Earwax Impaction: How Cerumen Blockage Affects Hearing and How to Remove It Safely

Most people think earwax is something to clean out - but the truth is, your ears are designed to clean themselves. When earwax builds up too much and hardens, it becomes a problem called earwax impaction. This isn’t just a minor annoyance. It can block your hearing, cause pain, make you dizzy, or even trigger a cough. And the worst part? Many of the things people do to fix it - like cotton swabs or ear candles - actually make it worse.

What Exactly Is Earwax Impaction?

Earwax, or cerumen, is a natural substance made by glands in your ear canal. It traps dust, bacteria, and tiny particles before they reach your eardrum. Normally, it slowly moves out on its own, carried along by jaw movements like chewing. But sometimes, it gets stuck. When that happens, it hardens and forms a plug - often blocking the ear canal from the eardrum all the way to the opening. This is earwax impaction.

It’s not rare. About 6% of adults deal with it, but the numbers jump to 12% in people over 65 and up to 30% in those with developmental disabilities. You’re more likely to have it if you wear hearing aids, have a lot of ear hair, or have an oddly shaped ear canal. And if you use cotton swabs? You’re part of the 60-70% of people whose attempts to clean their ears actually pushed wax deeper in.

How Do You Know If You Have It?

Symptoms don’t always show up right away. They usually build over a week or two. The most common signs include:

• Hearing loss - often the first thing people notice, affecting 65% of cases
• A feeling of fullness or pressure in the ear - reported by 58%
• Earache or discomfort - present in 42%
• Ringing in the ears (tinnitus) - affects nearly 3 in 10 people
• Dizziness or balance issues - happens in about 18%
• Itching inside the ear - 33% of cases
• Drainage or bad smell from the ear - seen in 22%
• A persistent cough - yes, really. This happens because the ear and throat nerves are connected

The key thing to remember: not all earwax needs removal. About 30-40% of people have visible wax during checkups but feel zero symptoms. That’s normal. Impaction only counts if it’s causing problems.

What Makes It Worse?

You’d think cleaning your ears helps. But here’s what actually happens:

• Cotton swabs: Push wax deeper. NHS England data shows they’re behind 60-70% of iatrogenic (doctor-caused) impactions.
• Ear candling: Totally useless and dangerous. The FDA says it causes around 12,500 ear injuries a year - including 3,000 perforated eardrums - between 2018 and 2022.
• Home suction devices: Sold online as quick fixes, but they’re not regulated. Many users report pain, bleeding, or worse.
• “Ear scoops” on TikTok: Over 1.2 billion views show people poking around their ears with metal tools. These videos are a public health risk.

Dr. William Luxford from the House Clinic says it plainly: “90% of earwax blockages come from people trying to clean their ears.”

How Doctors Diagnose It

Your GP or an ENT specialist won’t guess. They’ll use an otoscope - a small lighted tool - to look inside your ear. This isn’t just a quick peek. A pneumatic otoscope checks if your eardrum moves normally. If wax is blocking it, the drum won’t bounce back when air is gently puffed in.

Diagnosis requires two things: visible wax blocking the canal and symptoms. No symptoms? No treatment needed. That’s the rule from the American Academy of Family Physicians.

But here’s the catch: about 22% of people who think they have earwax impaction actually have something else - like an ear infection, cholesteatoma, or jaw joint problem. That’s why self-diagnosis is risky.

Safe Ways to Remove Earwax

There are three proven methods - and only one should ever be done at home.

1. Softening at Home (First-Line)

If you’re not in pain and your hearing is just muffled, try this NHS-recommended approach:

1. Lie on your side with the affected ear facing up.
2. Put 2-3 drops of olive oil, almond oil (if you’re not allergic), or mineral oil into the ear.
3. Stay in that position for 5-10 minutes so the oil soaks in.
4. Repeat 3-4 times a day for 3-5 days.
5. After that, gently wipe the outside of your ear with a damp cloth. Don’t stick anything inside.

This works for about 58-65% of cases. Carbamide peroxide drops (like Debrox or Murine) are slightly more effective but can irritate sensitive skin.

2. Professional Removal (Second-Line)

If home oil doesn’t help, see a professional. Here’s what they do:

• Manual removal: A doctor uses a tiny curette or forceps to gently scoop out the wax. It’s quick, painless, and 92% effective in one visit.
• Ear irrigation: Warm water or saline is gently flushed into the ear. Works 85% of the time, but not safe if you’ve ever had a perforated eardrum or ear surgery.
• Microsuction: A small vacuum removes wax under direct vision. It’s the gold standard - 96% effective, no water involved, and safest for people with past ear issues. Most clinics now prefer this.

A 2020 review in the Journal of Laryngology & Otology found microsuction had the lowest complication rate. Patients often say their hearing returns instantly. Trustpilot reviews show 92% satisfaction with microsuction.

3. Advanced Cases

For stubborn or complex blockages - like wax packed tightly around scar tissue or after ear surgery - endoscopic removal is used. Cedars-Sinai reports a 99.2% success rate with this method. It’s done under magnification with a tiny camera, so nothing is missed.

What NOT to Do

Stop these practices immediately:

• No cotton swabs: Even “just cleaning the outside” can push wax inward.
• No ear candles: They don’t work. They’re a fire hazard. The FDA banned them as misbranded medical devices in 2010.
• No suction tools: Those “ear vacuums” sold online aren’t regulated. They can rupture your eardrum.
• No metal tools: TikTok influencers show “ear scoops” - but real doctors use precision instruments under controlled conditions. You don’t.

Reddit users who tried swabs reported 74% worsened symptoms within 48 hours. Over 20% ended up in emergency care.

When to See a Doctor

You don’t need to wait until you’re in pain. See a professional if:

• Your hearing has gotten noticeably worse over a few days
• You feel pressure or fullness that won’t go away
• You have dizziness, ringing, or drainage
• You’ve had ear surgery, a perforated eardrum, or tubes in the past
• You use hearing aids or earplugs daily - these block natural wax movement

If you’re over 65, have diabetes, or a weakened immune system, don’t wait. Even mild blockage can lead to infection.

Prevention Tips

You can reduce your risk:

• Use earplugs sparingly - they trap wax inside
• If you wear hearing aids, get your ears checked every 6 months
• After swimming or showering, tilt your head to let water drain
• Use oil drops once a week if you’re prone to buildup - but only if you don’t have a history of ear problems
• Never insert anything smaller than your elbow - a phrase repeated across dozens of patient forums for good reason

What’s New in 2025?

The field is evolving. In 2023, the FDA cleared the Eareto OtoSonic - the first prescription-only home ultrasonic device shown to soften wax in 78% of users. It’s not a cure-all, but it’s a step toward safer home management.

New guidelines from the American Academy of Otolaryngology (coming June 2025) will include telehealth triage. A 2023 JAMA study found remote video assessments were 89% accurate at spotting true impaction - meaning you might not need an in-person visit just to confirm it.

But the biggest threat? Social media. TikTok and YouTube are flooded with videos of people digging into their ears. That’s not education - it’s dangerous misinformation.

Final Takeaway

Your ears don’t need cleaning. They clean themselves. Earwax impaction isn’t caused by dirt - it’s caused by interference. Every time you stick something in your ear, you’re disrupting nature’s design.

If you have symptoms, don’t try to fix it yourself. Use oil drops for a few days, then see a professional. Microsuction is fast, safe, and often life-changing - people describe it as “hearing again for the first time in years.”

And remember: if you’ve ever had ear surgery, use hearing aids, or feel sudden hearing loss - skip the home remedies. Your ears are delicate. Treat them that way.