Springdale Mason Pediatrics

Earwax Buildup


  • Concerns about earwax (cerumen) buildup or blockage
  • Questions about earwax removal

Call or Return If

  • Flushing out the ear canal doesn't return the hearing to normal
  • Earache occurs
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Too much earwax can cause rubbing of the ear or poking in the canal.
  • A piece of ear wax can become dry and hard in the ear canal. This creates a feeling that an object is in the ear.
  • Complete blockage (plugging) of the ear canal by wax causes more symptoms. These include decreased or muffled hearing.
  • A large piece of earwax may be seen inside the ear canal.


  • Usually from using cotton swabs. They push the wax back in and pack it down.
  • A few children (perhaps 5%) normally produce more wax than others. It usually will come out if it's not pushed back by fingers.
  • Wearing ear plugs of any type can also push wax back.

Earwax is Normal

  • Everyone has earwax. Earwax is normal and healthy. Earwax is not dirty or a sign of poor hygiene.
  • Earwax is also called cerumen.
  • Earwax is made by special glands in the outer third of the ear canal.
  • Earwax protects the skin lining the ear canal. It is a natural water-proofing agent.
  • Earwax also has germ-killing properties.
  • New earwax is soft and a golden-yellow color.
  • Older earwax becomes dryer and turns to a brown or black color.

Ear Canals are Self-Cleaning

  • Ear canals are designed to clean themselves.
  • The ear canal skin slowly moves out of the ear canal. It carries the earwax along with it. The wax dries up and becomes flaky. It falls out of the ear on its own.
  • There are some people who produce much more earwax than others. For such people periodic ear cleaning may be needed.
  • Earwax only needs to be removed from inside the ear if it causes symptoms. Examples of symptoms are decreased hearing, discomfort, fullness or blockage.

Problems From Using Cotton-Tipped Swabs

  • The cotton-tipped swab pushes the wax back in. The earwax builds up and causes symptoms.
  • Decreased or muffled hearing.
  • Blocked or full ear canal sensation.
  • Trapped water behind the wax (can lead to Swimmer's Ear).
  • Itchy or painful canals, especially in teens who frequently use Q-tips. A dry ear canal is always itchy.
  • Cotton swabs cause over 10,000 ear injuries each year in the US. Over 2,000 are punctured eardrums. Many occur in young children who are allowed to play with cotton swabs.

Prevention of Blocked Ear Canals:

  • Never put cotton-tipped swabs (cotton buds or Q-tips) into the ear canal.
  • Cotton swabs just push the earwax deeper into the ear canal. (Reason: Q-tips are usually wider than a child's ear canal).
  • Earwax doesn't need any help getting out. You can't hurry the process.
  • Never try to dig out pieces of earwax with toothpicks, match sticks or other devices. Usually, doing this just pushes the wax back in.
  • These objects can also scratch the ear canal and cause an infection.
  • If all of the ear wax is removed (as with Q-tips), the ear canals become itchy and prone to swimmer's ear. This can occur in teens when cotton swabs are smaller than the ear canal.
  • Limit the use of ear plugs.

After Care Advice

  • In general, leave earwax alone.
  • It will come out and fall away on its own
  • If you see some wax right at the opening, you can flick it away. Better yet, have someone else do it. Use something that won't push it back in, such as a paper clip.
Reasons to Flush out the Ear Canal:
  • Earwax is completely blocking an ear canal and can't hear on that side.
  • If the hearing seems normal on that side, the blockage is only partial. You can leave it alone.
Ear Canal Flushing with Water:
  • Age Limit: 6 years and older. Under age 6, use only if advised by your child's doctor.
  • Buy a soft rubber ear syringe or bulb from the pharmacy. No prescription is needed.
  • Have your child lean over the sink (Reason: To catch the water)
  • Use lukewarm water (body temperature). (Reason: To prevent dizziness)
  • GENTLY squirt the water into the ear canal. Then tilt your child's head and let the water run out. You may need to do this several (3-4) times.
  • If the earwax does not seem to be coming out, tilt the head. Then, flush with the blocked ear facing downward. Gravity will help the water wash it out (the waterfall effect).
  • Endpoint: Flush until the water that comes out is clear of earwax. Also, the ear canal should be open when you look in with a light.
  • Afterwards dry the ear thoroughly. You can do this by putting a drop of rubbing alcohol in the ear canal. Or you can set a hair dryer on low. Hold it a foot away from the ear for 10 seconds.
CAUTION - Ear Canal Flushing:
  • Do NOT perform flushing if your child has a hole in the eardrum or ear tubes.
  • STOP flushing if it causes pain or dizziness
  • Do NOT use a water jet tooth cleaner (such as a WaterPik) for ear flushing. Reason: The force of the jet can cause pain.
Ear Drops - Use for 4 Days to Soften the Earwax:
  • If the earwax is hard, soften it before flushing the ear canal. Use ear drops to break up the earwax.
  • Homemade ear drops: hydrogen peroxide and water mix. Use equal parts of each.
  • Other option: mild baking soda solution. Make it by adding ΒΌ teaspoon (1.25 mL) of baking soda to 2 teaspoons (10 mL) of water.
  • Drug store option: Debrox or Murine earwax removal drops. No prescription is needed.
  • Use 5 drops in affected ear, 2 times daily, for 4 days.
How to Use Ear Drops:
  • Lie on the side with blocked ear upward.
  • Place 5 drops into ear canal.
  • Keep drops in ear for 10 minutes.
  • Then lie with the blocked side down and let the ear drops run out on some tissue.
  • Use twice daily for up to four days.
  • Then flushing should be able to get everything out.
CAUTION - Ear Drops:
  • Do NOT use ear drops if your child has a hole in the eardrum. Also do not use them for children with ear tubes.
  • STOP using ear drops if pain occurs.
Earwax Removal Before 6 Years Old:
  • Earwax removal in this age group can be hard.
  • Removal may not be needed. The ear wax should come out on its own. Don't use cotton swabs.
  • Do not use eardrops or ear flushes unless it is advised by your child's doctor. This also can be done in your doctor's office.
What to Expect:
  • Once the wax is removed, the hearing should return to normal.
  • After 24 hours, the ear canal should feel normal.
  • If you stop using cotton swabs, ear wax should come out on its own. There are a few families where clogged earwax is a recurrent problem.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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