Ear wax impaction is when ear wax builds up enough to cause symptoms. Normally, ear wax helps to protect the insides of the ears and prevents injury or infection, but having too much earwax can cause symptoms such as pain and trouble hearing.

Young children and older adults are more likely than others to have ear wax impaction.

Several different things can cause ear wax impaction. Some health problems can affect the shape of the inside of the ear and make it hard for wax to move out. For example, skin problems that cause skin cells to shed a lot can lead to wax build-up in the ears. In some people, the ear canals are narrower than in others, and these people might be more likely to have ear wax impaction. A person’s ear canal can become narrower after an ear injury or after severe or multiple ear infections.

As people get older, their ear wax gets harder and thicker. This makes it difficult for the wax to move out of the ear as it should. Some people try to clean their ears using cotton swabs or other tools. This can actually push the wax deeper into the ear instead of getting it out. Over time, this can cause ear wax impaction. Some people make more ear wax than others. This can happen when water gets trapped in the ear, or when the ear is injured. But some people have a lot of ear wax for no obvious reason.

Symptoms of ear wax impaction can include; trouble hearing, pain in the ear, hearing a ringing noise in the ear, feeling like the ear is blocked or plugged, and these symptoms can happen in one or both ears.

If you or your child has any of these symptoms, see a doctor or nurse. He or she can check the insides of the ears to figure out if the symptoms are caused by ear wax impaction or another problem, such as an ear infection.

The insides of the ears do not usually need to be cleaned. Sticking things into the ears can push the wax in deeper and cause impaction, or cause injury to ones ear.

There are several treatments to remove impacted ear wax. Doctors and nurses normally offer these treatments only to people who have bothersome symptoms and may not recommend treatments for removing ear wax in people who have no symptoms, even if their ears are impacted, although in some cases, doctors or trained nurses will remove ear wax in people whose ears are impacted and who can’t clearly explain their symptoms. These include the young children, elderly, and people who have trouble thinking clearly.

Special ear drops can soften ear wax and help it to drain out, although ear drops are not usually safe for people with an ear infection or damage to the eardrum. In some cases, a doctor or nurse can remove impacted ear wax by squirting water (or a special liquid) into the ear to rinse it out. A doctor or nurse might use a special tool to remove ear wax. There are different types of tools that can do this safely. There are also tools that use suction to pull the wax out.

Dr. Ian Shyaka is a General Practitioner at Rwanda Military Hospital