Cerumen impaction: Prevalence and its broader implications in the United States

Cerumen, commonly known as earwax, is an essential natural substance that lubricates, cleans, and protects the external auditory canal. However, when its natural self-cleaning process is disrupted, cerumen accumulates excessively, leading to cerumen impaction. This condition is associated with symptoms like aural fullness, itching, and hearing loss, posing significant public health implications.

Prevalence and demographics of cerumen impaction

A recent study by Tolan and collaborators highlighted the widespread nature of cerumen impaction in the United States (U.S.) population. The analysis reveals that approximately 18.6% of individuals aged 12 and older experience some form of cerumen impaction. Among adults aged 70 and above, this figure rises sharply to 32.4%, emphasizing the condition’s age-related prevalence. Partial impaction—where the earwax partially obstructs the tympanic membrane—is far more common than a complete blockage.

Interestingly, the data also points to significant sociodemographic disparities. Males, individuals identifying as Black, and those with lower levels of education are far more affected. 

• For men, larger and coarser hair at the external auditory canal can obstruct the natural migration of earwax, increasing the likelihood of accumulation and impaction.
• For older adults, changes in the shape of the ear canal with age, increased hair growth in the ear canal, and a decreased ability for self-cleaning mechanisms contribute to the higher prevalence of impaction. 
• Regarding demographic disparities, the “wet” cerumen phenotype, more prevalent among individuals of African ancestry, is associated with a higher risk of impaction due to its sticky consistency.

Clinical and audiological impacts

Cerumen impaction has notable implications for hearing health. Complete impaction is linked to a measurable increase in pure-tone audiometric thresholds, signifying hearing loss. While the average increase in hearing thresholds due to complete impaction is small (ranging from 1.93 to 4.10 decibels), it can still affect individuals with existing hearing vulnerabilities.

Healthcare impact of cerumen impaction

Beyond individual health effects, cerumen impaction represents a considerable burden on healthcare systems. Annually, it accounts for approximately 12 million medical visits in the U.S., making it one of the most frequently managed conditions in otolaryngology and primary care settings. Additionally, cerumen removal ranks as the third most common procedure otolaryngologists perform, reflecting its widespread prevalence and economic impact. The demand for effective management of this seemingly minor condition highlights its substantial role in healthcare resource utilization.

Broader implications and recommendations

The high prevalence of cerumen impaction underscores the importance of addressing this condition through preventive and management strategies. Proper ear hygiene education is essential. Over-the-counter treatments for cerumen removal can offer safe and accessible options for at-home management, reducing the need for medical interventions and helping to surpass the sociodemographic disparity in earwax impaction.  

At Mitelos, we emphasize the role of prevention by offering OTC products that support long-term ear health, helping to prevent complex hearing problems. We not only develop and register OTC products, but we also love going down to business, helping with regulatory clearance in your country, market analysis, and follow-up during our partnership.

We are always looking for partners to distribute them. If you distribute products in the US, Canada, Germany, France, Baltic countries, CIS markets, Mexico, Asia-Pacific rim, or Australia, contact us. You can complete your portfolio with OTIBLOCK®, scientifically formulated to remove earwax from the outer ear. 

Contact us at info@mitelos.com

Sources

Tolan MM, Choi JS, Tibesar MT, Adams ME. Cerumen impaction: Prevalence and associated factors in the United States population. Laryngoscope Investig Otolaryngol. 2024 Mar 22;9(2):e1228. doi: 10.1002/lio2.1228.