Earwax build-up

What is earwax build-up?

Earwax (cerumen) can build up until the ear is almost or completely blocked. Earwax is a normal product of secretion in the external ear canal. It serves to clean the ear canal, for example by clearing up dead skin cells.
In addition, earwax repels water and keeps the ear canal lubricated and smooth. It is thought to provide protection from infections. ²⁰⁶

What are the complaints associated with earwax build-up?

Excessive earwax can result in a number of complaints such as itching, pain, tinnitus (ringing in the ears), dizziness and a full sensation in the ear.

Too much earwax makes bacterial infections more likely. In addition, excessive earwax impairs hearing and, due to longer-term hearing loss, a withdrawal from social intercourse (see also 'What are the complaints associated with impaired hearing and deafness?').

People with intellectual disabilities sometimes find it impossible to communicate these symptoms. The people around them may then notice only a change in behaviour.

How common is earwax build-up in the general population?

Earwax build-up is seen in approximately 2 to 4% of the general population. ^{207 208 209}

How common is earwax build-up in people with intellectual disabilities?

A larger study of 378 adults living in four care institutions in the Netherlands found that 43.1% had excessive earwax build-up in one or both ears. ²¹⁰  The risk increased with age (49% in people aged over 60), with an increase in intellectual disability (50% in people with severe intellectual disabilities) and in people with Down syndrome (67%).

A study of 344 people with visual impairment and intellectual disabilities found earwax build-up in 43%. ²¹¹  People with Down syndrome have narrow ear canals, as a result of which earwax accumulates in the ear canal. In addition, this group frequently has eczema in the ear canal, resulting in the accumulation of large numbers of dead skin cells and the impairment of the self-cleaning mechanism of the ear canal.

A hearing aid with an earpiece in the ear canal makes earwax build-up more likely because it interferes with the natural movement of the earwax to the outside. An earpiece also stimulates the production of earwax and the sebaceous glands. ²¹²

2% to 4% General population 43% People with intellectual disabilities 67% People with Down syndrome