Signs of ear wax build-up to look out for

The most common signs of ear wax build-up are muffled hearing and a blocked or full feeling, usually in one ear. Some people also get earache, itching, ringing or buzzing, or feel slightly dizzy. These symptoms often appear quite suddenly, after a shower or a swim, even though the wax has been collecting quietly for weeks or months.

The most common signs of ear wax build-up

Wax builds up in the ear canal without causing any trouble for a long time. Symptoms start when it fills enough of the canal to block sound, or presses on the skin or eardrum. The NHS lists hearing loss, earache or a blocked feeling, tinnitus and dizziness as the main ones.

Most people have two or three of these rather than the full set. The combination that most often turns out to be wax is muffled hearing plus a blocked feeling in one ear, in someone who otherwise feels well.

What each symptom feels like

Symptoms vary from person to person, and they can change from one day to the next as the wax moves about. Here is what each one tends to be like when wax is the cause.

Muffled hearing

Sounds seem dull and far away, as if you are wearing an earplug. You may turn the television up, move the phone to your other ear or struggle to follow conversation in a busy room. The muffling can come and go as the wax shifts when you chew or yawn. Our guide to ear wax and hearing loss explains why wax has this effect and why hearing usually comes straight back once it is cleared.

A blocked or full feeling

This is the pressure you get after a flight, except it doesn't pop when you swallow. Many people notice their own voice sounds louder or boomy on the blocked side, and chewing sounds louder too. Both happen because sound from inside your head can't escape through the canal.

Earache or discomfort

Wax tends to cause a dull ache or a feeling of tightness rather than sharp pain. A hard plug pressing on the canal wall can feel sore. Pain that throbs, keeps you awake or comes with a high temperature is more typical of an infection.

Itching

Dry, flaky wax and irritated skin both itch. The temptation is to scratch with a finger or cotton bud, which usually pushes the wax deeper and can break the skin. Itching with flaking or discharge may be eczema or an outer ear infection instead.

Ringing, buzzing or crackling

A blocked ear can bring on tinnitus, heard as ringing, humming, buzzing or a rushing sound. Loose wax can also crackle or rustle when you move your jaw. See our guide to ear wax and tinnitus for more on the link.

Feeling dizzy

Some people with a wax blockage feel slightly unsteady or light-headed. A true spinning sensation (vertigo) with sickness is more likely to come from the inner ear. Our guide on whether ear wax can make you dizzy covers the difference.

Hearing aid problems

If you wear a hearing aid, wax often shows up as whistling, known as feedback, because sound bounces back off the wax. The aid may also sound weaker, or its wax guard may clog more often. Our guide to ear wax and hearing aids has cleaning tips.

Why symptoms often start suddenly

People often say their ear blocked overnight, but the wax has usually been there a while. A small gap lets sound through until something closes it. Common triggers include:

• Water. A shower, a bath or a swim can make old wax swell and seal the last gap. Read more about swimming, showering and ear wax.
• Flying. Pressure changes can make a partly blocked ear feel much worse, and it may stay blocked after you land. See blocked ears after flying.
• A cotton bud. One push can pack loose wax into a solid plug.
• Something new in your ears, such as new earbuds, earplugs for sleeping or a first hearing aid.

A cold can also make an ear feel blocked, because the tube linking the middle ear to the back of the nose gets congested. That kind of fullness usually comes with a stuffy nose and clears as the cold does.

Signs in children and people who can't easily tell you

Young children rarely say "my ear feels blocked". Instead, they may tug or rub at an ear, not respond when called, ask for the television to be turned up or seem irritable. In children these signs are more often caused by glue ear or an infection than by wax, so a GP is the right first stop. Our guide to ear wax in children explains when wax is the likely cause.

Older adults, particularly people living with dementia, may not mention their ears at all. Watch for someone withdrawing from conversation, seeming more confused than usual, or a hearing aid that whistles or seems to stop working. NICE guidance suggests that people with dementia are referred for a hearing assessment, because hearing loss may be present alongside it. Our guide to ear wax in older adults has advice for carers.

Symptoms that suggest it isn't wax

Wax and ear infections share several symptoms, so it helps to look at the whole picture. This isn't a diagnosis, but it shows which way the signs usually point.

If your symptoms look more like the second list, see a pharmacist or GP before you think about wax removal. Our guide to telling a wax blockage from an ear infection goes into more detail.

What to do if you think it's wax

Start by softening the wax. The NHS suggests 2 to 3 drops of medical grade olive or almond oil, 3 to 4 times a day for 3 to 5 days, lying with the affected ear facing up. A pharmacist can recommend other drops if you prefer. Our guide on how to use ear drops shows the technique. Don't use drops if your eardrum may be perforated, and keep cotton buds out of your ear however tempting it gets.

If the ear is still blocked after 5 days, have it looked at. Some GP surgeries still remove wax, while others will point you to a community service or a private clinic. Our guide to ear wax removal on the NHS explains the options. A clinician will look in your ear first to confirm it is wax, then clear it, usually with microsuction or ear irrigation.