If the earwax is large and clumped together, cerumen embolism can occur, blocking the outer ear canal and causing ear blockage and hearing loss. If the earwax irritates the outer ear canal, it can even cause ear pain and some earwax can cause irritating coughing and other symptoms. If the earwax is not completely blocked to the outer ear canal and there is no obvious otitis externa, the earwax can be removed by a doctor using forceps or cerumen hooks. If the earwax is too large and hard to be removed, it is recommended that the patient soften the earwax with ear drops and then the doctor can use a suction device to suck it out or flush it out with an ear canal rinse. If the earwax is large enough to induce otitis externa, anti-inflammatory treatment should be given first, and then the earwax can be removed after the earwax has softened.