Earwax build-up explained

What earwax is and why it builds up

Earwax, or cerumen, is made by glands in the outer part of the ear canal. It traps dust and debris, keeps the skin of the canal moisturised, and has mild antibacterial properties, so it is a sign of a healthy ear rather than poor hygiene. Normally, jaw movement from talking and chewing slowly carries wax outwards, where it dries and falls away. Build-up happens when this natural process is overwhelmed or blocked. Common reasons include narrow or hairy ear canals, producing more wax than usual, older age, and, very often, pushing wax deeper with cotton buds or wearing hearing aids or earplugs that stop wax escaping. Once wax is packed in tightly, it can harden and form a plug that blocks the canal.

Recognising a blockage

Earwax build-up tends to cause a gradual sense that something is wrong in the ear. Common symptoms include muffled or reduced hearing, a feeling of fullness or blockage, earache or discomfort, itchiness, ringing in the ear known as tinnitus, and sometimes mild dizziness. Symptoms often affect one ear more than the other. Hearing aid wearers may notice whistling or that their aids stop working well because wax has blocked them. These symptoms are usually not serious, but they can overlap with other ear problems, such as infection, so it is worth being sure of the cause. Sudden hearing loss, severe pain, discharge, or bleeding are not typical of simple wax and should prompt medical assessment rather than home treatment.

Safe self-care with drops

Most earwax build-up can be treated at home by softening the wax so it works its way out naturally. Pharmacy ear drops, such as those containing olive oil, almond oil, or sodium bicarbonate, are commonly used; a few drops are put into the affected ear and left to soften the wax over several days, often up to a week or two. Lying with the treated ear facing up for a short time helps the drops stay in place. As the wax softens, it usually clears on its own. A community pharmacist can recommend suitable drops and advise on how to use them. Avoid drops if you know or suspect you have a hole in your eardrum or an ear infection, and check with a pharmacist if unsure.

Why cotton buds and ear candles are risky

It is natural to want to clean wax out, but poking anything into the ear canal usually makes things worse. Cotton buds tend to push wax deeper and pack it down, and they can scratch the delicate skin of the canal or even damage the eardrum, causing pain, infection, or bleeding. The general advice is not to put anything smaller than your elbow into your ear. Ear candling, where a hollow candle is placed in the ear and lit, is not recommended: there is no good evidence it removes wax, and it carries real risks of burns, dripping wax, and blockage. Cleaning only the outer ear with a flannel, and letting the canal look after itself with the help of softening drops when needed, is far safer.

How the NHS removes stubborn wax

If drops do not clear the wax and symptoms persist, a healthcare professional can remove it. Modern methods include microsuction, where a small suction device gently vacuums the wax out under magnification, and irrigation, where warm water is used to flush the canal; a clinician chooses the safest method for you. Availability of NHS earwax removal varies by area, and some people are referred to an audiology or ear service or seen in general practice, while others use private clinics. It is important to have removal done by someone trained rather than attempting it yourself. See a GP or pharmacist if home treatment has not worked after a couple of weeks, if hearing loss is troublesome, or if you have pain, discharge, or repeated build-up, so the right approach can be arranged.