Cerumen Buildup... Treatments and Tips

Cerumen, or earwax, is a yellow substance whose purpose is to lubricate, clean and protect the external auditory canal from dust particles, bacteria and fungus.

cerumen Most of the time, cerumen is moved out of the external auditory canal by jaw movements such as chewing. However, some people produce an abnormally large quantity of cerumen, or their body’s mechanism prevents cerumen from being moved out of the ear. The accumulation of this substance in the external auditory canal can lead to its partial or full blockage. Among the most frequently reported symptoms are a feeling of fullness in the ear, a subjective hearing loss, tinnitus and itching.

When a significant amount of cerumen buildup is suspected in addition to one or several of the aforementioned symptoms, what are the recommended treatment methods and which should be avoided?

However, don’t forget that cerumen protects the ears and is therefore necessary. The following treatments can be used to eliminate or reduce symptoms associated with an excessive buildup of cerumen.

For people with normal cerumen production, simply cleaning the outside of the ear with a washcloth will suffice to eliminate any excess cerumen produced by the external auditory canal.

Available treatments

These types of treatments should be avoided if you have a ruptured eardrum or frequently get external ear infections.

  • Unscented mineral or olive oil: This is a self-care remedy that can be done at home. Simply place two to three drops of oil in the external ear canal on a regular basis to soften the cerumen. It’s important to then clean the ear with a washcloth.
  • Eardrops (cerumenolytic solutions): This treatment can be done at home to soften cerumen and help it move out of the external ear canal. Cerumenolytic solutions can also be used before an irrigation treatment or curettage to maximize efficiency.
  • Ear irrigation: This involves using a stream of water to clear the external ear canal. A trained doctor or nurse uses a syringe filled with warm water or an electric irrigator to flush out excess cerumen. This type of treatment should be avoided if you have a perforated eardrum since water can reach the middle ear, which becomes prone to infection. Anyone who has had ear surgery should also avoid this type of treatment.
  • Manual removal (using a curettes or a suction): Manual removal consists in manually removing cerumen with a medical instrument such as a curette. This is the preferred treatment if you have a ruptured eardrum or have undergone ear surgery. Removal using suction involves the use of a suction bulb, which an ENT specialist usually performs in combination with a microscope.

Treatments to avoid

  • Cotton swabs: The instructions on cotton swab packages specify to only clean the outside surface of the ear without penetrating the external auditory canal, in order to prevent injury. The use of cotton swabs only pushes cerumen deeper inside the ear, thus increasing the risk of an external ear obstruction.
  • Ear candling (ear candles): These beeswax candles are placed in the external auditory canal and then lit. Manufacturers claim that they help extract cerumen. However scientific studies have not succeeded in proving their effectiveness. Furthermore, these candles can be very dangerous, posing potential burn and fire hazards. Health Canada warns that it is illegal to sell these candles for therapeutic purposes.
  • All other objects: No bobby pins or any other objects should ever be inserted into the external auditory canal. Like cotton swabs, these objects push cerumen into the ear, thus increasing the risk of blockage. Furthermore, severe injury can occur if the eardrum is touched.

Warning

If you think you’re producing too much earwax, we suggest consulting an ENT specialist, a healthcare professional or a pharmacist before using any treatment.

- GUEST, J.F., et al. (2004). ''Impacted cerumen: composition, production, epidemiology'', QJ Med, 97:477-488.
- ROLAND, P.S., et al. (2008). ''Clinical practice guideline: cerumen impactation'', Otolaryngology – Head and Neck Surgery, 139:1-21.