Ear wax impaction: symptoms, causes and how it's safely removed

Normal ear wax versus impaction

Ear wax — cerumen — is not dirt. It is a mix of glandular secretions and shed skin that keeps the ear canal slightly acidic, water-repellent and protected from dust and bacteria. In a healthy ear it migrates outwards on its own as the canal skin slowly grows, carrying debris with it. You can read more in our guide to what earwax actually is.

Impaction is when that self-cleaning process fails and the wax accumulates until it fills or blocks the canal. Importantly, the amount of wax alone is not the diagnosis: it is called impaction when it causes symptoms, or when it stops an audiologist seeing the eardrum or taking an accurate hearing measurement.

Symptoms of impacted ear wax

• Muffled or reduced hearing, often in one ear and often after a shower or swim, as trapped wax swells with water.
• A blocked, full or "underwater" feeling that does not clear when you swallow or yawn.
• Tinnitus — ringing, buzzing or hissing that appears alongside the blockage.
• Mild earache or pressure, sometimes with an itch deep in the canal.
• Dizziness or unsteadiness where wax presses against the eardrum.
• A cough — wax touching the canal wall can trigger a reflex in some people.
• Hearing aid problems — whistling feedback, aids sounding quiet, or receivers blocking repeatedly.

Discharge, bleeding, severe pain or a sudden loss of hearing are not typical of wax and should always be examined promptly — they point to something else.

Why wax becomes impacted

• Cotton buds. The single most common cause — they remove a little wax at the entrance and push the rest deep against the eardrum.
• Hearing aids, earplugs and in-ear headphones. Anything worn in the canal for hours a day blocks the natural outward migration.
• Narrow or bendy ear canals, and canals with more hair — common in older men.
• Age. Wax becomes drier and harder over time, so it moves less freely.
• Dry skin conditions such as eczema and psoriasis, which increase the amount of shed skin in the mix.

What to try at home first — and what to avoid

For a mild build-up, a few drops of plain olive oil or a pharmacy softening drop, twice a day for three to five days, is a reasonable first step. Lie on your side for a couple of minutes afterwards so the drops stay in the canal.

Avoid the following:

• Cotton buds and hair grips — they compact the wax and can scratch the canal or perforate the eardrum.
• Ear candling — there is no evidence it removes wax, and there are documented cases of burns, wax deposits in the canal and eardrum perforation.
• Home irrigation kits — pushing water at pressure into an ear with an unseen perforation or infection risks real harm.

If symptoms persist after a week of softening drops, the wax needs removing professionally.

How impacted wax is removed professionally

Microsuction is the method used at Drummond Hearing. The canal is examined under a microscope or loupes and the wax is lifted out with a fine, low-pressure suction tube. Nothing is pushed inwards, no water is used, and the audiologist can see the eardrum throughout. It is the safest option if you have a perforation, grommets, a history of ear surgery, a single hearing ear, or you wear hearing aids.

Manual instrumentation — a fine hook or crocodile forceps under the same direct vision — is often combined with suction for very hard or wall-adherent wax.

Irrigation (modern low-pressure syringing) still has a place in general practice, but it is performed blind and is contraindicated with any history of perforation, ear surgery or current infection.

A typical appointment takes 20–30 minutes for both ears, is not painful, and your hearing is usually clear the moment you leave. Our aftercare guide covers what is normal in the days that follow.

Impaction and your hearing test

Wax that blocks the canal artificially depresses air-conduction thresholds, which can look like a conductive hearing loss on an audiogram. That is why every assessment starts with otoscopy: if there is significant wax, it is cleared first so the results reflect your actual hearing. See what happens at a hearing test for the full sequence.

How to prevent it coming back

• Nothing smaller than your elbow in the ear canal — clean only the outer ear with a flannel.
• If you are prone to build-up, a few drops of olive oil once a week keeps wax soft and mobile.
• Hearing aid users: wipe your aids nightly and change wax guards on schedule.
• Book a check when hearing dulls gradually, not once the ear is completely blocked.

Frequently asked questions

What is ear wax impaction?

Ear wax impaction is when cerumen builds up and blocks the ear canal instead of migrating out naturally. It is only called impaction when the wax causes symptoms — such as muffled hearing, fullness or tinnitus — or when it prevents examination of the eardrum.

What are the symptoms of impacted ear wax?

The most common symptoms are muffled or reduced hearing, a blocked or full feeling, mild earache, ringing in the ear, itchiness, and occasionally dizziness. Hearing aid users often notice whistling feedback or that their aids sound quiet.

Can impacted ear wax clear on its own?

Sometimes. Softening drops such as olive oil used for three to five days can help a mild build-up move out naturally. If symptoms persist beyond a week, the wax usually needs removing professionally.

Is microsuction better than syringing or ear candling?

Microsuction is performed under direct vision with a microscope and a fine suction device, so nothing is pushed further in and no water is introduced. It is the preferred method for perforated eardrums, previous ear surgery and hearing aid users. Ear candling has no evidence of benefit and carries a risk of burns and canal blockage.

How long does an ear wax removal appointment take?

Most appointments take 20–30 minutes for both ears, including examination before and after. Stubborn, very hard wax occasionally needs softening drops and a short second visit.