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Understanding Earwax Buildup and When to Clean Your Ears

Earwax, also called cerumen, is a natural substance your body produces to protect and clean your ear canal. It traps dust, bacteria, and other particles, preventing them from reaching your eardrum. Most people don't need to clean inside their ears at all—the ear is self-cleaning and naturally moves earwax outward on its own.

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However, earwax buildup can occur in certain situations. According to the American Academy of Otolaryngology, about 1 in 20 adults experience problematic earwax impaction. This happens when earwax becomes compacted and blocks the ear canal. Signs of excessive buildup include hearing loss, ear fullness, ringing in the ears (tinnitus), ear discomfort, or drainage. Some people are simply more prone to earwax buildup due to genetics, ear canal shape, or having narrow ear canals.

Certain activities and conditions increase earwax accumulation. Using hearing aids, earbuds, or earplugs regularly can pack earwax deeper into the canal. Aging also affects earwax consistency—older adults often produce drier earwax that's more likely to accumulate. People who work in very dusty environments may also experience more buildup. Additionally, some medical conditions like eczema in the ear canal can contribute to excessive earwax production.

It's important to recognize that cleaning your outer ear—the part you can see—is completely normal and necessary. The problem arises when people attempt to clean deep inside the ear canal where they can't see. This is where most ear-cleaning injuries occur.

Practical takeaway: Observe your ears for signs of excessive buildup like hearing loss or fullness. If you experience these symptoms, consider seeing a healthcare provider rather than attempting deep cleaning yourself. Monitor whether your ears feel uncomfortable after using earbuds or hearing aids, as these can contribute to buildup.

Why Cotton Swabs and Other Common Methods Can Be Dangerous

Cotton swabs are the most commonly used at-home ear-cleaning tool, yet they are also one of the most dangerous. The American Academy of Otolaryngology specifically warns against using cotton swabs (Q-tips) to clean inside the ear canal. Despite this widespread warning, millions of people use them daily, often without realizing the risks.

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When you insert a cotton swab into your ear canal, you risk several injuries. The swab can perforate (tear) your eardrum, which separates your outer ear from your middle ear. A perforated eardrum can cause immediate pain, hearing loss, and drainage. In some cases, permanent hearing damage results. Additionally, cotton swabs can push earwax deeper into the canal rather than removing it, creating impaction. The swab can also damage the delicate skin lining your ear canal, causing inflammation, infection, or swimmer's ear (otitis externa).

Other common at-home methods carry similar or greater risks. Ear candles—hollow tubes you light and place in your ear—have been marketed for earwax removal but offer no proven benefit. The FDA has received reports of burns, perforated eardrums, and blocked ear canals from ear candle use. Metal ear picks, popular in some cultures, can easily scratch the ear canal or puncture the eardrum if the person using them lacks proper training and visibility.

Water or hydrogen peroxide spray bottles designed for ear cleaning can generate enough pressure to damage the eardrum if used incorrectly. Inserting any object into your ear canal becomes dangerous because you cannot see the eardrum—you're working blind in a sensitive space only about 1 inch long.

Even hairpins, toothpicks, or twisted paper can cause injury. The ear canal has a slight bend, making it easy to misjudge depth and force. The skin inside your ear canal is thinner and more delicate than skin elsewhere on your body, making it more prone to injury and infection.

Practical takeaway: Stop using cotton swabs for ear canal cleaning immediately. If you currently use any object to clean deep inside your ears, replace that habit with safe external cleaning methods only. Make a note to ask your healthcare provider about professional earwax removal options during your next appointment.

Safe Methods for Cleaning Your Outer Ear

The outer ear—the part visible on the side of your head and the entrance to your ear canal—can and should be kept clean. This is the area where dirt, dead skin, and earwax naturally accumulate, and regular cleaning prevents buildup.

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The safest approach involves simple warm water and a washcloth. During your shower or bath, wet a soft washcloth with warm (not hot) water and gently wipe the outer ear, behind your ear, and the entrance to your ear canal. Use your pinky finger or the corner of the washcloth to gently clean just inside the ear opening—you should never force anything deeper. Pat dry with a clean, dry cloth. This mimics your ear's natural self-cleaning process and removes surface debris without risk.

For the entrance to your ear canal specifically, you can use a slightly damp corner of a washcloth on your pinky finger. Move gently in a circular motion, cleaning only what you can see and reach comfortably. If earwax is visible at the opening, you can gently wipe it away. Never push or scrape. This takes only seconds and is completely safe.

If you notice excessive earwax at the entrance to your ear canal that won't come away with gentle wiping, resist the urge to dig it out. Instead, you have several professional options described in the next section. Many people simply need professional removal once or twice yearly.

Behind your ear and in the creases deserves attention too. These areas trap moisture and dead skin. Gently clean behind and around your ears with your washcloth during regular bathing. This prevents infection and odor without any risk.

If you have a hearing aid or earbuds, clean them separately. Wipe the outer surfaces daily with a dry cloth. Most hearing aid manufacturers provide cleaning brushes and cloth covers specifically designed for this purpose. Keeping your devices clean reduces earwax transfer to your ear canal.

Practical takeaway: Establish a simple daily habit of gently cleaning your visible outer ear with a damp washcloth during showering. Set aside your cotton swabs entirely and replace them with this safe method. Check behind and around your ears for moisture or buildup, especially if you wear hearing aids or earbuds regularly.

Recognizing When You Need Professional Earwax Removal

Professional earwax removal becomes necessary when buildup causes symptoms or when home care cannot safely address the problem. Several signs indicate it's time to contact your healthcare provider. If you experience hearing loss that seems related to ear fullness, this often signals earwax impaction. Tinnitus (ringing, buzzing, or roaring in your ears) can result from earwax pressure on your eardrum. Ear discomfort, itching, or a feeling that your ear is plugged are also common indicators.

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Some people experience drainage from their ear, which may indicate infection secondary to earwax buildup. If you have any ear drainage, especially if it's accompanied by pain or hearing loss, see a healthcare provider promptly. Dizziness or vertigo can occasionally result from earwax pressing on the eardrum, affecting your balance.

If you've already attempted home removal and the problem persists or worsened, professional care is needed. This includes situations where you've used cotton swabs and now have pain or hearing loss—you may have caused injury requiring evaluation.

Healthcare providers use several methods for safe earwax removal. Cerumen curettes are small, curved instruments that allow the provider to see and carefully scoop out earwax under direct visualization. Irrigation uses controlled water flow at specific pressure and temperature to flush out earwax; this is safe in professional hands despite risks when done at home. Suction removal uses specialized equipment to gently remove earwax while the provider watches. Some providers use microscopes or otoscopes that magnify the ear canal, improving visibility and precision. These methods are quick, typically taking only a few minutes, and most people experience immediate relief.

The cost of professional removal varies. Many insurance plans cover it when performed by a physician. Without insurance, costs typically range from $50 to $200 depending on your location