Ear Wax Removal: What You Need To Know (2024)

Recorded earwax removals fall into the category of oddly satisfying content. If you do a quick YouTube search on the procedure, you’ll see scores of removal videos populate in the search results. The most legitimate ones show a medical specialist performing the procedure. Some viewers have admitted to being fascinated by the process in video comments, and seeing it professionally done on camera may also show them how to safely clean their ears.

User-generated TikTok tutorials are a different ballgame. The social media platform often showcases non-medical professionals giving medical advice, but with little scientific backing. As a rule of thumb, it’s always best to take medical advice from a licensed practitioner over any influencer—someone with valid credentials, such as a degree or practitioner’s license.

Studies have already debunked the myth that it’s good to stuff Q-tips down your ear canal to eliminate excess wax (which we’ll explain later). Now, experts have their hands full yet again with the trending removal videos circulating the web. The aforementioned TikTok trend involves tilting your head to the side over a towel, filling your ear canal to the brim with hydrogen peroxide and letting the peroxide fizzle before repeating the process with your other ear.

The wax supposedly drains with the peroxide when you tip the liquid-filled canal toward the ground, TikTokkers claim. But what does pediatric otolaryngologist Nicole Aaronson, M.D., have to say about this method of removal?

“Hydrogen peroxide is perfectly safe, as long as there is no hole in the eardrum,” she says. “For patients with tympanic membrane perforation or a patent ear (PE) tube, use of peroxide will be quite painful.” While the removal method isn’t too far-fetched compared to other techniques (e.g., ear candling), it’s not a one-size-fits-all solution that’s safe for everyone.

Audiologist and Forbes Health Advisory Board member Amy Sarow, Au.D., suggests that “for the average person, the ear is shaped so that gravity helps any dead skin, cerumen [earwax] or other debris to naturally migrate out of the ear without additional assistance.” When natural earwax regulation isn’t enough, the excess buildup requires external removal methods.

“There are many different ways to remove earwax, including irrigation and suction. These are typically done during an office visit [with a health care provider],” according to Dr. Aaronson.

Irrigation is a cleansing method that involves inserting warm water into your ear canal to clear excess wax away, and removing loosened wax particles with a forceps delivery or other medical instrument. Suctioning requires the use of a microsuction tool to vacuum the buildup. While these clinically-proven removal methods have scientific backing, both have risks, and the aforementioned medical tools should be used under a medical professional’s (such as a licensed audiologist or an ear, nose or throat physician) supervision.

The British Medical Association indicates that one out of every 1,000 irrigation procedures end in complications that range from wax removal failure (37%) to external auditory canal damage (15%)^[1]Sharp JF, Wilson JA, Ross L, Barr-Hamilton RM. Ear wax removal: a survey of current practice. British Medical Journal. 1990;301(6763):1251-3. . Another common issue associated with irrigation, experts say, are perforated tympanic membranes (or ruptured eardrums).

In another study on the effects of microsuctioning, 55% of the 164 participants reported having adverse effects from the procedure, including noise discomfort, dizziness and reduced hearing—although the study notes these effects were minor and short-lived “in most cases”^[2]Radford J. Treatment of impacted ear wax: a case for increased community-based microsuction. British Journal of General Practice. 2020;4(2):bjgpopen20X101064. .

Other earwax removal trends to steer clear of include ear candling and the use of objects like cotton swabs. With ear candling, you’re tasked with holding a lit candle in your external ear canal, allowing it to burn for 15 minutes. This is meant to uproot a brown, sticky mixture of excess wax, bacteria and debris.

Why is ear candling another no-no? According to Dr. Sarow, “methods such as ear candling are quite dangerous and could cause third-degree burns in the ear from hot wax.”

Contrary to popular belief, Q-tips aren’t at all effective for removing wax, either. Cotton swabs can actually push earwax deeper into the canal and rupture your eardrum. You can also scratch the canal with frequent use, which puts you at risk of infection due to the swab’s accumulated bacteria.

Earwax serves an important purpose, in that the lubricant can protect your ear canal and eardrums from infection. “Some earwax is actually normal and healthy to protect from germs and bacteria, in addition to keeping the ear canal moisturized and preventing dry skin,” according to Dr. Sarow. Too much wax may cause a sticky situation with your hearing abilities, however.

Earwax buildup clogs your ears over time, which can reduce your hearing—a sign that removal is necessary. Circ*mstances that may cause you to have more buildup than usual include frequent use of earplugs or hearing aids. Buildup can further lead to infection.

At-home care is typically an appropriate way to handle normal buildup. “For those who produce more earwax than average, a few drops of mineral oil in the ear can help to soften the wax and help it to come out naturally with warm water in the shower,” explains Dr. Sarow. Mineral oil is a natural and acceptable relief agent backed by scientific research, along with hydrogen peroxide (however, it’s recommended to get checked by your doctor that your eardrum is intact before trying). If this removal method is ineffective, it may be time for a professional’s help.

Professional Earwax Removal

At-home earwax removal remedies might not be effective for excessive earwax buildup, or if you have hard wax plugs blocking your ear canals (known as impacted cerumen). “Earwax changes in consistency with age, and dryness can make one more susceptible to cerumen impaction,” says Dr. Sarow. In these cases, your safest bet is to have a professional step in and handle your earwax removal needs for you.

“Signs that it’s time to see a professional include muffled hearing, itchiness in the ear and pain or fullness in the ear,” says Dr. Sarow. “Individuals with ear canals that are very narrow, tortuous and surgically altered ears are more likely to need regular ear cleaning from a professional.”

A type of otolaryngologic procedure, audiologists or ear, nose and throat specialists commonly offer clinical earwax removal treatments. These professionals use an operating microscope to take a closer look into your ear canal. From there, they typically use irrigation or microsuction as a way to eliminate the excess wax. “[Practitioners] can vary the instruments used based upon the type of wax, and what will remove it most effectively,” says Dr. Aaronson.

As for the cons of professional treatment, Dr. Aaronson states that the downsides of going into the office are having to take time off from work and potentially paying a copay. The typical copay costs for removals, according to CostHelper, range from $5 and $75^[3]Ear Wax Removal Cost. CostHelper. Accessed 11/17/2022. .

Earwax Removal Kit

A store-bought earwax removal kit can safely relieve you of minor buildup. Many kits contain wax-softening drops and safe removal tools, such as a bulb syringe. Relatively safe cleaners include mineral oil and cleaning drops containing peroxide.

“If you must clean your ears yourself, the least dangerous method will be with a bulb syringe and water,” says Dr. Sarow. Filling the syringe with water and squeezing it near your ear opening releases the water to flush out the wax. Thereafter, tilting your head towards the floor releases the wax.

“Be careful to use water that is approximately body temperature, as much colder or warmer than body temperature can cause temporary dizziness. Additionally, this method should be avoided for those with a ruptured eardrum or PE tubes,” she adds. Also, be sure not to forcefully spray the water, as it can cause a perforation.

“These [kits] are considered safe, although they can potentially cause temporary dizziness, pain or damage to the eardrum,” according to Dr. Aaronson. The cost for these kits ranges anywhere from $3 and $400^[4]Rogers N, Stevermer J. Ear wax removal: Help patients help themselves. The Journal of Family Practice. 2011;60(11):671-3. .

Your ideal method for earwax removal ultimately boils down to the amount of earwax you’re trying to get rid of. The more wax you need to remove, the more likely you’re going to need a professional’s help. Some at-home solutions can safely remedy minor wax buildups.

“If your ear canal geometry is not conducive to the ear’s self-cleaning mechanism, professional advice on your specific situation is best,” says Dr. Sarow. ”Your doctor may recommend periodic professional ear cleaning appointments every three to six months, or as needed.”