Guidelines for managing earwax

Ear wax is a normal build-up of dead cells, hair, foreign materials such as dust and natural wax which forms a protective coating on the skin in the ear canal. The quantity of earwax produced varies greatly from person to person. 

A doctor or nurse can look in to the ear canal and confirm a plug of ear wax has formed. A plug of earwax is not a serious problem, more a nuisance. You only need to remove earwax if it is causing symptoms such as dulled hearing or when fitting a hearing aid. 

How to remove ear wax:

Important:  If you think you have ear wax, do not try to clean the ear canal with cotton wool buds. This can make things worse, as you will push some earwax deeper inside. It may also cause an ear infection.

Ear drops:

Ear drops alone will clear a plug of ear wax in most cases. Put 2/3 drops of ordinary olive oil down the ear 2/3 times a day for 2/3 weeks. This softens the wax so that it then runs out of its own accord without harming the ear. You can continue for any length of time, but 3 weeks is usually enough. Surprisingly, you will not necessarily see wax come out. It often seems to come out unnoticed. 

If you are prone to repeated wax build up you can continue to use olive oil drops twice a week to prevent recurrence. 

If olive oil does not work you can buy sodium bicarbonate drops from pharmacies. 

 How to use ear drops:

  1. Warm the drops to room temperature before using them
  • Pour a few drops into the affected ear
  • Lie with the affected ear uppermost when putting in drops
  • Stay like this  for 10 minutes to allow the drops to soak into the ear wax

Bulb syringing:

Bulb syringing is a safe, alternate way to remove ear wax.

Bulb syringes can be easily purchased from a pharmacy and allow you to clear your ears from wax in your own home.

If your ears are painful or have fluid coming out of them, or If you have a hole in the ear drum (perforation) or have recently had surgery on your ear you should see a doctor or nurse and don’t use this method. 

Instructions for Bulb Syringing:

Use olive oil drops twice a day for at least 14 days prior to bulb syringing. Or alternatively use sodium bicarbonate ear drops purchased from your pharmacy (please read the manufacturers leaflet). 

  1. Wash your hands.
  • Use a bowl of cooled water that is warm to the touch, not to hot or too cold
  • Prepare the syringe by squirting water in and out of it a few times
  • Gently pull your upper ear ‘up and out’ to help straighten out the canal, which will allow better access for the water
  • Tilt your head so the ear to be treated is upmost
  • Place the tip of the syringe into the opening 
  • Allow the water to remain in your ear for at least 60 seconds. Gently tilt your head in the opposite direction and wiggle your outer ear

Still no improvement?

Only after completing the above self-care treatments for at least 3 weeks with no improvement will the surgery be able to offer you an appointment with a clinician to review your ear(s) and decide the best course of action. The surgery will hold specific clinics routinely each month and will operate a waiting list system for this service.

At this appointment your clinician will assess your ears and discuss the treatments you have already tried and then decide the most appropriate course of action which may include Ear Syringing. If this is required, then this will be completed at this appointment and so it will be necessary for you to oil your ears for at least 5 days prior to attending to ensure that this is successful.

 Ear Syringing:

Ear syringing is only recommended in the rare occasions where ear drops and bulb syringing has failed to work. Ear syringing can lead to ear infections, perforated ear drum and tinnitus (persistent noise) and therefore it is only performed in exceptional circumstances.