What to do when earwax becomes a problem

2. TRY A SOFTENING AGENT People who tend to produce an abundance of earwax may try using a softening agent — such as mineral oil, baby oil or 3 percent hydrogen peroxide — to help the wax

leave the ear or to remove it more easily. Using an eyedropper, apply a drop or two into your ear, tilting your head so that the opening of the ear is pointing up toward the ceiling. Stay in

that position for a minute or two to let the fluid flow down to the waxy buildup. Then tilt your head in the opposite direction to let the fluid drain along with the wax that has broken

loose. Sometimes a few squirts of warm water, gently squeezed from a rubber bulb syringe into the ear, may be needed to dislodge loosened wax. This routine may need to be repeated before the

excess wax breaks free. 3. USE EARDROPS Or try an over-the-counter product to loosen small amounts of wax. These products may contain an oil-based solution or hydrogen peroxide. (Ying

recommends the Debrox Earwax Removal Kit.) Some include a bulb syringe that you squeeze to flush your ear with warm water, if needed. Irrigation, however, isn’t always appropriate,

particularly if you have a damaged eardrum or a middle ear infection. A hole in the eardrum may allow fluid to be flushed deeper into the ear canal. If it doesn’t come out, it can create a

moist environment, and that can lead to an outer ear infection. And if you’re not careful, irrigation can cause an eardrum perforation. “You’re doing it blind,” says Ying. “You think, _Let

me go in a little bit deeper,_ but you have no way to gauge that.” What’s more, if you’re softening the plugged-up wax but not dissolving or removing it, the fluid can turn all of that into

a wall of mud that can plug up your ears even more. 4. BE CAREFUL WITH COTTON SWABS It might be tempting to poke a cotton swab, bobby pin, pencil or finger into your ear to get the gunk out,

but don’t go digging. Yes, it’ll remove some of the wax, but it may also push the rest deeper into the ear canal. There’s also a risk of injuring the eardrum. “You might look at your Q-tip

and think, _Look at this stuff I got out of my ear,_” says Vaughan, who has seen plenty of this “pushy” behavior in his practice. “But that’s actually wax you got from the sides of the ear

canal, after you’ve pushed most of the wax further inside the ear canal.”  A tip from Nguyen-Huynh: When you put a cotton swab inside the ear and hear the sound of the tip rustling those

tiny hairs, that means you’re in a place you should not be. WHEN TO GET MEDICAL HELP If these measures don’t clear out the bad stuff, see your health care provider to remove a blockage. It’s

not uncommon to have a buildup after using cotton swabs because the “tip tends to plow earwax was deeper,” Nguyen-Huynh says. Do that over time and you will build up a big clump of wax,

called an impacted cerumen, which is difficult to remove, especially if it is hard and dry. If the buildup is fairly close to the opening of the ear canal, a general practitioner can do the

job. In fact, earwax removal is one of the most common otolaryngological procedures performed in a primary care setting. If the ear is impacted with a hard, stubborn chunk of wax that’s

really lodged in there, it may be time to bring out the big guns — namely, an ear, nose and throat doctor (that is, an otolaryngologist) — for a closer look. Otolaryngologists have an

arsenal of precise tools at their disposal to go deep without harming the delicate eardrum. “First and foremost is being able to visualize what is going on in there,” says Namdar. “We have

the endoscope to let us look inside the ear canal to see exactly how much wax you have, the texture of the wax, and then decide the best instrument to use to remove it.” There are various

techniques doctors employ to remove impacted wax. One involves using a curette, a slender instrument designed to fit into the narrow ear canal that has a curved tip to scrape or scoop out

wax. Another method Ying uses involves dilating the ear canal with a speculum, then using suction to dislodge the wax. A clean ear canal can make a world of difference. One study found that

35 percent of hospitalized patients over age 65 had impacted earwax and 75 percent of those had improved hearing after it was removed. Some experts estimate that removing an earwax plug can

improve hearing by 10 decibels. (The difference between whispering and normal conversation is around 20 decibels.) And if earwax is causing tinnitus, getting it removed may very well resolve

the problem. Better hearing might not be the only benefit to maintaining a clean ear canal. There may be a link between earwax blockage and brainpower. In a small 2014 study, Japanese

researchers found significant improvements in hearing — as well as in cognitive ability — among elderly patients with memory disorders after impacted earwax was removed from their ears.

“There may also be an improvement in your balance,” Vaughan says. “Some patients actually feel as though their lives have changed.” _Editor’s note: This story, originally published on April

7, 2020, was updated to include additional guidance on proper earwax removal._