Earwax, also known as cerumen, is a physiological substance that cleans, protects and lubricates the ear canal.

This substance is a natural secretion from the sebaceous and apocrine glands to capture dust and dirt, as well as repelling water from the tympanic membrane.
Put simply, the functions of earwax are to clean and lubricate the ear canal and protect it from bacteria, fungus, and insects.

The high concentration of lipids in the sebum produced by the sebaceous glands lubricates the ear and acts as a water repellent and a natural soothing agent.

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The external ear canal is self-cleaning, thanks to the movement of the jaw (while you chew, talk, and even yawn) that causes the earwax to move towards the outside.

Despite this self-cleaning mechanism, a lot of people tend to suffer from earwax accumulation and impaction because of excessive production or reduced elimination efficacy.

Impaction does not necessarily mean that the ear canal is completely obstructed.

How frequent is earwax impaction?

Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical Practice Guideline (Update): Earwax (Cerumen Impaction). Otolaryngology – Head and Neck Surgery 2017; 156 :(1S)S1-S29.


Cerumen impaction is present in:

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Approximately 10 % of children

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5 % of healthy adults

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Estimates suggest that between 19 % and 65 % of patients over 65 years old have cerumen impaction and that elderly patients in nursing homes are likely at the upper end of this spectrum.

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Some reports suggest in the developmentally delayed adult population, 28 % to 36 % have excessive or impacted cerumen. The reasons for this increased prevalence are not clear, however, anatomical differences in the structure of the canal (associated with Down syndrome, for example), poor hygiene or excessive cerumen production may be contributing factors.

  1. Schwartz et al. Otolaryngology–Head and Neck Surgery 2017,vol 156 (1S) S1-S29

Causes of excessive production:

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  • Irritation due to foreign objects (hearing aids and earplugs).
  • Over-cleaning of the ear.
  • Chemical irritation: hairspray, gel, shampoo, constant moisture due to lack of drying, etc.

Causes of reduced elimination efficacy:

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  • Anatomical deformity of the ear canal.
  • Increased number of hairs in the ear canal.
  • Physical barriers to natural ear wax elimination (e.g. cotton buds, hearing aids, earplugs, etc.).

While often harmless, blockage of the ear canal by earwax can lead to a host of symptoms.


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Hearing loss
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(ringing sound in the ears)
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Sensation of fullness
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In addition, earwax impaction can make diagnostic assessment more difficult, as it prevents your healthcare professional from seeing the external ear canal and/or tympanic membrane correctly.