Excessive Earwax Buildup in Children: When to See a Pediatrician

All children have different amounts of earwax, also known as cerumen. It can be helpful to understand the symptoms of excessive earwax so you can watch for them in your child. While there are ways to safely clean your child's ears, there are times when it's best to see their pediatrician for additional help.

This article explores the purpose of your child's earwax, signs of buildup, the best earwax removal methods for children and babies, earwax prevention, and when to seek help from a pediatrician.

Earwax Buildup Symptoms

It is thought that up to 10% of children have excessive earwax. In some cases, symptoms of excessive earwax may include:

• Hearing loss ranging from 5 to 40 decibels (dB)
• Ringing in the ears, known as tinnitus
• Ear canal that feels full or clogged
• Itchiness in the ear canal
• Ear pain, known as otalgia
• Discharge or ear drainage, known as otorrhea
• Odor from the ear canal
• Dizziness
• Cough
  

When to Seek Help

If your child is complaining of ear pain, is tugging on their ear, or is showing any other signs of discomfort, be sure to speak with their pediatrician. You should also call their pediatrician if you think your child got something stuck in their ear, or if they are having difficulty hearing.

The Purpose of Earwax

Earwax builds up naturally in the ear canal and helps keep the ear clean. Earwax carries dirt, dust, and other small unneeded or harmful things out of the ear. For example, if your child has ever gotten sand in their ears, their earwax will likely carry the sand out of their ears as it builds up over time. 

Earwax may even help prevent bacteria from entering the ear and causing ear infections such as swimmer's ear.

Types of Earwax

There are two types of earwax—wet and dry. Dry earwax is more flaky than wet and is tan or gray. Wet is usually a dark earwax, and may be brown and sticky.

Genes can impact the type of earwax you have. Wet earwax is common among those of African and European ancestry. Dry earwax is more common among those of Asian and Native American descent.

Why Does My Child Have So Much Earwax?

Children with narrow ear canals are more likely to have too much earwax. Wearing hearing aids and regularly using earbuds can also cause excessive earwax. Those with Down syndrome, chronic ear infections, and ear trauma also have a higher risk of having excess earwax.

How Do I Get Wax Out of My Baby's Ear?

Earwax should be left alone if it is not causing symptoms and is not preventing your pediatrician from examining your child's ear. If you plan on cleaning your child's ears, use a soft washcloth to wipe away wax that makes its way to the very outer part of the ear.

There are three main methods of earwax removal if excessive wax is causing a problem.

Wax-Softening Agents

Wax-softening agents, also called cerumenolytics, are typically available as ear drops. These may be water-based (containing acetic acid, hydrogen peroxide, or sterile saline), oil-based (olive oil), or non-water, non-oil based products (carbamide peroxide, which goes by the brand name Debrox).

Most can be bought over the counter at your local pharmacy, often with some type of earwax removal tool, like a bulb syringe.

Irrigation

Irrigation uses a fluid to flush out earwax. This is typically done in a doctor's office. Earwax irrigation should be avoided in children who are more at risk for getting ear infections.

Manual Removal

With manual removal, your pediatrician may use a small tool, known as a curette, to remove the excess earwax. Wax can also be manually removed by suctioning it out. This procedure is called microsuction ear cleaning.

Manual removal may be the best choice for kids who have ear tubes or who have had eardrum trauma. However, manual removal may not be the best choice for children who have bleeding disorders.

Preventing Earwax Buildup

There are several ways to prevent your child's earwax from building up.

• Let the earwax come out naturally.
• If possible, have your child use noise-canceling headphones instead of earbuds.
• Have your child routinely use a preventive wax-softening agent.
• Help your child irrigate their ears regularly.
• Have your child's pediatrician manually clean their ears every six to 12 months.

If your child continues to have trouble with excessive earwax, reach out to a pediatric ear, nose, and throat specialist for additional help.

Summary

Excessive earwax can build up in children if they are prone to ear infections, if they have small ear canals, and if they have experienced ear trauma. Hearing aids, earbuds, and improper wax removal can also lead to excess earwax.

Too much earwax can cause painful and uncomfortable symptoms. These may include dizziness, ear pain, ear itchiness, ear discharge, ringing, and coughing.

To remove your child's earwax safely, gently wipe away the wax in the outer ear with a soft cloth. Other removal methods include irrigation, using wax-softening products, and manual removal. If your child is showing signs of ear-related pain or discomfort, it's best to reach out to their pediatrician.