Black earwax: Causes & treatments

Causes of black earwax

Contrary to what you may have heard, black earwax isn’t the result of poor hygiene or being “dirty.” Earwax naturally turns darker the longer it stays inside our ear canals. When someone’s ears aren’t able to properly remove earwax, a buildup can occur that causes that compacted wax to turn black.

Research suggests that these effects are especially pronounced in males and older people. As we age, the ceruminous glands of the outer ear start to shrink and make less secretions, resulting in dry earwax that can’t clear the canal as easily as it used to.

Black earwax may be indicative of one (or more) of the following issues:

Earwax buildup

Our ears are constantly producing earwax — and constantly cleaning it out. Wax normally leaves the ear openings slowly over time, when it’s naturally washed or wiped away by daily activities like showering. However, when the cerumen glands produce too much earwax, or the ears are unable to easily remove wax on their own, an earwax buildup can occur. Build-ups are often made worse when people use cotton swabs and other items to try to clear the wax and unintentionally end up pushing it deeper in.

Foreign bodies in the ear

Similar to cotton swabs, the routine insertion of hearing aids, earplugs, in-ear headphones, and other types of ear buds can push earwax deeper into the canal, blocking the wax’s usual exit through the ear opening and contributing to buildups that gradually turn darker over time.

Fungal infections

Some fungal ear infections like otomycosis may cause grayish-black or yellow spores to appear in the ear canal, and subsequently on any earwax that gets expelled. This can take on an appearance similar to true black earwax but isn’t as common as the other causes in this list. Otomycosis is most prominent in tropical and sub-tropical parts of the world, especially during periods of intense heat and humidity.

Patients who prove resistant to traditional anti-fungal treatments may develop a chronic form of otomycosis that requires regular support from an ear care specialist. Fungal infections can also persist if a patient faces continued exposure to the fungus after being treated (for example, by regularly swimming in contaminated water).

Compressed earwax

Whether it’s a Q-tip or an AirPod, the insertion of any foreign object into your ear canal increases your chances of earwax compaction. Compressed earwax not only darkens and hardens the longer it stays in the canal, it can also lead to unwanted symptoms including ear pain, dizziness, and temporary hearing loss. Patients with conditions linked to increased earwax production, like ear eczema, are at increased risk of developing compressed earwax.

Black earwax treatment options

Treatment for black earwax ultimately depends on the cause and severity of the issue. If you have black earwax without any accompanying symptoms, you may opt to not seek further treatment. On the other hand, severe earwax buildups require professional evaluation and treatment to restore a patient’s hearing ability and prevent the development of further complications.

Ask your doctor if one of these procedures or home remedies is a good option for treating your black earwax:

Home remedies

At-home treatments for earwax buildup often involve a combination of ear drops and proper ear irrigation. Drops are usually available over-the-counter (OTC) in the form of hydrogen peroxide; natural oils like olive oil, mineral oil, and baby oil; and ear drop solutions like Debrox Gentle Microfoam Ear Wax Remover. Apply 2 or 3 drops of any of these liquids to the opening of the canal and give it time to soak into the earwax. Before long, the wax should start to break up and naturally leave the ear.

Ear irrigation uses water and a small, rubber bulb or syringe to flush wax and other debris out of the ear canal. Just fill the syringe with warm water, gently insert the bulb into the canal until you can’t go any further, and squeeze. The process works better if you tip your head as you’re doing this, with the ear you’re irrigating pointed up toward the ceiling.

Once you’ve squirted the water into the canal, try rolling your head back slightly to help the water work its way through. Hold for a minute or two before tipping your head to the side and allowing it to drain. Irrigation is an especially effective method for removing earwax buildup when used in combination with an essential oil or hydrogen peroxide.

 🚨 Don’t try these home remedies without your doctor’s consent. Conditions like torn eardrums can actually be made worse by the use of these treatments, so make a point to ask before attempting anything new.

Professional medical treatment

If you find the home remedies aren’t quite cutting it, or if you notice any symptoms besides the presence of black earwax, the best course of action is to schedule a doctor’s appointment. Audiologists are fully trained to manage earwax removal, but they may refer patients with a history of chronic earwax buildup to a specialist called an otolaryngologist, more commonly known as ear, nose, and throat doctor (ENT).

Depending on the severity and location of the buildup, the doctor may use one or more of these methods to clean out your ear canals:

• Extraction. Doctors may use a small, spoon-shaped tool known as a curette to remove excess earwax. Unlike cotton swabs, these tools are specially designed to extract earwax without damaging the canal or causing further impaction.
• Suction. Alternatively, your ENT may try to remove your earwax using a small suction device similar to vacuum. This method is considered even gentler than removal with a curette, and may be a better choice for patients with particularly sensitive ears.
• Irrigation. This technique is similar to the DIY irrigation method outlined above, and may be performed by a doctor in the event a patient hasn’t already tried doing it themselves. The main difference here is that professionals may forgo the rubber bulb syringe in favor of a water pick, a motorized device with a pressurized stream that sometimes does a better job of targeting stubborn wax buildups.

How to prevent black earwax

Your ears are designed to be self-cleaning, and they don’t need any outside assistance to clear earwax when they’re working properly. Many people are tempted to remove wax from their ear with the help of cotton swabs, but these instruments often end up pushing wax deeper into the canal and making the buildup worse.

To keep your ears as clean as possible, we recommend avoiding the use of long objects like Q-tips. You should also do your best to limit your use of in-ear headphones, earplugs, or any other object that requires routine insertion into the ear canal. This is especially true for patients with a history of earwax buildup.

Doctors may recommend OTC products like the Murine Ear Wax Removal Kit to help soften compacted earwax and clear the canals. Stay on top of proper dosing for optimal results, and schedule regular follow-ups with your hearing care specialist every 6 to 12 months so they can accurately track your progress.

When should you see a doctor for black earwax?

Black earwax may be serious when it’s accompanied by dizziness, pain, and bleeding in the ears, and difficulty hearing/hearing loss. When they present together, these symptoms suggest a more serious underlying issue, such as a torn or perforated eardrum. These cases require immediate medical attention to prevent infection.

We also recommend seeing a professional if it’s your first time experiencing black earwax, and before starting any kind of at-home treatment for earwax buildup.

🚨 See a doctor ASAP if you’re notice any discharge from your ear besides earwax. 

Black earwax isn’t something most people expect to happen to them — but when it does, we can at least rest easy knowing that it’s probably going to be okay. Follow your doctor’s instructions to remove excess earwax, and remember this condition is temporary. Practice good hygiene and be patient with your ears as they start to clean themselves again, and you’ve got a good chance of nipping this issue in the bud once and for all.