What Is Earwax (Cerumen) Impaction?

Cerumen impaction is a condition in which earwax accumulates and hardens in the ear canal, resulting in either a full or partial blockage and potentially causing hearing loss, pain, itchiness, irritation, or ringing in the ears.

Cerumen, also called earwax, is a natural, protective part of ear health. It is usually a yellow, orange, or brownish color and is made of keratin (from shed skin cells) and lipids and peptides produced by special glands in the ear. Earwax helps clean the ears and protect them from dirt, dust, and other small particles, as well as from water damage and infection. Without earwax, our ears would be dry and itchy, reports the American Academy of Otolaryngology-Head and Neck Surgery.

Most of the time, our ears and earwax are innately self-cleaning. Earwax prevents small particles from getting too far into the ear, and then, thanks to jaw motions like chewing and cell turnover, old wax moves from inside the canal to the ear opening, where it is washed away during bathing or flakes off on its own.

Sometimes, however, cerumen impaction occurs, with earwax collecting in the narrow portion of the ear canal and blocking it, either completely or partially. About 10% of children and 5% of adults experience earwax impaction (Cleveland Clinic). Peer-reviewed Research in Laryngoscope: Investigative Otolaryngology puts the prevalence higher, at 18% of people over 12 and 32% of people over 70.^[1] For the broader topic, see our earwax buildup post.

Given that cerumen impaction is relatively common, it is important to know how to prevent it and care for it so that ear pain or fullness, hearing changes, irritation, and other symptoms do not persist or get worse.

Symptoms of Earwax Impaction

Symptoms of earwax impaction include ear pain, ear fullness, hearing loss, ringing in the ears (tinnitus), itching, dizziness, and sometimes a dry, tickling cough. The Cleveland Clinic reports that these symptoms can range from mild itch to noticeable hearing loss.

Signs of Impacted Earwax

• Pain or earache
• Feelings of ear "fullness" or that ears are "plugged"
• Hearing loss that may worsen over time
• Change in hearing aid functionality
• Ringing in the ears or tinnitus
• Ear itchiness
• Ear odor or discharge
• Dry, tickling cough
• Dizziness
• A healthcare provider being unable to clearly view your ear canal or eardrum (tympanic membrane) with an otoscope

If you are experiencing disruptive, uncomfortable ear symptoms, talk to your healthcare provider about whether you have impacted earwax and if earwax cleansing may be necessary.

There are gentle, non-invasive at-home treatments available to loosen, dissolve, and cleanse excess earwax. More serious cases may need a different treatment.

What Causes Cerumen Impaction?

Earwax impaction can happen for a number of reasons, and some people are more prone to impacted earwax than others. Genetics, age, ear-canal shape, frequent in-ear device use, and improper cleaning attempts (especially with cotton swabs) are the most common contributors.

Clinical guideline According to the Cleveland Clinic and American Academy of Otolaryngology-Head and Neck Surgery, cerumen impaction is more likely to occur in people who:^[2]

• Are over the age of 55
• Frequently use hearing aids, earbuds, or earplugs
• Have more ear hair
• Have skin conditions like eczema
• Have narrow or unusually shaped ear canals
• Have developmental disabilities or are a young child
• Use cotton swabs or put other items in their ears, which can push wax further into the narrow part of the canal and cause blockage or irritation

What Does Impacted Earwax Look and Feel Like?

Impacted earwax typically looks like a dense plug of black, light or dark brown, or dark orange wax filling part or all of the ear canal and blocking the view of the eardrum. It is usually visible only through an otoscope (a handheld medical device with a bright light and a magnifying lens) but can be felt as ear fullness, pain, itching, hearing changes, or ringing in the ears. The impacted wax may appear flaky and dry, or thick and sticky; in more severe cases, impacted earwax on the eardrum can press against the membrane and contribute to muffled hearing or discomfort.

If you have any of these symptoms, address the impaction either with gentle home treatment or with the help of a healthcare provider, who can confirm the diagnosis with an otoscope exam.

Can Impacted Earwax Cause Other Problems?

Yes. Impacted earwax can cause hearing loss, ringing in the ears, jaw pain, dizziness, and an increased risk of ear infection, especially when removal is attempted improperly with cotton swabs or other objects.

While cerumen impaction is common and earwax is a healthy substance, impacted earwax symptoms should not be ignored. Without treatment, symptoms can worsen, leading to increased discomfort and hearing changes.

Peer-reviewed Impacted earwax can also be more likely to harbor fungus or bacteria, potentially contributing to increased infection risk. A study in the American Journal of Otolaryngology found that samples of earwax from patients with frequent severe impaction showed evidence of fungal growth, and when bacteria were present, they were most commonly Staphylococcus aureus.^[3]

Peer-reviewed Additionally, improper attempts to remove impacted cerumen can push wax deeper into the ear canal and can injure the ear canal or eardrum, increasing infection risk. Research in the International Journal of Pediatric Otorhinolaryngology tied 70% of cases of otitis externa (a type of ear infection) in children to cotton swab usage.^[4] Also of concern, if the ear canal remains blocked and invisible to healthcare providers, other ear conditions may be hard to diagnose.

For persistent ringing, see our post on the earwax and ear ringing connection or our what is tinnitus hub.

How Is Cerumen Impaction Treated?

Cerumen impaction is treated with one or more of three approaches: observation (allowing self-clearance), wax-softening drops (cerumenolytics), and clinician-performed irrigation or physical removal. Choice of approach depends on the severity of impaction and the patient's history.

To diagnose impacted earwax, your healthcare provider will look in your ears with an otoscope. If impaction is confirmed, guidelines from the American Academy of Otolaryngology-Head and Neck Surgery recommend the following treatments.^[2]

Cerumen Impaction Treatments

Observation. Because human ears and earwax are naturally self-cleaning, earwax impaction may clear on its own. Depending on your situation, your healthcare provider may recommend waiting to see if the buildup resolves with time. If this approach is chosen, follow up with your clinician if your symptoms continue or get worse.

Irrigation. Earwax impaction can be cleared with irrigation performed by a healthcare provider, typically using a bulb syringe to gently stream warm water into and out of the ear. Irrigation is not advised for people who suffer from frequent ear infections, have ear tubes, or have a damaged eardrum.

Wax softening agents or cerumenolytics. These are drops that can be provided by your healthcare provider or purchased over-the-counter, such as the LIPO Earwax Cleansing Solution. These solutions have active ingredients that soften and break up earwax.

For mild to moderate cases, the LIPO Earwax Cleanser is one over-the-counter option. It is formulated with gluconolactone, a trusted skincare active ingredient that emulsifies stubborn earwax so it can wash out, and is designed to dissolve current blockages in as little as 3 minutes while helping prevent future buildup.

Wax-softening agents may be effective on their own or in combination with another method recommended by your healthcare provider, such as irrigation or physical removal by a trained professional. If you are wondering how to get rid of earwax impaction at home, a properly formulated cerumenolytic is generally the safest starting point for milder cases.

Physical earwax removal by a healthcare provider. Sometimes it is necessary for a healthcare professional to remove impacted earwax with a special instrument, often in combination with a wax-softening agent or irrigation. This is the recommended impacted earwax removal pathway for severe cases. Because the internal ear contains delicate structures, never attempt physical earwax removal on your own, and do not place items like cotton swabs in your ear canal.

Key Takeaways About Impacted Earwax

We all have earwax, and earwax serves important protective functions in our ears. Most of the time, our earwax does not cause problems, and our ears stay clean simply through routine bathing habits (no cotton swabs necessary).

Sometimes, however, earwax can build up or plug the ear canal. When this happens, it is called earwax impaction or cerumen impaction. Symptoms include ear discomfort (pain, itchiness, fullness), hearing changes like muffled hearing, ringing or buzzing in the ears, dizziness, and ear discharge or odor.

Fortunately, treatments are available, including warm-water irrigation by a healthcare provider, wax-softening agents (cerumenolytics) like LIPO, physical earwax removal by a healthcare provider, or combinations of these options as directed by your provider.

Frequently Asked Questions About Cerumen Impaction