Ear Cleaning 101: The Ultimate Guide to Safe and Effective Ear Care

Many people suffering from earwax build-up (also known as cerumen build-up) will often complain of feeling plugged up, or are experiencing symptoms like crackling noises, the sensation of fullness, and popping or muffled sounds. 

When I hear someone ask, “How should I clean my ears of earwax?” I typically reply, “Don’t do it!” 

Most people have no idea how much earwax might be in the outer ear canal, let alone the exact location. 

Going after the earwax yourself can have a ripple of negative side effects. 

However, if you have a trusted person to help you with the process – like an audiologist- you can be successful and safely remove non-occluding earwax buildup from the outer portion of the auditory canal.

Why Your Ears Make Wax

Earwax is produced by a process similar to when our bodies sweat. It secretes from your sebaceous glands from the outer third of your ear canal and combines with skin and hair cells that shed. 

Earwax is meant to protect and lubricate our ears. The substance can appear anywhere from oily, to soft and sticky, to quite hard. 

Earwax buildup can vary in color from yellowish-orange to light brown or dark brown. 

The earwax has antibacterial qualities, and it is meant to trap dirt, bugs, and other materials from traveling too far down your ear canal. 

Not having enough earwax can result in itchy ears. It is generally considered healthy to have some earwax in the canal, and it is best just to leave it alone.

Signs of Ear Wax Buildup

Earwax, or cerumen, is a natural substance produced by the glands in the ear canal to protect and lubricate the ear. However, an excessive buildup of earwax can lead to various symptoms. Here are some common signs of earwax buildup:

  • Hearing Loss:

One of the primary signs of earwax buildup is a gradual or sudden decrease in hearing. The earwax may block the ear canal, affecting the transmission of sound.

  • Earache or Pain:

Earwax pressing against the eardrum can cause discomfort or pain in the affected ear. It may feel like fullness or aching in the ear.

  • Tinnitus (Ringing in the Ears):

An increased amount of earwax can contribute to the development of tinnitus, which is the perception of noise or ringing in the ears.

In some cases, earwax impaction can affect the balance system, leading to symptoms such as vertigo or dizziness.

  • Itching in the Ear:

Earwax buildup may cause itching in the ear canal, prompting individuals to insert objects into their ears in an attempt to relieve the itching.

  • Coughing:

Sometimes, the sensation of earwax in the throat can trigger a cough reflex. This is known as the Arnold reflex.

  • Tinnitus (Ringing in the Ears):

An increased amount of earwax can contribute to the development of tinnitus, which is the perception of noise or ringing in the ears.

  • Ear Discharge:

In some cases, earwax impaction may lead to a discharge from the ear. The discharge may be dark and appear wax-like.

  • Odor:

A foul odor from the ear may occur if there is an infection associated with earwax buildup.

  • Difficulty in Cleaning Ears:

Individuals may experience difficulty cleaning their ears due to the presence of hardened or impacted earwax.

It’s important to note that these symptoms can also be indicative of other ear-related issues, and a healthcare professional should be consulted for an accurate diagnosis. 

Attempting to remove earwax at home with objects like cotton swabs can push the wax further into the ear canal and may cause injury. 

If you suspect earwax buildup or experience any of the symptoms mentioned, it is advisable to seek medical advice for appropriate evaluation and treatment.

Importance of Ear Cleaning

Ear cleaning is an essential aspect of personal hygiene, and it serves several important purposes. Here are some reasons why ear cleaning is important:

Prevention of Infections:

Earwax (cerumen) naturally forms in the ear canal and helps to protect the ears by trapping dust, bacteria, and other foreign particles. However, an excessive buildup of earwax can lead to infections. Regular cleaning can help prevent these infections.

Improved Hearing:

Accumulated earwax can block the ear canal, leading to a temporary decrease in hearing. By cleaning the ears, you can help maintain optimal hearing and prevent issues related to blocked ear canals.

Prevention of Tinnitus:

Tinnitus is a condition characterized by the perception of noise or ringing in the ears. Excessive earwax can contribute to tinnitus, and proper ear cleaning can reduce the risk of this bothersome condition.

Comfort and Well-being:

Regular ear cleaning contributes to overall comfort and well-being. It can prevent the sensation of fullness or discomfort caused by a buildup of earwax. This is particularly important for individuals who are prone to excessive earwax production.

Facilitation of Medical Examinations:

During medical examinations, healthcare professionals may need to inspect the ear canal. Clean ears make it easier for doctors to identify any issues, such as infections, abnormalities, or foreign objects.

Prevention of Vertigo and Dizziness:

In some cases, a blockage in the ear canal can affect the balance system and lead to vertigo or dizziness. Cleaning the ears can help reduce the risk of such symptoms.

Hearing Aid Effectiveness:

For individuals using hearing aids, clean ears are essential for the effective functioning of the devices. Earwax buildup can interfere with the proper functioning of hearing aids, affecting their performance.

It’s important to note that while regular ear cleaning is beneficial, excessive cleaning or the use of improper tools (such as cotton swabs) can lead to complications, including pushing earwax deeper into the ear canal. 

If you experience persistent earwax problems, it’s advisable to consult an audiologist for guidance on safe and effective ear-cleaning methods. 

Additionally, individuals with a history of ear issues or hearing problems should seek professional advice before attempting to clean their ears independently.

Do’s and Don’ts of Ear Cleaning

Our bodies are designed to make earwax move out toward the outer ear (concha bowl) as we smile, talk, and chew. Once in the bowl area, it can be removed easily with a washcloth or cotton swab.

Below are some do’s and don’t for ear cleaning:

  • Use mineral oil or glycerin

If earwax needs some help moving into the bowl area, you can lie on your side and have another person lift up and back on your outer ear (pinna) and administer a couple of drops of mineral oil or glycerin. 

The movement of the pinna helps to straighten out the ear canal, and the mineral oil or glycerin will travel down the canal and soften the wax. If the canal is not straightened, the oil may never reach the target. 

After 5-10 minutes, you may sit up and prepare to use a tissue to wipe the excess oil and earwax from the concha bowl. 

  • Use over-the-counter earwax removal kits

Your local pharmacy will also carry earwax removal systems where oil and chemicals are pre-mixed to work a little more aggressively to soften the wax when you insert it into the canal opening. 

The kit may contain a bulb syringe which can be used to direct warm water (irrigate) into the canal to help push the wax out of the ear canal and into the bowl.

  • Don’t use the wrong temperature for DIY ear irrigation.

If you try the irrigation method at home, either with a bulb syringe or an attachment to a water pick, be very careful as the wrong water temperature can create a feeling of dizziness, and too hard of pressure can cause the water force to rupture the eardrum.

Warm water and a gentle pressure is the best combination. Irrigation can be messy, so be sure your helper has you over a sink or that a catch basin is available!

If you feel pain after irrigation or suspect the eardrum was ruptured, seek medical help immediately. 

There is a high risk of infection to the middle ear once the eardrum barrier has been broken and impurities from the outer ear canal reach the middle ear space. 

Even if the eardrum is left intact, water remaining in the outer ear canal can also occasionally trigger an outer ear infection, so drying the ear with a drop of alcohol/peroxide placed in the canal or using low heat from a hair dryer on a gentle setting can be helpful to remove moisture after an irrigation.

  • Don’t use ear candles.

One method for wax removal that is NOT recommended is an ear candle. The earwax is just too heavy to actually move based on the suction created by the candle. I have witnessed ash left in an ear canal, along with the cerumen they were attempting to get out, so it really does not clean out the canal. I have also heard reports of burns resulting from the use of ear candles from my local ENT doctor; he states the burns in the canal are difficult to heal properly. Proper tools like an otoscope or a pen light will help you to see better down into the canal if you are going to attempt earwax removal. 

  • Don’t insert sharp and small objects to clean the ears.

Avoid sharp objects in the ear, as lacerations to the ear canal can bleed easily and may take time to heal. 

People who are on blood thinners or are diabetic are at a higher risk for injury and infection if the removal is not done properly.

What Happens When Too Much Wax Builds Up In The Ear?

Unfortunately, if there is a lot of earwax to begin with in an ear canal, adding water or oil can cause it to expand and completely occlude the ear. Occlusion of an ear canal can also occur when a cotton swab or other device has been pushed deeper than the first part of the canal opening. 

Pushing too far results in the earwax getting stuck in the curved area of the canal, where there is less movement to help it move out naturally. If a person keeps pushing a cotton swab, ear plug, or other object into the canal, earwax can eventually “build a wall” and create a complete blockage or impaction of wax.

Symptoms Of Impaction

When impaction occurs, the sound will be muffled, tinnitus (ringing in the ear) can get louder, and discomfort may occur. If an impaction is suspected, don’t attempt to clean the ear yourself – contact your audiologist or medical professional for assistance.

When To Seek Professional Help

You should also see a professional if you have a decrease in hearing, pain, itching, discharge, or an odor coming from the ear. An ear infection in the outer ear is possible after earwax removal and may require medication to clear. It should not hurt to hear and any decrease in hearing needs attention quickly.

Bottomline: What is the best method of ear cleaning?

Your ears were designed to be self-cleaning and the process works most of the time. The daily use of a cotton swab may over-dry the skin and irritate the ear canal. 

Irritation, in turn, can cause itching and the need for a topical cream to resolve. If you are concerned about the way your ears feel, or if they might need cleaning, ask an audiologist to determine your best course of treatment.

Dr. Sharon Hirstein

Sharon Hirstein has a passion to help others communicate their best. She is ASHA certified, maintains Board Certification Through the American Academy of Audiology, and has her Master’s degree from Michigan State Univeristy (1985). You can find Sharon at Elkhart Audiology Rehab in Elkhart, IN.
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Dr. Sharon Hirstein

Sharon Hirstein has a passion to help others communicate their best. She is ASHA certified, maintains Board Certification Through the American Academy of Audiology, and has her Master’s degree from Michigan State Univeristy (1985). You can find Sharon at Elkhart Audiology Rehab in Elkhart, IN.
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