to do with personal hygiene. The buildup of earwax in the outer ear canal is particularly common in men and older people. Our earwax also changes in older age: The ceruminous glands start to shrink and make less secretions. The earwax becomes drier, but dead skin particles still continue to build up. The outer ear canal can then no longer clean itself as well as it does in younger people.

If a lot of earwax is made, or if dead skin particles build up in the ear canal, a plug of earwax may form and affect your hearing. Experts estimate that removing an earwax plug can improve hearing by 10 decibels. To give you an idea of what this means: The difference between quiet whispering and normal conversation is about 20 decibels.

Older age isn't the only thing that can affect the ear’s ability to clean itself. Cleaning your ears with cotton buds or similar objects may cause problems too. Doing so only removes some of the earwax – the rest is usually pushed further into the ear, where it may become harder and form a plug. There is also a risk of irritating or injuring the eardrum or the skin lining the outer ear canal.

Hearing aids, in-ear headphones or earplugs worn to protect you from noise, dust or water may also cause earwax to build up and harden if used too often.

You can normally use a soft washcloth or facial tissue to remove earwax that has come out of the ear, for instance after washing or having a shower. There are different ways to remove larger amounts of earwax from the outer ear canal, or to remove hard plugs of earwax:

• Softening the earwax at home: Warm olive oil, almond oil, water or special ear drops and sprays (called cerumenolytics) can be used to soften the earwax, allowing it to leave the ear more easily.
• Having your ear rinsed (irrigation) or cleaned at the doctor's: Your family doctor or ENT (ear, nose and throat) doctor can rinse out the outer ear canal or remove the earwax using special instruments.

Before having your ear rinsed by the doctor, you can try out cerumenolytics at home first. If they don't get rid of the earwax, they can still help to prepare the ear to be rinsed out by a doctor (irrigation).

Irrigation isn't always suitable – particularly in people who have a damaged eardrum or a middle ear infection. An ENT doctor can then decide how a hardened plug of earwax should best be removed.

To find the most effective way to remove earwax, researchers in Great Britain analyzed a total of 22 randomized controlled trials (good-quality studies) testing different approaches.

Overall, these studies show that cerumenolytics and oils can effectively remove earwax, and that ear irrigation works better when cerumenolytics are used first.

But these results aren't completely reliable: Most of the studies only looked at a small number of people, and some had other weaknesses as well.

Researchers from the Cochrane Collaboration – an international research network – also looked at studies on different types of ear drops for removing earwax. Their results aren't reliable either, but they point in the same direction: Ear drops can help. It is not clear whether certain products are more effective than others, though.

As well as using cerumenolytics, some people use complementary or alternative treatments such as “ear candles.” These candles are placed in the ear canal and then lit on the other end. It is claimed that the candles help to soften and remove earwax, but this hasn't been proven in scientific studies.

What's more, the U.S. regulatory authority FDA has issued a public warning that the use of ear candles can lead to serious ear injuries.

Most of the studies looking at the side effects of ear drops found that they either had no side effects, or that side effects were rare. These side effects mainly included itching, dizziness, skin irritations, and inflammation of the outer ear canal.

The outer ear canal can become inflamed after earwax has been removed with cotton buds or sharp objects. Removing earwax also removes the natural protective barrier in the ear canal.

Ear irrigation rarely leads to side effects, as long as it is done by a doctor.