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How to Manage a Build Up of Earwax

What is earwax?

Earwax is produced naturally in your ear canal. It has a function to keep the ear clean and free from any germs of infection. As the ear is self-cleaning it usually does not cause any problems unless it builds up to such an extent that it starts to block the ear canal.

When does it become a problem?

The signs of earwax build up can be as simple as the feeling that your ear is blocked and you cannot hear as well. Sometimes you may experience ear pain and itching, or you may start to notice tinnitus (noises in your ear). If you have a hearing aid, you may notice that you hearing aid starts to whistle, or that the mould or tubing is blocked by earwax. This can affect the level of sound that you hear.

  • If you experience a sudden change in hearing that is not thought to be the result of earwax build up, it is important to contact your GP surgery.
  • If you have significant ear pain and itching or notice discharge from your ears this could be signs of an ear infection so you will need to seek GP advice.

What can you do about earwax build up?

If you have NO recent ear infections (within the last 6 weeks), perforations (a hole in your eardrum), past ear surgery or cleft palate history you can use olive oil in your ears to help soften the earwax.  If you do have a history of frequent or recent ear infections, perforations, cleft palate  or had ear surgery please contact your GP surgery for advice.

It is important that you DO NOT use cotton wool buds or any other device in your ear as there is a risk of damage or pushing the wax down further down, which then becomes more difficult to treat.

You will need to purchase olive oil (for your ears) from your local chemist. It is usually available as drops or a spray. The spray may be easier to use. Warming the olive oil is not advised and it should be used at room temperature.

How to use olive oil in your ears:

  • Lie on your side with the affected ear facing upwards. Pull the ear gently backwards and upwards to open and straighten the ear canal. This will allow the drops to enter deeper into the ear.
  • Carefully let three droplets of olive oil fall into your ear (or three sprays if you are using a spray olive oil product). You may find it helpful to have somebody help you. Gently massage the area directly in front of the ear.
  • Lie still for at least five minutes to ensure the olive oil drops have penetrated properly.
  • If you need to treat both ears, turn over onto your other side and repeat the process. DO NOT insert cotton wool or tissue paper into your ears as this can absorb the oil, leaving the wax dry and hard.

Earwax build up in children

If you have a child aged 5 years or over with earwax build up, you can treat them as outlined above using olive oil. If your child starts to develop ear pain during treatment then stop and seek GP advice. If their hearing is affected and this has not resolved with olive oil use, you can arrange an appointment to see an Advanced Audiology practitioner at your GP surgery where this service is available. If your GP surgery does not have an Advanced Audiology service, please discuss your child’s hearing concerns with their GP, as referral to a specialist service may be required.

If your child is under 5 years of age please contact your GP surgery for advice. If there are hearing concerns, referral to a specialist service may be required.

When to seek further advice

If you have been using olive oil as outlined above for 7 days and your symptoms have not improved you should contact your GP surgery for advice. In some cases, an appointment with a professional trained in earwax removal may be offered.  

NHS Earwax removal service

We are in the process of setting up a new earwax removal service. Earwax removal will be performed by an Audiologist and the service will be developed over the next three years. If the service is not yet available in your GP surgery, they can advise you on other local options for wax removal.

Find out if this service is available at your local GP surgery:

If you live in North Powys, please see the Powys Teaching Health Board website for advice on earwax removal 

How to book an appointment

You can book a wax removal appointment directly with GP surgery reception staff if the service is available at your surgery.  If the service is not yet available, reception staff will be able to signpost you to other NHS services or discuss further options.

How is earwax removed

There are three methods of earwax removal in cases where self-management has not been successful or was not advised in the first place due to other ear related problems.

Manual removal

This is using a small instrument to remove wax from the ear without the need for any other equipment. Ideal in cases where the wax is quite dry but not hard, and not too close to the ear drum.

Irrigation

This is where water is used to flush wax out of the ear canal. The equipment required to do this has been designed for this purpose.  In people where there is a history of ear infections, perforation (a hole in your eardrum), cleft palate or past ear surgery, irrigation is not advised. Irrigation to remove wax is the common method used by district nurses and some GP practice nurses.

Micro-suction 

This is where air is used to remove wax from the ear canal by suction  The equipment required to do this has been designed for this purpose. A plastic tip is inserted into the ear canal to protect it and a suction probe is used to remove the wax. This method is safe for patients who have had perforations and some ear surgery, or had recent infections. Audiologists working in the new wax removal service are all trained in micro-suction.

With all procedures the wax must be softened before it can be removed so regular use of olive oil beforehand is advised. 

Does wax removal hurt

Providing the wax has been softened beforehand the procedure should be painless. If the wax is too hard you will be advised to carry on with olive oil drops. Most people are able to have the procedure performed without any problem at all, while some people have very sensitive ear canals. At any point if you experience discomfort and want to stop,  you can notify the person performing the procedure.

What should I do after earwax removal?

If your hearing has improved then no further action is required and you can continue to use olive oil drops or spray at least once a month to help with future wax build up issues.

If your hearing has not improved you should contact your GP surgery for advice.