Specialized glands in the skin of the outer half of the ear canal secrete wax into the ear canal. The wax serves several functions. Among these is the lubrication of the skin of the canal, assisting in cleaning foreign debris from the ear canal, and protection against invasion of the skin by bacteria and fungi. The ear canal skin migrates slowly outward, dragging wax and any adherent particles toward the ear opening. When this mechanism is functioning as intended, the ear canal should be “self-cleaning.”

Wax becomes impacted in the ear for a variety of reasons. Probably the most common cause is the habit of using Q-tips to try to clean the ears. This is an extremely common routine for many people but tends to create the opposite and unintended effect of actually pushing earwax deeper into the ear canal, which builds up and becomes impacted. Wax buildup also occurs more commonly when hearing aids or earplugs are used since these also may interfere with wax migrating out of the ear canal. Sometimes, the consistency of a particular individual’s wax or the condition of the ear canal skin may promote wax buildup.

Most individuals are best off leaving the ears alone rather than taking routine steps to “clean” the ears. Since the ears are designed to be “self-cleaning,” avoiding Q-tips and other similar objects goes a long way toward avoiding the tendency of these objects to tamp down the wax against the eardrum. If you feel you must do something to remove wax from the ears, the over-the-counter kits designed to soften the wax so that it can later be rinsed from the ear canal are occasionally effective. Alternatively, you can dribble hydrogen peroxide into the ear canal to try to achieve the same effect. The most expeditious way to deal with excessive or impacted earwax is to see your ear, nose, and throat doctor to have it removed under direct vision using the ear microscope.