Earwax - Treating earwax build-up

In most cases, earwax falls out on its own, so there's no need to remove it. However, if it's completely blocking your ear canal and causing hearing loss, it may need to be removed.

Earwax also sometimes needs to be removed so that an impression of the ear canal can be made for a hearing aid mould. It can also be removed 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're 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 between three and five days will cause the plug to soften. The wax should then gradually fall out of your ear bit by bit.

Eardrops should not be used if you have a perforated eardrum (a hole or tear in the 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 (which was used in the past), to avoid damaging the ear. The irrigator has a variable pressure control so that syringing can begin at the lowest 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 that's used 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 experience any:

pain
dizziness
vertigo – the sensation of moving when you're still
hearing loss

These symptoms may be caused by 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 are referred to an ear, nose and throat (ENT) specialist to remove the earwax

When ear irrigation is not recommended

Ear irrigation isn't suitable for everyone. It shouldn't be used if you have:

previously had problems with irrigation, such as pain in your ear or severe vertigo
a perforated eardrum, or if you've 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 that's surgically inserted into your ear if you've had 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 (otitis externa) with pain in the ear canal or pinna (the visible part of your ear)

Ear irrigation isn't 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 ear irrigation.

You shouldn't have ear irrigation if the ear to be treated is your only hearing ear. This is because there's a small chance it could cause permanent hearing loss.

Young children who cannot tolerate it and some people with learning difficulties may also not be able to have ear irrigation.

Other treatments

If eardrops and ear irrigation prove ineffective at removing your earwax, or if you're unsuitable for these treatments, there are some alternative options that you may want to consider. These are described below.

Microsuction - where a special suction device is used to remove the earwax under a microscope. The procedure is quick, safe and painless, and it doesn't involve putting liquid into your ear.
Aural toilet - where an instrument called a Jobson Horne probe is used. A Jobson Horne probe is a thin metal instrument with a small ring at one end that the specialist can use to remove earwax from your ear canal.