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Cerumen Impaction

(Earwax; Ear Impaction; Ear Blockage)


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.


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 or ear plug use
  • Skin conditions such as eczema or seborra
  • Intellectual disability


Symptoms may include:
  • Itchy ear
  • Pain in the ear
  • Ringing in the ear—tinnitus
  • Hearing loss
  • Hearing aid feedback or malfunction


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 involves removal of the earwax from the ear canal. 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


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


Armstrong C. Diagnosis and Management of Cerumen Impaction. Am Fam Physician. 2009 Nov 1;80(9):1011-1013. Available at: http://www.aafp.org/afp/2009/1101/p1011.html.
Cerumen impaction. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/cerumen-impaction-earwax-buildup-and-blockage. Updated December 20, 2013. Accessed August 22, 2017.
Cerumen impaction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T230359/Cerumen-impaction. Updated May 18, 2017. Accessed August 22, 2017.
2/26/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T230359/Cerumen-impaction: Ear candles: risk of serious injuries. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201108.htm. Updated September 5, 2013. Accessed September 11, 2014.

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