Paediatric: Ear Wax Removal

Understanding Impacted Earwax

Impacted Earwax Removal for Children

Earwax, scientifically known as cerumen, plays a crucial role in protecting the ear canal by trapping debris and preventing bacterial growth. However, when earwax becomes impacted—often due to factors like excessive production, use of cotton buds, or small ear canals—it can lead to discomfort and hearing issues in children.


Causes of Earwax Buildup in Children

However, sometimes, earwax can block up the ear canal. Earwax buildup (Figure 1a-d) that fails to clear on its own is usually due to these reasons:

  1. Digging the ear with cotton buds or ear picks
  2. Excessive production of earwax
  3. Dry skin in the ear canal
  4. Narrow ear canals
  5. Regular use of hearing aids or earplugs


Impacted earwax

Safe Methods for Earwax Removal

For children experiencing impacted earwax, safe and effective earwax removal methods are crucial. Avoid using cotton swabs or other objects that can push earwax deeper into the ear canal, potentially causing damage.

Many children attempt to clean their ear canals using cotton buds, but this practice can be harmful. Cotton buds are designed for external use to clean or dry up fluid outside the ear canal (Figure 2a). It is not meant to be inserted into the ear canal (Figure 2b). The cotton bud is too big for the child’s ear canal and insertion into the ear canal will only push the earwax and debris deeper against the child’s ear drum. Doing so can push earwax deeper against the eardrum (Figure 3a) and the self-cleansing mechanism of the ear will fail. In some cases, this might potentially lead to complications such as ear infections when patients may scratch the lining of the ear canal, ear drum punctures (Figure 3b), or lodging of the bud in the canal.

Cotton Bud

Symptoms of Impacted Earwax in Children

Impacted earwax can manifest with symptoms such as hearing loss, ear pain, tinnitus (ringing in the ears), dizziness, or a sensation of fullness in the ear. If left untreated, it may even result in secondary ear infections.


Ear Wax Removal in Singapore


Earwax, or cerumen, is a mixture of fatty secretions from a number of glands in the walls of your ear canal. They combine with other debris such as dead skin and hair, and will generally remove themselves from our ear canal when there is a movement of our jaws during chewing or talking. Earwax lowers the risk of ear infections and prevents discomfort in your ear canal. However, there are times where your body may overproduce earwax and cause it to block the ear canal, requiring professional earwax removal. Earwax that picks up a lot of debris, sits in the ear canal for too long, or is pushed inwards by foreign objects such as earbuds, are also likely to cause a blockage.


Safe Methods for Earwax Removal

For children experiencing impacted earwax, safe and effective earwax removal methods are crucial. Avoid using cotton swabs or other objects that can push earwax deeper into the ear canal, potentially causing damage.


If you or your child is suffering from an impacted earwax, you can either seek medical help for earwax removal, or do it yourself. Some symptoms of earwax blockage can include hearing loss, pain in the ear, tinnitus, dizziness, cough, or a feeling of fullness in the ear. Without earwax removal, infection can occur and result in serious symptoms such as drainage from the ear canal, itching, odour, and/or fever.


Many people make use of cotton swabs or other foreign objects for earwax removal, but it does not clean your ears and will only push the earwax deeper inside, causing damage to your middle and/or inner ear. This can lead to serious injuries and even cause hearing loss. For a safer earwax removal method, you can soak a cotton ball with water or saline solution and drip it into your ear with your head tilted to the side. Remain in the position to allow the liquid to flow through the earwax. Then, tilt your head the other way to let the fluid and earwax drain out before wiping the outer parts of your ears. Read on for other earwax removal treatment methods.


Microsuction for Safe and Gentle Earwax Removal for Children

Microsuction is a recommended method for removing impacted earwax in children. This procedure uses a small suction device to gently extract the wax without the need for ear irrigation or harsh chemicals. It is performed under direct visualization using a tiny camera to ensure precision and safety.


Microsuction is one method of removal. It is a safe, painless, and no-mess process that utilises a small, long and thin suction device to gently dislodge the earwax and vacuum it out of your ears. It uses a device with an attached camera to give the doctor a clear view of your ear and the amount of wax inside. This allows your doctor to thoroughly remove earwax blockages while also inspecting your ear for any problems. The entire procedure will only last a few minutes. You may feel some suction inside your ear, a slight tickling sensation, and/or some crackling or squeaking sounds during the procedure.


Using microsuction for earwax removal is extremely safe as it is gentle on the child’s ears, fast, effective, and does not damage the inner ear lining. No solution will be flushed through your ear. Hence, people who suffer from a ruptured eardrum, a history of ear surgery, have foreign matter in the ear, or mild ear infection can also rely on microsuction for earwax removal. However, do speak to your doctor about your current and previous conditions, and your allergies to determine whether you are a suitable candidate for microsuction.


Microsuction can be administered once every four to six months. Some may require more sessions of earwax removal if they are prone to blockages or are wearing hearing aids.


As with every procedure, microsuction also comes with its risks and side effects. Most side effects are mild and temporary. They include:

  • Dizziness
  • Discomfort
  • Reduced hearing


In more serious cases, which rarely occur, side effects may include:

  • Infection
  • Temporary or permanent hearing loss
  • Injury to the eardrum
  • Tinnitus


Other Ear Wax Removal Methods for Children


Apart from microsuction for earwax removal, there are several other earwax removal treatments available in Singapore. Depending on your condition, some methods may not be suitable for you. Do speak to your doctor for medical advice. Here are other alternative methods to removal:

  • Earwax Softener: Also known as ear drops, doctors may prescribe medicated solutions such as carbamide peroxide to soften the earwax in your ear to help it dislodge and fall out naturally. If buildup continues, your doctor may schedule an earwax removal procedure to manually remove the blockage.
  • Ear Irrigation: A ear cleansing method used to remove a buildup of earwax, ear irrigation involves flushing liquid into your ears to dislodge and remove any earwax. This procedure is not recommended for people with certain medical conditions or who have gone through ear surgery as it can cause more damage to the ears.
  • Manual Earwax Removal: Your doctor will use a flexible plastic loop, a cerumen curette, forceps, or a small hook to manually remove the earwax from your ear canal.


Some patients may attempt to remove earwax via ear candling, which involves lighting one end of a candle and placing the unlit end into the ear to create a vacuum seal that will draw the wax up. This method is not recommended as it does not work and may even burn or damage your ears.



If your child shows symptoms of impacted earwax, such as reduced hearing or ear discomfort, seek medical advice promptly. Professional earwax removal ensures safety and reduces the risk of complications associated with untreated earwax buildup.

When Should You See an ENT Specialist in Singapore?

  • Any ear, nose or throat symptoms that you are troubled with or concerned about
  • Persistent blocked nose with mouth breathing or snoring

Dr Gan provides a comprehensive management in a broad array of Ear, Nose and Throat as well as Head & Neck conditions. He has a special interest in treating various nose and sinus conditions including snoring and Obstructive Sleep Apnoea (OSA)

Blue Banner Mobile

Our ENT Clinic in Singapore

  • clinic_img
  • clinic_img
  • clinic_img
  • clinic_img
  • clinic_img

Our Location

Make an Enquiry

Fill up the form and our clinic staff will get back to you within a few hours!

    Prefer Whatsapp? Message us directly to book an appointment with our Dr Gan.