There are several ways to remove ear wax build up at home or in a doctor's office. People who have experienced perforated ear drums and severe ear infections should consult a doctor if they think they have a build up of ear wax, as there are some special concerns about their ears which must be addressed. For these individuals, it is safer to have a doctor remove the wax, as he or she can do so with specialized equipment which will not damage the ear drum.
Before one makes the decision to remove ear wax build up, it is important to think about whether or not the build up of wax should be removed at all. The ears generate lots of wax naturally to clean the ears and protect them from dust and other dangers, and it is normal to have some wax in and around the ear. If the hearing is impaired or a suspected build up is causing pain and irritation, it should be removed. Likewise if ear wax has been pushed into the ear canal because of overzealous use of cotton swabs. But if only a small amount of wax is present, it may be better not to remove ear wax build up.
At home, the goal is to soften the ear wax so that it can flow out of the ear, and then to flush the ear so that it is clean. Softening can be accomplished by pouring a few drops of a warm, neutral oil such as baby oil into the ear, by holding a hot water bottle to the ear, or by applying a few drops of a solution specifically designed for softening ear wax. It is best to do this with the head lying on a table and an ear pointing up, and to hold this position for several minutes before tilting to allow the wax to flow out. Once the wax has come out, the ear can be flushed with warm salt water, either with the use of an bulb syringe or by pouring water slowly into the ear.
Some people recommend using hydrogen peroxide for ear wax removal. Hydrogen peroxide should not be used alone to remove ear wax build up, as it will not soften the wax. It can be used with softened wax, as the bubbling motion of the hydrogen peroxide will help remove ear wax from the ear.
In a doctor's office, the doctor has an array of tools to choose from to remove ear wax build up. Doctors can use specialized water jets to get wax out of the ear, or scoops which can be gently inserted into the ear to pull out wax. These techniques should not be used at home, as they require special training to avoid damage to the ear.