From the Guidelines
To prevent cerumen impaction, use over-the-counter ear drops containing carbamide peroxide, hydrogen peroxide, or mineral oil once or twice monthly for routine maintenance, as recommended by the most recent clinical practice guideline update in 2017 1. This approach is supported by the latest evidence, which emphasizes the importance of gentle and safe ear hygiene practices to minimize the risk of cerumen impaction and other complications.
The following measures can be taken to prevent cerumen impaction:
- Apply 5-10 drops of ear drops in each ear, remain lying on your side for 5 minutes to allow penetration, then gently rinse with warm water using a bulb syringe.
- Alternatively, place 1-2 drops of mineral oil or baby oil in each ear weekly to keep wax soft.
- Avoid using cotton swabs, ear candles, or other objects inside the ear canal, as these can push wax deeper and cause impaction, as warned by experts 1.
- For those prone to excessive earwax, consider professional ear cleaning every 6-12 months, as suggested by clinicians 1.
- People who wear hearing aids, use earbuds frequently, or have naturally narrow ear canals may need more frequent preventive care, due to their increased risk of cerumen impaction 1.
It is essential to note that cerumen production is a normal physiologic process, and preventive measures should be focused on those individuals who are at greatest risk for developing occlusion and those with a history of impaction, as highlighted in the clinical practice guideline update 1. By following these recommendations and taking a proactive approach to ear hygiene, individuals can reduce their risk of cerumen impaction and maintain good ear health.
From the FDA Drug Label
Directions FOR USE IN THE EAR ONLY. Adults and children over 12 years of age: Tilt head sideways and place 5 to 10 drops into ear Tip of applicator should not enter ear canal Keep drops in ear for several minutes by keeping head tilted or placing cotton in the ear Use twice daily for up to 4 days if needed, or as directed by a doctor Any wax remaining after treatment may be removed by gently flusing the ear with warm water, using a soft rubber bulb ear syringe To prevent cerumen impaction, hydrogen peroxide (OTIC) can be used as follows:
- Place 5 to 10 drops into the ear
- Keep the drops in the ear for several minutes
- Use twice daily for up to 4 days if needed, or as directed by a doctor
- Remove any remaining wax by gently flushing the ear with warm water using a soft rubber bulb ear syringe 2
From the Research
Preventing Cerumen Impaction
To prevent cerumen impaction, it is essential to understand the proper methods of ear care.
- Avoid using cotton-tipped swabs, as they can push cerumen further into the ear canal 3
- Refrain from using ear candling, as it is not an effective or safe method for removing cerumen 3
- Do not use olive oil drops or sprays, as they are not recommended for cerumen removal 3
- For selected adults, home irrigation with a bulb syringe may be an appropriate method for removing cerumen 3
- Patients with certain medical conditions, such as coagulopathies or those taking antiplatelet or anticoagulant medications, should be cautious when removing cerumen due to the increased risk of bleeding in the external auditory canal 3
Effective Treatment Options
If cerumen impaction does occur, there are several effective treatment options available, including: