Cerumen, commonly known as earwax, is a naturally occurring substance that plays an important protective role in the ear canal. This waxy material lubricates the skin and traps dust, debris, and microorganisms, preventing them from reaching the eardrum. Produced by specialized glands in the outer third of the ear canal, cerumen is a mixture of glandular secretions and shed skin cells. As a person ages, the physical and chemical properties of this substance undergo changes that can alter its function and lead to complications.
Consistency and Composition Shifts
Aging modifies the substance of cerumen, causing it to become less pliable and more difficult to manage. The ceruminous and sebaceous glands within the ear canal begin to atrophy over time, which reduces the production of their oily secretions. This decrease in the lipid component of the wax leads to a substance that is significantly drier than the softer, stickier cerumen found in younger individuals.
The chemical makeup shifts to contain a higher proportion of keratin, which is composed of dead, sloughed-off skin cells. The relative lack of lubricating oil means the wax is drier and harder. This change in consistency causes the cerumen to become brittle and crumbly, making it far more prone to accumulating within the ear canal rather than flowing out naturally.
Impairment of Natural Clearance
Beyond the change in substance, the body’s self-cleaning mechanism for the ear canal becomes less effective with age. Normally, a process described as a “conveyor belt” moves the earwax outward through the slow, continuous migration of skin cells from the eardrum toward the ear canal opening. This process is assisted by jaw movements, such as talking and chewing.
With aging, the rate of skin cell turnover slows down, disrupting the smooth migration of cerumen out of the ear. Furthermore, the supportive cartilage of the outer ear canal can become less firm, sometimes leading to a narrower or more convoluted passage that impedes the outward movement of the harder wax. This combination of drier wax and a sluggish clearance system means cerumen remains in the canal longer, drying out further and becoming firmly fixed.
Increased Risk of Impaction and Symptoms
The combination of dry, hard cerumen and impaired clearance increases the risk of cerumen impaction, which is an accumulation that causes symptoms or blocks a clear view of the eardrum. Impaction is prevalent in older populations, affecting a large percentage of individuals over the age of 65. The hardened accumulation can press against the eardrum, leading to uncomfortable and sometimes serious symptoms.
The most common consequence is conductive hearing loss, where the blockage physically prevents sound waves from reaching the inner ear. Individuals may also experience a sensation of aural fullness or pressure within the ear. Other symptoms include tinnitus (a ringing or buzzing sound) and otalgia (ear pain). In some cases, severe impaction can affect the balance system, causing dizziness or vertigo. These symptoms are often mistaken for age-related hearing decline, but they may resolve once the impacted wax is removed.
Safe Management of Age-Related Earwax
The management of age-related hard cerumen requires a gentle approach to prevent injury to the delicate ear canal skin. For home care, the goal is to soften the hardened wax using cerumenolytic agents. Over-the-counter drops containing mineral oil, glycerin, or hydrogen peroxide can be applied for several days to soften the accumulation before removal.
It is advised to avoid inserting objects like cotton swabs, ear picks, or hairpins into the ear canal, as these typically push the dry, hard wax deeper, worsening the impaction and risking damage to the eardrum. Ear candling is not a recommended method due to its ineffectiveness and risk of burns. When home softening methods are insufficient, a healthcare provider should be consulted for professional removal using techniques like irrigation or microsuction.