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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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In this Article

• What is ear wax?
• What does ear wax look like?
• When should ear wax be removed?
• Is it OK to use Q-tips?
• Find a local Ear, Nose, & Throat Doctor in your town
• Ear Wax Index

Cerumen varies in form and appearance from person to person. It may be almost liquid, firm and solid, or dry and flaky. The color of ear wax varies depending upon its composition. Glandular secretions, sloughed skin cells, normal bacteria present on the surface of the canal, and water may are present in ear wax.

Most of the time the ear canals are self-cleaning; that is, there is a slow and orderly migration of the skin lining the ear canal from the eardrum to the outer opening of the ear. Old earwax is constantly being transported from the deeper areas of the ear canal out to the opening where it usually dries, flakes, and falls out.

Under ideal circumstances, a person should never have to clean their ear canals. However, we all know that this isn't always the case and sometimes removal of ear wax is necessary. Excessive ear wax may build up in the ear canal for many of reasons including:

• narrowing of the ear canal resulting from infections or diseases of the skin, bones, or connective tissue;
• production of a less fluid form of cerumen (more common in older persons due to aging of the glands that produce ear wax); or
• overproduction of cerumen in response to trauma or blockage within the ear canal.

When wax has accumulated so much that it blocks the ear canal (and interferes with hearing), a physician may have to wash it out (known as lavage), vacuum it, or remove it with special instruments. Alternatively, a physician may prescribe ear drops that are designed to soften the wax [such as trolamine polypeptide oleate-ear drops (Cerumenex)].

The patient may first try an over-the-counter product (OTC) if they need to remove ear wax, such as Debrox or Murine Ear Drops. If the ear still feels blocked after using these drops, a physician should be consulted. If the person does try OTC ear wax softeners, it is imperative to know that he or she does not have a perforated (punctured) eardrum prior to using the product. Putting ear wax softeners in the ear in the presence of a perforated eardrum may cause an infection in the middle ear. Similarly, simply washing one's ear in the presence of a perforation may start an infection. If a person is uncertain whether or not he or she has a perforation (hole) in the eardrum, consult a physician. Some individuals may also be hypersensitive to products designed to soften ear wax. Therefore, if pain, tenderness or a local skin rash develops, the use of these drops should be discontinued.