Ear Wax Build-Up: Causes, Symptoms, and When to Seek Help

Ear wax, known clinically as cerumen, is a naturally occurring substance produced by glands in the outer third of your ear canal. It's not a sign of poor hygiene; rather, it's a crucial element of your ear's self-cleaning mechanism. Its primary role is protective: it lubricates the ear canal, preventing dryness and itching, and it traps dust, debris, and microorganisms, safeguarding the delicate structures of your middle and inner ear. Typically, the wax migrates out of the ear naturally, carrying impurities with it, aided by jaw movements like chewing and talking.

However, for a significant number of people, this natural process can be disrupted, leading to an excessive accumulation or impaction of wax. When this occurs, the wax can form a blockage, interfering with hearing and potentially causing a range of uncomfortable symptoms. At our private audiology clinic in High Wycombe, we frequently see clients who have mistakenly tried to resolve this issue themselves, often exacerbating the problem. Understanding the difference between normal, healthy ear wax and a problematic blockage is the first step toward effective management.

Several factors can disrupt the ear's natural wax-expulsion process, leading to impaction. These can be broadly categorised into individual predispositions and external influences.

Individual and Anatomical Factors

• Overproduction: Some individuals simply produce more ear wax than is necessary.
• Anatomy of the Ear Canal: Narrow, sharply bending, or hairy ear canals can physically impede the natural outward migration of wax.
• Ageing: As we age, the consistency of cerumen changes. It becomes drier and harder, making it less mobile and more prone to creating a hard, impacted plug.
• Skin Conditions: Certain dermatological conditions like eczema can affect the skin in the ear canal, contributing to build-up.

External and Lifestyle Factors

This is where we see the most preventable causes of ear wax impaction. The adage 'nothing smaller than your elbow in your ear' holds significant clinical weight.

• Improper Cleaning: Using cotton buds, hairpins, or other objects is a primary culprit. These tools push wax deeper into the bony, narrower part of the canal, compacting it against the eardrum where it cannot escape.
• Ear-worn Devices: Regular use of hearing aids, earplugs, or in-ear headphones can block the canal and prevent wax from migrating out naturally.

As audiologists serving the Loudwater and High Wycombe communities, we cannot overstate the risks associated with attempting to remove ear wax at home. Pushing wax deeper can not only cause a more severe blockage but also risks perforating the eardrum or damaging the delicate skin of the ear canal.

The symptoms of impacted cerumen can range from mildly annoying to severely debilitating. They often develop gradually, but can also appear suddenly, particularly after activities like swimming or showering, which can cause the wax plug to swell.

While it may be tempting to try over-the-counter drops or other home remedies, self-treatment is not always effective and carries risks. It is essential to seek a professional diagnosis and treatment from a qualified audiologist, especially if you experience 'red flag' symptoms.

Red Flag Symptoms Requiring Urgent Attention

• Severe or sharp pain in the ear.
• Sudden or rapid loss of hearing.
• Discharge or fluid leaking from the ear canal.
• A history of eardrum perforation or previous ear surgery.

At our audiology clinic near Loudwater, your consultation begins with a thorough examination using a clinical otoscope or video otoscopy. This allows us to visualise the ear canal and eardrum, confirm the presence and extent of the wax blockage, and rule out other potential causes for your symptoms, such as infection or middle ear issues. This diagnostic step is critical for ensuring the correct treatment is provided.

Once a diagnosis of impacted cerumen is confirmed, we can proceed with removal. While older methods like irrigation (syringing) are still used in some settings, the safest and most effective technique, and the one we specialise in at our High Wycombe clinic, is microsuction.

Microsuction: Precision and Safety

Microsuction is considered the gold standard for ear wax removal by audiology professionals. The procedure involves using a high-magnification microscope and a fine, sterile suction device to gently and precisely remove the wax from the ear canal. Unlike irrigation, it is a completely dry procedure, which significantly reduces the risk of infection. It is safe for individuals with eardrum perforations or a history of ear surgery and provides immediate relief from symptoms.

For more information on how we can help, see our core service page onEar Wax Removal. We also recommend afull hearing assessment if hearing loss persists after wax removal.