Earwax, also known by the medical term cerumen, is a waxy substance secreted in the ear canal of humans and other mammals.

[1] Major components of earwax include cerumen, produced by a type of modified sweat gland, and sebum, an oily substance.

The chemical composition of earwax includes saturated and unsaturated long chain fatty acids, alcohols, squalene, and cholesterol.

[11] Cleaning of the ear canal occurs as a result of the "conveyor belt" process of epithelial migration, aided by jaw movement.

Removing earwax is in the scope of practice for nurses, audiologists, Family Medicine physicians, and otorhinolaryngologists (ear, nose, and throat doctors).

The high lipid content of the sebum produced by the sebaceous glands causes the cerumen to work like lubrication.

Cerumen has been found to reduce the viability of a wide range of bacteria, including Haemophilus influenzae, Staphylococcus aureus, and many variants of Escherichia coli, sometimes by as much as 99%.

[20] Earwax helps protect the ear by trapping dust and other foreign particles that could filter through and damage the eardrum.

Untreated impacted wax can result in hearing loss, social withdrawal, poor work function, and mild paranoia.

[5] Impacted earwax is more common in those with Down's syndrome, due to the smaller, curved shape of the ear canal.

[28] A number of softeners are effective; however, if this is not sufficient,[28] the most common method of cerumen removal is syringing with warm water.

Topical preparations for the removal of earwax may be better than no treatment, and there may not be much difference between types, including water and olive oil.

Microsuction can be preferred over other methods as it avoids the presence of moisture in the ear, is often faster than irrigation, and is performed with direct vision of the earwax being removed.

[5] This may be effectively accomplished with a spray type ear washer, commonly used in the medical setting or at home, with a bulb syringe.

[36] Ear syringing techniques are described in great detail by Wilson & Roeser[33] and Blake et al.[37] who advise pulling the external ear up and back, and aiming the nozzle of the syringe slightly upwards and backwards so that the water flows as a cascade along the roof of the canal.

In the late 2010s, battery-operated 'smart' curette earwax removal devices were introduced to the commercial personal grooming market.

These endoscope-like devices are roughly the size and shape of a thick ballpoint pen, combining a miniature digital video camera, LED light source, Wi-Fi connectivity, and various earwax removal attachments.

With practice and careful technique, the device enables patients to inspect their own ear canals and remove excess earwax while also visualizing the tympanic membrane.

However, the risks of accidentally breaking the delicate skin within the ear canal or perforation the eardrum remain concerns.

"[39] This was confirmed by Sharp et al.,[29] who, in a survey of 320 general practitioners, found that only 68% of doctors inspected the ear canal after syringing to check that the wax was removed.

[45] Extrapolating from data obtained in Edinburgh, Sharp et al.[29] place this figure much higher, estimating that approximately 7000 ears are syringed per 100,000 population per annum.

In the New Zealand claims mentioned above, perforation of the tympanic membrane was by far the most common injury resulting in significant disability.

When a man is becoming dull of hearing, which happens most often after prolonged headaches, in the first place, the ear itself should be inspected: for there will be found either a crust such as comes upon the surface of ulcerations, or concretions of wax.