Earwax tends to have some type of odor, but when it turns into a foul scent, it typically signals an underlying issue. What smelly earwax indicates can vary, but it always warrants a trip to your doctor.
With proper and safe ear hygiene, you can usually prevent smelly earwax in the first place.
What Is Earwax and Why Does It Smell?
The ear canal has glands that produce a waxy oil called cerumen. This often emerges from the opening of the ear and is commonly known as earwax.
It may fall out naturally or be washed away.
Earwax serves to protect your ear by trapping and preventing dust, bacteria, and germs from entering and damaging it. It also protects the ear canal’s skin from irritation when water gets inside.
“Normal earwax is a natural mixture of oils, dead skin cells, and sweat that typically has a faint or neutral smell,” says Geoffrey B. Trenkle, DO, an otolaryngologist and the founder of the Los Angeles Center for Ear, Nose, Throat, and Allergy. “A foul odor usually signals a disruption in this natural mixture by either biochemical or environmental factors.”
Here are some of the causes of foul-smelling earwax.
Excessive Earwax
A surplus of earwax can cause a bad smell because it creates a prime environment for microbial overgrowth, Dr. Trenkle says.
“A large plug of wax can completely block the ear canal, creating an airtight, oxygen-deprived space,” Trenkle says. Trapped material like dust, moisture, sweat, or drainage, combined with skin cells, becomes the perfect place for bacteria or fungus to colonize — certain bacteria, particularly those associated with foul odors, thrive in these environments with no oxygen, he adds.
Untreated earwax buildup can lead to a blockage in your ear. You’re more likely to develop this if you use hearing aids, earplugs, or earbuds. Other risk factors include more ear hair, skin conditions such as eczema, using cotton swabs, or being older than 55.
Excessive earwax typically has a faint odor that is sometimes musky, Trenkle says.
Swimmer’s Ear
The scientific name for swimmer’s ear is otitis externa, or inflammation of the external ear canal. This inflammation can either be infectious or non-infectious.
“Swimmer’s ear is often caused by Pseudomonas or Staph bacteria, both of which commonly create foul-smelling discharge,” says Ravi Patel, MD, an otolaryngologist with ENT and Allergy Associates in New York City.
Swimming is among the main risk factors, with swimmers five times more likely than non-swimmers to develop it. Others include humidity, cotton swabs or external tools like earplugs, narrow external ear canals, stress, or a compromised immune system.
Swimmer’s ear, along with cholesteatoma and other infections (more on both of those ahead), typically has a strong scent that’s rotten, sour, or even cheesy, Trenkle says.
Cholesteatoma
Cholesteatoma is a skin cyst found in the middle ear. Although some people are born with it, it usually occurs due to a chronic ear infection. These cysts are filled with old skin cells and other waste. Symptoms include dizziness, ear drainage, hearing loss in one ear, or a feeling of fullness or pressure in the ear.
Surgery is necessary to remove this cyst. Otherwise, it may become infected or continue to grow.
“The cyst continuously sheds dead skin cells into a confined, unventilated space, causing a very strong and distinct cheesy odor,” Trenkle says.
Ear Infection
A foul odor accompanied by symptoms like ear pain or trouble hearing is a strong indicator of an infection. Sometimes, if a middle ear infection causes eardrum perforation, drainage may also occur alongside pain and hearing issues.
In an ear infection, the eustachian tubes that run from the middle ear to the throat become blocked and swollen, leading to mucus that can become infected. Bacteria or a virus in the middle ear — usually coming from another illness like a cold, flu, or allergy — cause ear infections.
Although children are more likely to get ear infections because of the size and shape of their eustachian tubes (which run from the middle ear to the throat), adults can experience them as well.
As mentioned, Trenkle says infections usually have a strong rotten, sour, or cheesy odor.
Side Effects and Complications of Smelly Earwax
The potential complications of smelly earwax depend on the cause. All conditions — except for cholesteatomas, which require surgery — can be treated in the doctor’s office by cleaning the ear and then using appropriate antibacterial or antifungal ear drops (or, if needed in rare cases, oral antibiotics), Trenkle says.
Impacted earwax typically doesn’t cause complications. But in rare cases, complications can arise from removal treatments. These include swimmer’s ear, earache, temporary hearing loss, dizziness, water retention in the ear canal, eardrum perforation, ringing in the ears, or bleeding.
Some patients have minimal or no symptoms at all, Trenkle says.
Untreated swimmer’s ear can lead to complications like deep tissue infection, bone and cartilage damage, and even fatal infection in other parts of the body like the brain. But these complications are rare, Trenkle says.
Cholesteatoma complications may include hearing loss, weakness or paralysis of the facial muscles, changes in taste, fluid leaking from the brain, infection around or inside the brain, and brain tissue pushing into the ear. “All cholesteatomas carry the risk of these serious, permanent complications and require timely treatment by an ENT provider,” Trenkle says.
Ear infections often clear up on their own, but repeated infections can cause serious complications like hearing loss or the spread of infection to nearby tissues.
When to See a Doctor About Smelly Earwax
It’s best to see your doctor if you notice smelly earwax, rather than treating it at home, so you can address the underlying cause, which is usually infection, Trenkle says.
See a doctor if you notice a persistent odor (that smells musky, sour, rotten, or cheesy), drainage, ear pain, hearing loss, bloody or watery discharge, or any other unusual symptoms. An ENT specialist can use tools like a curette (a small spoon-shaped tool) and micro-suction to safely remove impacted wax, Trenkle says.
How to Prevent Smelly Earwax
You can prevent issues that cause smelly earwax with general best practices for healthy ears. Experts advise against using cotton swabs to clean your ears, since they can push and pack the wax deeper into your ear.
You should never put anything smaller than your elbow in your ear, Trenkle says. “We also recommend avoiding any aggressive irrigation at home as this can potentially cause damage to the eardrum or canal skin,” he adds. Other best practices include cleaning the outside of your ear with a soft cloth (but not the inside), never putting objects or hot or cold oil into the ear, not sharing earphones or plugs with others, and not swimming in dirty water.
“Regular appointments for earwax removal for patients who have excessive production to avoid buildup can also be beneficial,” Dr. Patel says.
The Takeaway
Smelly earwax can be caused by underlying issues like earwax buildup, swimmer’s ear, cholesteatoma, and ear infection.
Complications of these issues can be serious — and in rare cases, even fatal — so it's important to see your doctor right away if you notice a foul odor.
You can prevent many issues that cause smelly earwax with general best practices for healthy ears, such as not sharing headphones and not putting objects like cotton swabs in your ears.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Jessica Lee, MD, practices general otolaryngology at Charleston ENT and Allergy in South Carolina. After several years in clinical and surgical practice, Dr. Lee wanted to learn more about the impact of nutrition, activity, and sleep on general health and ear, nose, and throat health, so she pursued additional training in integrative, lifestyle, and functional medicine topics and became board-certified in lifestyle medicine in 2021.
Her practice centers on first addressing the lifestyle causes of disease and chronic illness, with the understanding and ability to use medical and surgical care for more acute concerns. She is also the co-founder and director of the Keto Hope Foundation, a nonprofit dedicated to helping families use the ketogenic diet as medical treatment for epilepsy
Lee enjoys cooking, strength training, reading, and spending time with friends and family.
Kelsey Kloss is a health and wellness journalist with over a decade of experience. She started her career as an in-house editor for brands including Reader’s Digest, Elle Decor, Good Housekeeping, Prevention, Woman's Day, and Redbook, and her work has been featured in over 50 publications.
