Earwax Build-Up or Ear Infection? How to Tell the Difference
Earwax Build-Up or Ear Infection? How to Tell the Difference
Ear infections and earwax blockages are common issues, especially in children. Both can cause uncomfortable symptoms such as ear pain, pressure, or hearing loss. Understanding the signs can help you know when to watch and wait—and when to seek medical attention.
What Is Earwax Build-Up?
Earwax, also called cerumen, plays a protective role in your ear canal. It keeps your ears free of dust and dirt by trapping particles so they cannot reach the deeper parts of your ear, possibly preventing infection. Sometimes, however, earwax can accumulate and lead to a blockage known as cerumen impaction. While an earwax blockage can happen to anyone, in more severe cases, it affects about 10% of children and 5% of adults.
What Is an Ear Infection?
Ear infections occur when the ear becomes infected with bacteria or a virus. Infections can develop in different parts of the ear:
- Outer ear infections happen when moisture becomes trapped in the ear canal (often called “swimmer’s ear”).
- Middle ear infections are the most common and often follow being sick with a virus or allergies.
- Inner ear infections are rare and usually caused by viruses.
“An ear infection diagnosis relies on having a good examination,” says Albert Park, MD, a pediatric otolaryngologist at University of Utah Health. “We use a magnifying device called a pneumatic otoscope to examine the ear, form an airtight seal, and very gently apply pressure to elicit movement of the eardrum. A normal eardrum will move with gentle pressure; an infected eardrum will not move, and that can help improve the diagnosis of ear infections.”
How to Tell the Difference
Recognizing whether symptoms stem from earwax build-up or infection can guide patients to the right care at the right time.
It’s important to note that earwax build-up does not cause fever or symptoms of an upper respiratory infection. If you or your child have recently been sick or are currently sick with the above symptoms, that’s a good indicator of an ear infection and you should see a doctor.
Finding Relief for Ear Pain
If You Suspect an Ear Infection
See a health care provider for an evaluation. If antibiotics are needed, follow the prescription directions exactly. Taking antibiotics when you don’t need them can lead to antibiotic resistance.
“We sometimes see children with fever whose ear pain is actually viral,” Park says. “In those cases, an antibiotic isn’t helpful.”
If an ear infection is confirmed, amoxicillin is a commonly prescribed antibiotic that's safe and effective at reducing symptoms and helping the infection clear up faster. Children who experience chronic ear infections should talk to their pediatrician about a tympanostomy (ear tubes), a surgical procedure in which small, hollow tubes are placed in the eardrum to improve ventilation.
If You Suspect Earwax Build-Up
It’s best to see a professional to address an earwax blockage.
“If a child has a tremendous amount of wax, I may recommend using a mixture of hydrogen peroxide and water at home to liquefy the material, and then have them come back for removal,” Park says. “Oftentimes, home remedies aren’t very effective. If you use hydrogen peroxide chronically, it can cause skin irritation, so it needs to be used judiciously.”
Proper ear care is important. Avoid inserting objects into your ears—like cotton swabs or ear candles—which can push the blockage further into your ear canal.
When in doubt, see your family medicine practitioner, pediatrician, or a general or pediatric ENT (ear, nose, throat) specialist. They are equipped with the tools and training to find the cause of your symptoms and treat them accordingly.
Hearing Loss in Kids: Signs, Risks, and Prevention
Is your child ignoring you, or do they have a real hearing problem? Hearing loss in kids can be subtle, often mistaken for inattention or learning difficulties. ENT specialist Jeremy Meier, MD, explains the warning signs parents should watch for, the biggest threats to children's hearing, and how to prevent long-term damage.
Tonsils—When Is It Time to Take Them Out?
Tonsils are small glands on either side of the throat that stop bacteria from entering the body. They are an important part of your child’s immune system, but sometimes can become ‘ginormous’ and cause problems like difficulty swallowing, heroic snoring, or chronic strep throat.
