Ear Care Advice

What is ear wax?

Wax is normal – it protects and lubricates the ear canal. It is a mixture of Cerumen (a sweatlike substance) and Sebum (an oily substance) both secreted by glands in your ear canal, which combines with dust, debris, hair etc. to form ear wax. It is normal to have ear wax, and it usually only becomes a problem when it has been pushed deeper into the ear canal.

Your ears are self-cleaning – if you use cotton wool buds or similar objects to try to remove the wax, it will only be pushed further into the ear canal, become impacted and block your ear.

Advice to help you manage and prevent ear wax blockage

Ear wax only becomes a problem if it causes deafness or discomfort, or if your health professional requires a clear view of your ear drum.

If you experience any of the following, you should seek advice from the nurse or GP:

• Pain
• Discharge or bleeding from the ear
• Sudden deafness or buzzing
• Foreign bodies in the ear
• Dizziness

If you are not experiencing any of the above the safest treatment is to use olive oil or sodium bicarbonate drops available from any community pharmacist or chemist.

Why is my ear blocked with wax?

The amount of ear wax produced varies from person to person. You are more likely to develop a blockage of wax in the canal if you:

• Use cotton buds to clean the ear as this pushes the wax deeper into the canal
• Wear a hearing aid, ear plugs or use in- ear speakers for i-pods etc, as these can all interfere with the natural process of wax expulsion
• Have abnormally narrow ear canals
• Have a particularly hairy ear canal
• Are elderly – because the ear wax you produce is drier and harder
• Have a dry skin problem such as eczema or psoriasis - keeping your ears dry will improve this condition

The easiest way to keep ears dry when bathing/ showering is by using a small piece of cotton-wool smeared in Vaseline/petroleum jelly.

How to remove earwax – ear drops

DO NOT use ear drops if there is any chance you have a perforated ear drum or grommets.

There is no clear evidence to suggest the best type of ear drops for everyone, or how frequently they should be used. Impacted earwax is very hard and dry so needs to be softened and lubricated to encourage the natural movement of wax from the outer ear.

Olive oil ear drops

Though not proven, this is the medical professional preferred method of treatment as it is harmless and often very effective. Carry out treatment for 10 to 14 days to see full effects.

Sodium Bicarbonate drops

Can also be used if the olive oil methods have failed to relieve the blockage. They dissolve the wax leading to easier removal of the excess wax from the outer ear. Again, these drops can cause discomfort so make sure to read instructions thoroughly before use.

Ear drops should be at room temperature before use.

Note

Sodium bicarbonate drops are better for dissolving stubbornly hard wax but should not be used for more than a few days to 1 week as it may result in irritation to the skin.

If you still feel that you have wax after 1 week of using sodium bicarbonate, then you may continue using a further 3 weeks of olive oil.

How to apply ear drops

The following needs to be done 2 to 3 times daily for at least 14 days:

1. Lie on your side with the affected ear uppermost
2. Pull the outer ear gently backwards and upwards to straighten the ear canal
3. Put 2 to 3 drops of olive oil into the affected ear and gently massage just in front of the ear
4. Stay lying on your side to allow the wax to soak in for around 5 minutes
5. Afterwards, wipe away any excess oil but do not plug your ear with cotton wool as this simply absorbs the oil

Your hearing problem may initially worsen after first starting to use olive oil so we advise you to concentrate on treating one ear at a time if both ears are blocked with wax. In most cases after 14 days the wax will have softened sufficiently to encourage the wax to come out without further intervention.

If at any time you are experiencing pain, worsening deafness or an unpleasant smelling discharge you should stop using the drops and consult a doctor or nurse at the surgery.

Please note that ear syringing is no longer recommended as a way to treat ear wax due to the potential risk of complications.

If you think you have persisting wax despite taking the above measures please make an appointment with your doctor or nurse to discuss.