In most cases, earwax falls out on its own and there is no need to remove it. However, if earwax is completely blocking your ear canal and causing hearing loss, it may need removing.
Earwax also sometimes needs to be removed to make an impression of the ear canal for a hearing aid mould, or if the earwax is causing the hearing aid to whistle.
Eardrops
Eardrops, available from your pharmacy, can be used to soften and loosen the earwax which may help it to work its way out naturally. Speak to your pharmacist about which eardrops are suitable for you.
Eardrops should only be used when they are at room temperature. Pour a few drops into the affected ear and lie on your side for a few minutes with the affected ear facing upwards.
This will allow the eardrops to soak into the wax and soften it. Repeating this two or three times a day for three to five days will cause the plug to soften. It may then gradually fall out of your ear bit by bit.
Eardrops should not be used if you have a perforated eardrum.
Ear irrigation
Ear irrigation may be recommended if your earwax blockage persists, even after using eardrops. It involves using a pressurised flow of water to remove the build-up of earwax.
An electronic ear irrigator is used, rather than a metal syringe as happened in the past, to avoid damaging the ear. The irrigator has a variable pressure control so that syringing can begin at the minimum pressure.
During the procedure, a controlled flow of water will be squirted into your ear canal to clean out the earwax. The water is a similar temperature to your body.
While irrigating your ear, the healthcare professional treating you may hold your ear at different angles to ensure the water reaches all of your ear canal.
They may also look inside your ear several times using an auriscope (an instrument designed to examine the inside of the ear) to check whether the wax is coming out.
Ear irrigation is a painless procedure, but your ear may feel strange as the water is squirted around your ear canal.
Tell the person who is treating you if you have any:
Symptoms such as these may be the result of an ear infection and will need further investigation.
If ear irrigation is unsuccessful at removing earwax from your ear, your GP may recommend:
- using eardrops again and returning for another irrigation
- putting water into your ear before irrigating again after 15 minutes
- that you be referred to an ear, nose and throat (ENT) specialist to remove the earwax
When ear irrigation is not recommended
Ear irrigation is not suitable for everyone. It should not be used if you have:
- previously had problems with irrigation, such as pain in your ear or severe vertigo
- a perforated eardrum, or you have had a perforated eardrum in the last 12 months
- a discharge of mucus from your ear, which may indicate an undiagnosed perforation
- had a middle ear infection (otitis media) in the past six weeks
- a grommet (a small, hollow tube surgically inserted into your ear if you have a build-up of fluid that causes hearing difficulties – see below)
- had ear surgery, apart from cases of extruded grommets, within the last 18 months
- a cleft palate (whether repaired or not)
- a foreign body in your ear
- a severe external ear infection (acute otitis externa) with pain in the ear canal or pinna (the visible part of your ear)
Ear irrigation is not recommended if you have a grommet. The grommet creates a passage in your middle ear which allows water to enter during syringing.
Grommets come out naturally, and the passage created by the grommet should eventually heal. Once the passage has healed, you can have your ear irrigated.
You should not have ear irrigation if the ear to be treated is your only hearing ear. This is because there is a small chance it could cause permanent hearing loss.
Young children who are un-cooperative, and some people with learning difficulties, may also not be able to have ear irrigation.
Other treatments
If your earwax cannot be removed using eardrops and ear irrigation, or if you are unsuitable for these treatments, alternative options may be considered. These include:
- microsuction: a noisy and possibly uncomfortable technique that uses gentle suction under a microscope
- aural toilet: where a specialist uses an instrument called a Jobson Horne probe to manually remove the earwax
