Ear wax is meant to be there. It protects your ear canals and usually clears itself. Here is what is normal, how to tell when it has built up, what to try first and when to have it removed.
Most of the time ear wax needs nothing from you. It does a useful job, then leaves on its own. Trouble starts when it can't get out, and most of that trouble is easy to put right. Each section below gives you the essentials, with a link to a guide that goes into more detail.
In short
Ear wax (cerumen) is made in the outer part of your ear canals. It protects the skin and normally works its way out without help.
It only needs treating when it causes symptoms, such as muffled hearing, or stops a clinician seeing your eardrum.
The usual first step is olive or almond oil drops for 3 to 5 days. Cotton buds and ear candles make things worse, not better.
If drops don't work, microsuction or electronic irrigation by a trained clinician usually clears the wax in one visit.
Sudden hearing loss, severe pain, discharge or bleeding need your GP or NHS 111, not a wax removal appointment.
01The basics
What ear wax is and what it does
Ear wax, or cerumen, is a mix of secretions from two kinds of gland in the skin of your outer ear canal, combined with flakes of dead skin, a few fine hairs and whatever dust has found its way in. It is only made in the outer third of the canal, the part nearest the opening. The deeper part, next to the eardrum, has no wax glands at all.
It isn't a sign of dirty ears. A thin coating of wax:
keeps the skin of the canal moist, so it doesn't crack and itch
traps dust and grit before they get anywhere near the eardrum
repels water after a bath or a swim
is slightly acidic, which may help protect against infection
How your ears clean themselves
The skin lining the ear canal grows slowly outwards from the eardrum and carries old wax with it, rather like a conveyor belt. Talking and chewing help it along. By the time wax reaches the opening it has usually dried out, and it falls away or washes off in the shower without you noticing.
So for most people the only cleaning an ear needs is a wipe of the outer ear with a flannel. Our guide what is ear wax and why does it build up? goes into the detail, from the glands involved to what wax is made of.
Inside the ear canal
1The outer third. Skin with wax glands and fine hairs. This is the only place wax is made.
2Wax on the move. Skin growth and jaw movement carry old wax out towards the opening.
3The eardrum. There are no glands deep in the canal, so wax packed against the eardrum has usually been pushed there.
02Types of wax
Wet and dry ear wax
There are two normal types of ear wax, and which one you have is down to your genes. A single variation in a gene called ABCC11 decides it. Wet wax is the most common type in people of European and African descent. Dry wax is more common in people of East Asian descent.
Neither type is healthier, and both can build up. Wax also darkens the longer it stays in the ear, so dark brown or almost black wax is usually just old. Blood, a yellow or green discharge, or a bad smell is a different matter, because that points to a problem in the ear rather than wax.
Yellow, brown, grey or flaky: what each usually means and which changes are worth showing a clinician.
Wet and dry ear wax compared
Wet and dry ear wax compared
Wet ear wax
Dry ear wax
Texture
Soft and sticky
Dry and flaky
Colour
Honey-coloured to dark brown
Grey or pale beige
Most common in
People of European and African descent
People of East Asian descent
Can it build up?
Yes
Yes
03Causes
Why ear wax builds up
Your ears don't make wax to cause trouble. Blockages happen when wax can't find its way out, or gets pushed back in. These are the usual reasons, and many people have more than one.
Narrow or curved ear canals
Less room for the wax to move and more corners for it to collect in. Some people are simply born with small canals.
Hair in the ear canals
More common as you get older, particularly in men. The hairs hold wax back instead of letting it drift out.
Cotton buds and fingers
They lift a little wax from the entrance and pack the rest deeper, where it dries and hardens.
Wax problems are also more common in people with learning disabilities, who may find it hard to say that an ear feels blocked. If you care for someone, changes in hearing or behaviour can be the first clue.
04Symptoms
Signs of an ear wax build-up
Symptoms often come on suddenly, typically after a shower or a swim, when water makes the wax swell and closes the last gap that was letting sound through. It is usually one ear rather than both.
You might notice
Muffled or dull hearing
A blocked or full feeling
Earache or discomfort
Itching deep in the ear
Ringing or buzzing (tinnitus)
Feeling dizzy or off balance
Your own voice sounding boomy
A hearing aid that whistles
None of these proves it's wax. An ear infection, a cold or fluid behind the eardrum can feel much the same, which is why a clinician always looks in your ear before removing anything.
What a clinician sees when they look in your ear. Wax only needs removing when it blocks the canal like this and causes symptoms, or gets in the way of an examination or a hearing aid fitting.
05Self-care
What to try at home, and what to avoid
If your ear feels blocked and you're fairly sure it's wax, you can usually start at home. The NHS suggests softening the wax with oil drops before anything else.
Using olive or almond oil drops
1
Lie on your side
Blocked ear facing up. Warm the bottle in your hand first, as cold drops can make you feel dizzy.
2
Put in 2 or 3 drops
Use medical-grade olive or almond oil from a pharmacy. Skip almond oil if you are allergic to almonds.
3
Stay put for 5 to 10 minutes
This gives the oil time to reach the wax. Wipe away anything that runs out when you sit up.
4
Repeat for 3 to 5 days
Three or four times a day. Over about 2 weeks the softened wax should work its way out, often at night.
Do
ask a pharmacist about drops such as sodium bicarbonate or urea hydrogen peroxide if oil doesn't suit you
keep going for the full course, even if your hearing dips for a day or two as the wax softens
clean only the outer ear, with a damp flannel
Don't
put cotton buds, fingers, hairgrips or anything else inside your ear
use oil or drops if your eardrum is perforated, or might be
use ear candles or ear vacuums: the NHS says there is no evidence they work, and candles can burn
dig at the wax with scoops or camera picks bought online
Still blocked after 5 days of drops?
The NHS advises seeing a nurse at your GP surgery, or sooner if the ear is so blocked you can't hear anything. Many surgeries no longer remove wax, so you may be referred to a community service or pointed towards a private clinic.
When drops aren't enough, NICE recommends electronic irrigation, microsuction or manual removal by a trained clinician, and advises against the old hand-pumped syringe.
Most blocked ears are wax and can wait a few days. A few symptoms can't, because they point to an infection, a perforated eardrum or something a doctor should see the same day.
See a pharmacist or practice nurse if
your symptoms haven't cleared after 5 days of drops
your ear is so blocked you can't hear anything through it
you keep getting blocked ears and want to know why
you're not sure whether it is wax or something else
They can look in your ear, confirm what is going on and tell you whether removal would help. Our guide on telling ear wax from an infection explains the differences.
Contact NHS 111 or your GP urgently if
you suddenly lose hearing in one or both ears
you have severe ear pain, or ear pain with a high temperature
blood, pus or fluid is coming out of your ear
your ear or the skin around it is red, swollen or hot
something is stuck in your ear
you feel very dizzy, or the room spins and won't stop
Call 999 if one side of your face droops or feels weak, or you suddenly have trouble speaking or moving an arm. Don't wait to see if sudden hearing loss clears by itself.
08Who it affects
Who is more prone to ear wax problems
Anyone can get a blocked ear, but some people have to deal with wax far more often than others. These three groups come up most.
Hearing aid users
A hearing aid sits in the ear canal for most of the day, so wax can't fall out and gets pushed back in. It can clog the receiver or set off whistling. Ask your audiologist how often to have your ears looked at.
Wax gets drier with age and canals often grow more hair. A build-up can slowly dull hearing and be mistaken for age-related hearing loss. If getting to a clinic is hard, some clinicians visit people at home.
Children make wax too, and it rarely needs removing. Don't put anything in a child's ear to clean it. Earache with a high temperature is more likely to be an infection, so speak to a pharmacist or GP.
Not from inside the ear canal. Your ears clean themselves, and cotton buds or fingers push wax further in. Wipe the outer ear with a damp flannel and leave the rest alone. If wax is causing symptoms, soften it with drops or have it removed by a trained clinician.
How do I know if my ear is blocked with wax?
Muffled hearing and a full feeling in one ear, often after a shower or swim, are the classic signs. Other things can feel the same, including an infection or fluid behind the eardrum, so the only way to be sure is for someone to look in your ear. A pharmacist, practice nurse or ear care clinician can do that in a minute or two.
How long does olive oil take to clear ear wax?
The NHS suggests using drops 3 or 4 times a day for 3 to 5 days. Softened wax usually works its way out over about 2 weeks. If your ear is still blocked after 5 days of drops, get it looked at. Our guide to olive oil for ear wax covers what it can and can't do.
Can ear wax cause dizziness or ringing in the ears?
Yes. A blockage can bring on tinnitus and, less often, dizziness, and both often settle once the wax is out. They have plenty of other causes too, so see a GP if they carry on after the wax has been removed, or if the dizziness is severe.
Can I get ear wax removed on the NHS?
Sometimes. NICE recommends that ear wax removal is offered in primary care or community services, but many GP surgeries no longer do it, and what is available depends on where you live. Ask your practice first. Our guide to ear wax removal on the NHS explains your options if they can't help.
How much does private ear wax removal cost?
Prices vary between clinics and parts of the country. As a rough guide, many clinics charge somewhere between £45 and £100 to treat both ears, and home visits usually cost more. Check what is included, such as a follow-up if wax remains, before you book. See how much ear wax removal costs.
