What is earwax? Why we have it, and when it needs removing

"How much wax can you see?" is the first question most of my patients ask when I look into the ear.

There's a huge fascination with earwax. Many people think wax in the ear should be removed by any means possible — some YouTube videos of wax removal attract millions of viewers eager to see it come out. But does wax always need to be taken out, or are there benefits to having wax in the ear?

As an audiologist I'm always keen to give the positives of wax. Yes, in some cases a build-up in the ear can have unwanted effects and does need removing, but overall earwax is a good thing — and in most cases should be left where it is: in the ear.

Why do we have earwax in the first place?

If wax should ordinarily be left alone, the most important question to understand is why we have wax at all and what benefits it brings. I've summed up the positives of earwax below:

• Earwax lubricates the ear canal, which in turn helps move debris and dead skin out of the ear.
• Earwax acts as a natural defence against some infections — it has antibacterial and antifungal properties that slow the growth of bacteria.
• It protects the sensitive skin in the ear canal from irritation caused by water.
• It stops debris, dirt and foreign objects — including insects — making their way further into the ear.

Interestingly, wax isn't the same for everyone. The amount you produce, the colour and the consistency are all determined genetically. Some people over-produce wax, and excessive wax can become troublesome. So when should we start thinking about removing wax — and how can it be done?

Signs you might have too much wax

If you have too much wax, you'll likely notice one or more of the following symptoms:

• Pain or discomfort in the ear
• Itchiness
• A blocked sensation, similar to being underwater
• Hearing that sounds reduced or dull
• Dizziness
• Ringing in the ear (tinnitus)
• Ear infection

Of course, having one or more of these symptoms doesn't necessarily mean you have wax — but you should get your ears checked by an audiologist or your GP. If your ears are checked and you do have too much wax, don't despair. There are a couple of options.

Wax ear drops

Ear drops can help soften wax, which in turn helps it work its way out of the ear. Generally there are two types of drops available: olive oil or sodium bicarbonate. Olive oil drops are very good at softening wax, while bicarbonate drops can help dissolve it.

Earwax removal

In many cases wax drops alone will be more than sufficient. In some cases, though, wax needs to be removed in clinic. Wax can be removed in various ways and should always be done by a professional trained in wax removal, such as an audiologist or ENT doctor.

The two most common techniques are wax syringing and microsuction. In our clinic we tend to advise microsuction: it can be carried out even if there's any damage to the eardrum, it's widely thought to be less painful, and there's less chance of causing any damage to the ear.

Related reading: Ear wax removal aftercare — what to expect after microsuction.