Remove the impacted cerumen
The outer ear canal is lined with many oil glands (sebaceous glands) and modified sweat glands. They together produce a sticky substance called the ear wax or cerumen. Cerumen helps trap dead skin cells, dirt, and other foreign materials that can harm the ear if it goes deep within the ear canal. Cerumen normally gets cleared on its own. The acts of talking and chewing further help proper the cerumen from the ear. Certain situations may prevent normal clearing up of the ear wax. These include cases where
- There is excessive production of ear wax or cerumen.
- The cerumen produced is harder than normal as occurs with aging.
- The ear wax gets pushed deeper in the ear canal while cleaning with a cotton bud or bobby pin.
- There are skin diseases, such as eczema.
- The ear canal is narrowed by birth or due to some injury or inflammation.
- There is an otitis externa (an infection of the ear).
- There is long-term use of swimming plugs or hearing aids.
The built-up or impacted cerumen can give rise to symptoms such as:
- Difficulty in hearing
- A sensation of fullness in the ear
- Pain in the ear
- Tinnitus (a sensation of ringing in the ear)
- Itching in the ear
- Ear discharge
- Foul smell coming from the ear
Impacted ear wax may clear on its own in due course. If you have any symptoms or discomfort due to impacted cerumen, then you must consult your healthcare provider. They may examine your ear with a special instrument called an otoscope. Some remedies for ear removal that can be done at home include:
- Saline solution: Soak a cotton ball in some saline solution and instill two to three drops into the ear. Keep the head tilted so that the saline stays in contact with the wax for a few minutes. Tilt your head so that the affected ear is facing downward. This will allow the saline and the dissolved cerumen to tickle out of the ear canal. Wipe the ear with a clean cloth. Repeat it one to two times a day. A syringe with a bulb may also be used to gently remove the cerumen and saline. A bulb should not be used if the eardrum is damaged or perforated (has holes in it).
- Hydrogen peroxide: Soak a cotton ball in some clean water and dilute hydrogen peroxide solution. Instill two to three drops into the ear. Keep the head tilted so that the solution stays in contact with the ear wax for a few minutes. Then, tilt your head so that the affected ear is facing downward. This will allow the solution and dissolved cerumen to tickle out of the ear canal. Wipe the ear with a clean cloth. Repeat it one to two times a day. A syringe with a bulb may also be used to gently swish the wax out of the ear. A bulb should not be used if the eardrum is damaged or perforated.
- Oils: You may put one to two drops of baby oil or mineral oil in the ear. It will lubricate the ear and soften the wax for easy removal.
- Over the counter (OTC) ear drops: You may use cerumenolytics (OTC ear drops, such as Debrox, which will dissolve the cerumen).
- Ear irrigation: Once the ear wax has been softened using cerumenolytics, such as hydrogen peroxide or mineral oils, you can carefully try ear syringing or irrigation. It should not be done if the eardrum is damaged or perforated. Irrigation involved the use of a syringe to rinse the ear canal with saline or water.
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McCarter D, Courtney U, Pollart SM. Cerumen Impaction. Am Fam Physician. May 15, 2007;75(10):1523-1528. https://www.aafp.org/afp/2007/0515/p1523.html