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Cerumen Impaction

(Earwax; Ear Impaction; Ear Blockage)
  • Definition

    Cerumen is the soft yellow wax made by glands in your ear canal. It is more commonly known as earwax. Cerumen impaction is a buildup of earwax that becomes wedged in, blocking the ear canal.
    The Ear Canal
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    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Cerumen impaction is usually caused by:
    • An inability of the ear to naturally clear itself of cerumen due to hardening
    • Putting objects into your ears that push the cerumen deeper into the ear canal
  • Risk Factors

    Cerumen impaction is more common in older adults. It can cause hearing loss.
    Other factors that may increase your chance of cerumen impaction include:
    • Trying to remove cerumen with a cotton-tipped swab
    • A twisted, narrow, or complicated ear canal
    • Ears that overproduce or make thick cerumen
    • Dense hair growth in the ear canal
    • Hearing aid use
    • Intellectual disability
  • Symptoms

    Symptoms may include:
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. An ear exam will be done to look for impacted cerumen.
  • Treatment

    Treatment involves removal of the earwax from the ear canal. Talk with your doctor about the best treatment plan for you. Cerumen can be removed by:
    • Using one of several instruments, including:
      • Curette—This is a surgical instrument shaped like a scoop.
      • Suction—When the cerumen is loosened, the earwax will be vacuumed.
    • Flushing—The impacted cerumen may be rinsed using flushing equipment.
    • Ceruminolytic agents—A ceruminolytic agent may be prescribed. This is a liquid-like solution used in the ear to soften the earwax and ease removal.
    Earwax moves out of your ear naturally. Earwax should not be removed by you. In fact, continuously trying to clean your ear of cerumen by using a cotton swab, for example, can damage your ear. By trying to remove earwax, you can:
    • Damage your eardrum—the membrane that vibrates and transmits sound to the middle ear
    • Make yourself more prone to otitis externa—an infection or inflammation of the skin that lines the ear canal
    • Injure the ear canal
    • Cause the cerumen to become more impacted and more difficult to remove
  • Prevention

    To help reduce your chance of cerumen impaction:
    • Do not clean your ears with anything more than a soapy washcloth on the outer rim of your ear.
    • Do not use cotton-tipped swabs to clean anywhere inside your ears.
    • Use medications as advised by your doctor to help prevent the buildup of earwax.
    • If you are concerned about earwax, see your doctor. Do not attempt to remove the earwax by yourself.
    • Schedule regular visits to remove earwax buildup as advised by your doctor.

    American Academy of Audiology

    American Speech–Language–Hearing Association


    Canadian Society of Otolaryngology—Head and Neck Surgery

    Health Canada


    Cerumen impaction. EBSCO DynaMed website. Available at: Updated October 30, 2012. Accessed August 7, 2015.

    Jabor MA, Amedee RG. Cerumen impaction. J La State Med Soc. 1997;149(10):358-362.

    Mahoney DF. Cerumen impaction. Prevalence and detection in nursing homes. J Gerontol Nurs. 1993;19(4):23-30.

    Olusanya BO. Hearing impairment in children with impacted cerumen. Ann Trop Paediatr. 2003;23(2):121-128.

    Pray WS, Pray JJ. Earwax: Should it be removed? US Pharmacist. 2005;30(5).

    2/26/2010 DynaMed's Systematic Literature Surveillance Ear candles: risk of serious injuries. US Food and Drug Administration website. Available at: Updated September 5, 2013. Accessed September 11, 2014.

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