Earwax is a build-up of dead cells, hair, foreign material such as dust, and cerumen. Cerumen is the natural wax produced by glands in the ear. It forms a protective coating of the skin in the ear canal. Small amounts are made all the time. Flakes or crusts of earwax break off and fall out of the ear from time to time.
The quantity of earwax made varies greatly from person to person. Some people form plugs of earwax in their ear canal. This may cause a feeling of fullness and dulled hearing. It can feel uncomfortable. A hard plug of earwax can also sometimes cause 'ringing in the ear' (tinnitus) or even a mild type of dizziness (vertigo).
A doctor or nurse can look into the ear canal and confirm a plug of earwax has formed. A plug of earwax is not a serious problem, more a nuisance. You only need to remove earwax if it is causing symptoms such as dulled hearing. Earwax may also need to be removed for fitting of a hearing aid, or if a doctor or nurse needs to examine your eardrum.
Note: do not try to clean the ear canal with cotton wool buds, etc. This can make things worse, as you will push some earwax deeper inside. It may also cause an ear infection. So, let the ear clean itself.
What can I do if earwax builds up and causes symptoms?
Ear drops alone will often clear a plug of earwax. You can buy drops from pharmacies. For example, olive oil, almond oil, sodium bicarbonate, and sodium chloride ear drops are commonly used for this purpose. Warm the drops to room temperature before using them. (Let the bottle stand in the room for about half an hour.) Pour a few drops into the affected ear. Lie with the affected ear uppermost when putting in drops. Stay like this for 2-3 minutes to allow the drops to soak into the earwax. The earwax is softened and it often breaks up if you put drops in 2-3 times a day for 4 weeks. Flakes or crusts of earwax often fall out bit by bit. You may not notice the wax as it comes out of your ear.
Ear irrigation may be needed if ear drops do not work after being used for 4 weeks. The ear canal is washed out with warm water. Irrigating the ear with water will usually clear plugs of earwax. But it is only safe if the plug of earwax has been softened. Irrigation when the wax is hard increases the risks of perforating the ear drum. Therefore, use ear drops (such as olive oil ear drops) to soften wax before you have ear irrigation.
Ear irrigation is usually painless. Lukewarm water is squirted into the ear canal. This is usually done by a machine that squirts water at the right pressure. This dislodges the softened plug which then falls out with the water.
Ear irrigation may not be advised if you have certain ear problems. In particular, if you:
Have had complications following this procedure in the past.
Currently have grommets in place. (Grommets are small plastic tubes placed in the eardrums in an operation.)
Have had ear surgery in the past (apart from grommets that have come out at least 18 months previously and you have been discharged from the hospital ear department).
Have a cleft palate (even if it has been repaired).
Have an ear infection or have had an ear infection in the previous six weeks.
Have recurring infections of the ear canal (recurring otitis externa).