Earwax: How to Remove It Without Damaging Your Eardrum

Most of the time you don’t need to do anything about earwax: the ear pushes it outwards by itself, and cleaning the outer part in the shower is enough. If a blockage forms, the usual approach is to soften it for a few days with drops and, if it doesn’t come out, have a professional remove it. What you must never do is put cotton buds or any other object into the ear canal.

What earwax is for

The ear canal has glands that make a waxy substance called cerumen. It is not a sign of poor hygiene. It has two clear jobs:

• It traps dust, dirt and germs before they reach deeper parts of the ear.
• It protects the skin of the canal, which is very thin, and stops it getting irritated when water gets in.

The ear also cleans itself. As you chew and move your jaw, and as the skin of the canal renews itself, old wax gradually moves towards the opening, where it falls out or is washed away.

Why a blockage forms

Earwax blockages are less common than they seem. According to figures from the US National Institute on Deafness and Other Communication Disorders (NIDCD), about 1 in 10 children and 1 in 20 adults have them, rising to around 3 in 10 older people.

The most common causes are:

• Producing more wax than the ear can push out. In some people the extra wax hardens and ends up blocking the canal.
• Using cotton buds. The cotton tip doesn’t pull the wax out: it squashes it and pushes it further in. It is the most typical way of turning normal wax into a blockage.
• Trying to clean the inside of the ear with any object, for the same reason.

How to tell if you have a blockage

The most common symptoms are:

• A feeling that the ear is full or blocked.
• Partial hearing loss, which may get worse.
• Ringing or buzzing (tinnitus).
• Itching or earache.
• For hearing aid users, the aid suddenly working less well.

Be careful: these symptoms are not unique to earwax; other ear problems can feel similar. If you are not sure of the cause, or there is severe pain, fever or discharge, don’t treat it yourself.

What you can do at home

Most earwax blockages can be treated at home by softening them. The idea is for the wax to soften and come out on its own, not to dig it out.

Option	How it works	Notes
Earwax drops (medicine)	Dissolve and soften the wax	Spain has medicines authorised for this use; follow the leaflet
Mineral oil or baby oil	Softens the wax	A few drops, several days in a row
Glycerine	Softens the wax	Same as oil
Rinsing with lukewarm water	Washes out wax that has already softened	Check with your doctor or pharmacist first

Earwax drops

One example of a medicine authorised by the AEMPS, Spain’s medicines agency, to dissolve earwax combines turpentine oil, chlorobutanol, benzocaine, phenol and castor oil. Its leaflet says:

1. Temperature: warm the bottle in your hands for a few minutes so the drops aren’t cold.
2. Dose: 2 or 3 drops in the affected ear, morning and night, for 3 or 4 days.
3. Position: tilt your head and hold it there for about 30 seconds so the drops go well into the canal.
4. Hygiene: don’t let the dropper touch your ear or fingers.

The same leaflet warns that the blockage often doesn’t come out with the drops alone; in that case you need to go to a healthcare centre to have it removed. It also says it must not be used:

• If your eardrum is perforated.
• If the ear is discharging anything.
• In children under 2.
• Together with other medicines applied to the ear.

If you are pregnant or breastfeeding, ask before using it. Once opened, the bottle is thrown away after a month. Frequent use can irritate and dry the skin, and allergic reactions occasionally occur; if that happens, get advice.

Rinsing the ear at home

Once the wax is soft, it can sometimes be washed out with a gentle rinse. Ask your doctor or pharmacist first whether it is suitable for you and, if they agree:

• Use water at body temperature. Cold water can cause brief but intense dizziness or vertigo.
• With your head upright, gently pull the ear upwards to straighten the canal.
• With a bulb syringe, aim a gentle stream at the wall of the canal, not straight at the blockage.
• Tilt your head so the water runs out. You may need to repeat this several times.
• When you finish, dry the ear well, for example with a hairdryer on a low setting held at a distance.

Never use a dental water jet to clean your ear, and don’t rinse or use drops if your eardrum may be perforated or you have had recent ear surgery.

What never to do

• Cotton buds, hairpins, keys or toothpicks. They push the wax further in and can injure the skin of the canal or the eardrum. This applies to children too.
• Ear candles or cones. The US Food and Drug Administration (FDA) concludes there is no evidence they work and that holding a flame near the face carries a high risk of burns to the skin, hair and ear.
• Cleaning too much or too hard. Removing all the wax leaves the canal unprotected and more prone to irritation.
• Keeping at it if it won’t come out. If after a few days of drops the ear is still blocked, the next step is a professional, not more attempts at home.

How to clean your ears every day

Washing the outer ear and the entrance to the canal in the shower and drying it with a towel or a tissue wrapped around your finger, without pushing it in, is enough. If your wax tends to dry out and form blockages, a few drops of mineral oil now and then help keep it soft.

If you wear a hearing aid, it is a good idea to have your ear canal checked every 3 to 6 months to make sure wax is not building up.

What a professional does

If the blockage won’t come out at home, a doctor or ear, nose and throat specialist can remove it with:

• Irrigation done in the clinic.
• Gentle suction of the canal.
• A special small scoop (curette), often with the help of a microscope.

In most cases hearing comes back fully as soon as the blockage is removed. Bear in mind that it can form again over time.

When to see a doctor

See your doctor or pharmacist, instead of carrying on with home treatment, if:

• The ear is still blocked after 3 or 4 days of drops.
• There is discharge, blood or a bad smell.
• You have severe earache or a fever.
• Hearing loss is sudden, affects both ears or continues after the wax is cleared.
• You have dizziness, vertigo or ringing that doesn’t settle.
• You have or have had a perforated eardrum, or have had ear surgery.
• It is a child under 2.

This article is for information only and does not replace an assessment by a healthcare professional. If you have any doubts about your particular case, ask your pharmacist or doctor.

Sources: Otocerum ear drops, solution: package leaflet (CIMA, AEMPS) · Ear wax (MedlinePlus Medical Encyclopedia, NIH) · Why You Shouldn’t Use Cotton Swabs to Clean Your Ears (NIDCD, NIH) · Import Alert 77-01: Ear Candles (FDA)