How-to guide
How to Manage Earwax Safely at Home
Quick answer: Earwax protects your ears, and most ears clean themselves, so you only need to do something if wax causes muffled hearing or a blocked feeling. Then, soften it with ear drops for a few days and let it work its way out. Never put cotton swabs or other objects in the ear canal, and do not use ear candles. If you have ear tubes, a hole in your eardrum or past ear surgery, skip home care and call us.
Do I need to clean my ears?
Usually not. Earwax traps dust and dirt and keeps the skin of the ear canal healthy. The canal cleans itself: wax slowly moves outward and falls away. Wax that causes no symptoms does not need to come out (AAO-HNS guideline, 2017).
- Every day: wash and dry your outer ear with a washcloth. That is all most ears need.
- Signs wax may be blocking your ear: muffled hearing, a full or plugged feeling, itching, ringing, or a hearing aid that whistles or sounds weak.
- Wax builds up more often in people who use cotton swabs, hearing aids or earbuds, in people with narrow ear canals, and in older adults, whose wax tends to be drier.
What do I need?
- Earwax softening drops. Any of these work: store-bought earwax drops (often carbamide peroxide, such as Debrox), mineral oil or baby oil, or plain saline. In studies, no type of drop worked better than another, and saline did about as well as store-bought drops (Aaron et al., 2018).
- A dropper, if your drops do not come with one.
- A towel or tissues for drips.
Skip Home Care and Call Us If
- You or your child have ear tubes: use only ear drops we prescribed, never over-the-counter drops
- You have a hole in your eardrum, or have had ear surgery
- Your ear hurts, or there is drainage or blood coming from it
- Your hearing dropped suddenly
How do I soften earwax?
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Warm the drops
Hold the bottle in your hand for a few minutes so the drops are close to body temperature. Cold or hot liquid in the ear can make you dizzy.
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Lie on your side
Lie down or tilt your head so the blocked ear faces up.
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Open up the ear canal
Gently pull the outer ear up and back. For a young child, pull the earlobe gently down and back.
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Put in the drops
Use the number of drops on the label. Do not put the tip of the dropper inside the ear canal. Peroxide drops may fizz or crackle, which is normal.
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Stay still for a few minutes
Keep your head tilted for as long as the label says, usually about 5 minutes, so the drops can soak into the wax.
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Let it drain
Sit up with a tissue against the outside of your ear to catch drips. Wipe the outer ear only.
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Repeat for a few days
Most labels say up to twice a day for up to 4 days. Softened wax usually works its way out on its own.
Your hearing may feel a little more muffled at first as the wax softens. If your ear still feels blocked after 4 or 5 days, stop and call us. Do not try to flush the wax out yourself with a syringe or water: if drops are not enough, we can remove it safely in the office.
Do and don’t
Cotton swabs push wax deeper toward the eardrum, where it cannot work its way out, and can scratch the canal or injure the eardrum. Ear candles do not remove wax and can burn the face and ear canal, block the canal with candle wax or damage the eardrum. Ear specialists recommend against them (AAO-HNS guideline, 2017).
Do
- Leave earwax alone if it is not bothering you
- Clean only the outer ear, with a washcloth
- Warm the drops in your hand first
- Give drops a few days to work
- Call us if your ear is still blocked after 4 or 5 days
Don’t
These push wax deeper or can injure the ear:
- Cotton swabs inside the ear canal
- Bobby pins, keys, fingernails or other objects
- Ear candles
- Flushing your ear with a syringe, water flosser or other water device
- Over-the-counter drops if you have ear tubes
What if I wear hearing aids or earbuds?
Hearing aids and earbuds can keep wax from moving out, so it builds up more often. If you wear hearing aids:
- Wipe them daily and change the wax filters or domes as your audiologist showed you.
- A hearing aid that whistles, sounds weak or keeps clogging may mean wax is in the way. Have your ears checked.
- If wax keeps coming back, ask us about regular cleanings in the office.
What about children?
Children’s ears clean themselves too, so wax at the opening of the ear usually needs nothing more than a washcloth. Do not put anything into a child’s ear canal. If your child has trouble hearing, pulls at their ear or says it feels blocked, we can check it. Children with ear tubes should use only ear drops we prescribed, and their ears should not be rinsed. See our ear tube recovery guide.
How do we remove earwax in the office?
When drops are not enough, or home care is not safe for you, our physicians and physician assistants remove wax while looking directly into the ear, using gentle suction or small instruments such as forceps and tiny loops. Because we can see the wax and the eardrum, we can clear it without pushing it deeper. Tell us if you take a blood thinner. Read more about ear care at Capital ENT and our article on ear wax buildup and when to see an ENT.
When should I call?
Call our office if
- Your ear still feels blocked after 4 or 5 days of drops
- Your ear hurts, or there is drainage or blood coming from it
- You have ringing or dizziness that does not go away
- Wax keeps building up, or your hearing aid keeps clogging
- You or your child have ear tubes and wax seems to be building up
- Your hearing dropped suddenly in one ear: this needs to be seen as soon as possible, and definitely within two weeks
Get care right away
Go to the ER or call 911 for constant, severe dizziness (vertigo), or dizziness with trouble speaking, weakness, numbness or a drooping face.
Austin 512-339-4040 · Lakeway 512-682-4798 · Marble Falls 830-992-2830
Questions patients ask
Usually not. Your ear canals clean themselves: wax slowly moves out on its own and falls away. Wash and dry your outer ear with a washcloth, and leave the canal alone unless wax is causing muffled hearing, fullness or other symptoms.
Only on the outer ear. Inside the canal, a cotton swab usually pushes wax deeper, which can pack it against the eardrum, and it can scratch the canal or injure the eardrum. The same goes for bobby pins, keys and other objects.
No type of drop has been shown to work better than another. Store-bought drops, mineral or baby oil, and plain saline all soften wax. Choose one that does not bother your ear, and follow the label.
Usually a few days. Most labels say to use them up to twice a day for up to 4 days. If your ear still feels blocked after that, stop and call us: the wax may need to be removed in the office.
No. Ear candles do not remove earwax, and they can burn your face or ear canal, drip candle wax into the ear or damage the eardrum. Ear specialists recommend against them.
No. If your child has ear tubes, use only ear drops we prescribed, never over-the-counter drops, and do not rinse the ears. Call us if wax seems to be building up.
This guide is for educational purposes only and does not replace an in-person evaluation. If your provider gave you different instructions, follow theirs.
Full guide and sources: capitalent.com/earwax.html
Sources
- Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical practice guideline (update): earwax (cerumen impaction). Otolaryngology–Head and Neck Surgery. 2017;156(1 Suppl):S1-S29. doi:10.1177/0194599816671491. PMID: 28045591
- Aaron K, Cooper TE, Warner L, Burton MJ. Ear drops for the removal of ear wax. Cochrane Database of Systematic Reviews. 2018;7:CD012171. doi:10.1002/14651858.CD012171.pub2. PMID: 30043448