Earwax Impaction: How to Recognize and Safely Remove Cerumen Blockage

Most people think earwax is something to clean out - but the truth is, your ears are designed to clean themselves. When earwax builds up and hardens, it becomes a problem called earwax impaction. This isn’t just a minor annoyance. It can mess with your hearing, cause pain, and even lead to infections if you try to fix it yourself.

What Exactly Is Earwax Impaction?

Earwax, or cerumen, is your body’s natural defense system. It traps dust, dirt, and germs before they reach your eardrum. Normally, it slowly moves out of the ear canal on its own, carried by jaw movements like chewing and talking. But sometimes, it gets stuck. When it builds up enough to block the ear canal and cause symptoms, that’s impaction.

It’s not rare. About 6% of adults deal with it, but the numbers jump up for certain groups. Around 12% of people over 65 have it. For those with hearing aids or developmental disabilities, the rate hits 30%. The biggest cause? Trying to clean your ears with cotton swabs. Studies show 60-70% of cases happen because people poke things into their ears - even if they mean well.

How Do You Know You Have It?

You might not realize you have earwax impaction until symptoms show up. They don’t come on all at once. Most people notice them over a week or two. Common signs include:

• Hearing loss - reported in 65% of cases
• Feeling like your ear is full or plugged
• Earache or pressure
• Ringing in the ear (tinnitus)
• Dizziness or balance issues
• Itching inside the ear
• Odd-smelling or watery discharge

Here’s the thing: if you have earwax but no symptoms, you don’t need to do anything. A 2018 study from the American Academy of Family Physicians found that 30-40% of people have visible earwax during routine checkups - but they’re perfectly fine. Impaction only counts if it’s causing problems.

And not every ear problem is earwax. About 22% of people who think they have a blockage actually have something else - like an ear infection, a skin growth, or even a jaw joint issue. That’s why seeing a professional matters.

Why You Shouldn’t Use Cotton Swabs

It’s the most common mistake. You see the wax on the swab and think you’re helping. But you’re not. You’re pushing the wax deeper, compacting it against your eardrum. That’s how impaction starts.

Research from NHS England shows cotton swabs are behind most cases of iatrogenic (doctor-caused) earwax problems. People end up in urgent care with pain, bleeding, or even a punctured eardrum. Reddit threads from audiology communities show 74% of users who used swabs had worse symptoms within two days. Some needed emergency care.

And it’s not just swabs. Ear candles, home suction kits, and those viral TikTok “ear scoops” are dangerous. The FDA reports over 12,500 ear injuries between 2018 and 2022 from these devices. About 3,000 of those were perforated eardrums. These aren’t myths - they’re documented medical emergencies.

Safe Ways to Remove Earwax

There are three proven, safe methods - and they’re all done professionally. Home remedies can help, but only if you do them right.

1. Softening at Home (First Step)

If you’re not in pain and don’t have a history of ear surgery, try softening the wax first. The NHS recommends this simple 5-step method:

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

Mineral oil, baby oil, or glycerin work too. Studies show these soften wax about 58% of the time. Carbamide peroxide drops (like Debrox) are slightly more effective at 65%, but can irritate sensitive skin. Hydrogen peroxide? It’s 52% effective but often stings - and can make things worse if your skin is already irritated.

2. Professional Removal

If home softening doesn’t help, or if you have symptoms, see a clinician. There are three standard methods:

• Manual removal - Using tiny tools like curettes or forceps. This works 92% of the time in one visit. It’s quick, quiet, and doesn’t involve water.
• Ear irrigation - Warm water or saline is gently flushed into the ear. It’s 85% effective. But it’s not safe if you’ve ever had a perforated eardrum, ear surgery, or a tube in your ear.
• Microsuction - A small vacuum gently removes wax under a microscope. It’s the gold standard. Studies show 96% success with almost no risk. No water. No pressure. Just precision.

Microsuction is especially good for people with hearing aids, diabetes, or a history of ear problems. It’s also the method most patients prefer. Trustpilot reviews of clinics show 92% satisfaction with microsuction versus 85% for irrigation.

Who Needs Professional Help?

You should definitely see a professional if:

• You have hearing loss, dizziness, or pain
• You’ve tried home remedies for 5 days with no improvement
• You’ve had ear surgery, a perforated eardrum, or ear tubes
• You use hearing aids or earplugs regularly
• You have diabetes or a weakened immune system

And if you’re over 65? Don’t wait. The risk of impaction goes up with age, and so does the chance of complications.

What About New Devices?

There’s a new device called the Eareto OtoSonic - the first FDA-cleared home ultrasonic earwax softener. It’s prescription-only and showed 78% effectiveness in trials. But it’s not for everyone. It’s meant for mild cases, and you still need to follow up with a clinician if it doesn’t work.

Meanwhile, telehealth is getting better. A 2023 study showed that doctors can accurately diagnose earwax blockage 89% of the time just by reviewing a video of the ear. That means more people might be able to get advice without leaving home - but still, physical removal is needed if it’s impacted.

What Not to Do

Here’s the list of things you should never do:

• Never insert cotton swabs, bobby pins, or any tool into your ear canal.
• Avoid ear candles - they don’t work and can burn you.
• Don’t use home suction devices - they’re unregulated and risky.
• Stop using water jets or syringes on your own.
• Don’t ignore symptoms. If your hearing changes or you feel pressure, get checked.

One Reddit user summed it up perfectly: “Never put anything smaller than your elbow in your ear.”

Prevention Is Simple

You don’t need to clean your ears daily. In fact, you shouldn’t. Here’s how to prevent impaction:

• Let your ears clean themselves - they’re designed to do it.
• If you use hearing aids, get your ears checked every 6-12 months.
• Wipe the outer ear with a damp cloth after showering.
• Use oil drops once a week if you’re prone to buildup (ask your doctor).
• Stay away from ear picks, scoops, and viral cleaning hacks.

Most people never need professional removal. But if you do, it’s quick, safe, and often life-changing. One patient told me, “I thought I was going deaf. After 10 minutes, I heard birds outside again.”