Wax blocking the ear canal causes muffled hearing, fullness and sometimes ringing. Microsuction clears it under direct vision in about 20 minutes, without water. Softening drops for 3 to 5 days beforehand make it quicker. Removal is £195 for both ears.
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Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
Ear wax is produced by the outer third of the ear canal and normally moves out on its own. It becomes a problem when it fills the canal and blocks sound, which causes muffled hearing, a feeling of fullness, and sometimes ringing.NICE NG98, 2018
Impaction is more common in people who use earphones or hearing aids, in narrow or hairy canals, and in anyone who uses cotton buds, which push wax inwards rather than removing it.ENT UK ENT UK position paper, 2023
Muffled hearing that came on gradually, a blocked feeling, ringing, and sometimes a cough from irritation of the canal. It does not cause pain, and pain in a blocked ear points at infection instead.ENT UK ENT UK position paper, 2023
Sudden hearing loss in one ear over hours or days is not wax and is an emergency. So is hearing loss in one ear alongside a blocked nose on the same side, which is a head and neck referral rather than a wax appointment.NICE NG12, 2015
Send us what you are seeing and we will tell you what it is likely to be.
The canal and the drum are examined before anything is done. That is what separates wax from infection, from a perforated drum, and from hearing loss that has nothing to do with the canal at all.NICE NG98, 2018
Hearing loss is the fourth commonest cause of disability worldwide and most of it goes untreated for years. So an ear that is still muffled once the wax is out gets an audiogram rather than a second appointment for more suction.World Health Organization WHO report, 2021
Where hearing does not return after the wax is cleared, that is followed up rather than assumed. Persistent hearing loss on one side is assessed rather than watched.NICE NG98, 2018
Softening drops alone
Olive oil or sodium bicarbonate drops for 3 to 5 days clear a proportion of blocked ears without any procedure. The evidence for drops is limited and low quality, and they are still the cheapest first step and worth 5 days.Cochrane Database of Systematic Reviews Aaron, 2018
Irrigation with water
Flushing the canal. It cannot be used where the drum is perforated, where there has been ear surgery, or where the ear is infected, and it is done without seeing what is being removed.ENT UK ENT UK position paper, 2023
Microsuction
Wax removed with a fine suction tube under a microscope, with the canal in view throughout and no water used. It is what is done here, and it is the method used where the drum is perforated or the ear has had surgery. The noise and what it will feel like are explained before it starts.General Medical Council GMC guidance, 2020
Doing nothing
Wax that is not blocking the canal and not affecting hearing does not need removing. Ears are self cleaning, and treating wax that is causing nothing is a procedure for its own sake.NICE NG98, 2018
Hearing usually returns immediately once the canal is clear. The appointment takes about 20 minutes for both ears, and there is nothing to recover from afterwards.ENT UK ENT UK position paper, 2023
The inconvenient half. If hearing does not come back once the wax is out, the wax was not the whole problem. That happens, it is why the drum is examined afterwards as well as before, and it is why we would rather find it in the room than send you away pleased.NICE NG98, 2018
Wax comes back in people whose ears make a lot of it, and there is no procedure that prevents that. Once or twice a year is a normal interval for some people, and more often than that is worth a conversation about why.Cochrane Database of Systematic Reviews Aaron, 2018
Use olive oil drops twice a day for 3 to 5 days before the appointment. Two or three drops, lie on your side for 5 minutes afterwards. It softens the wax, shortens the procedure and sometimes clears the ear entirely, which costs you a bottle of oil rather than an appointment.Cochrane Database of Systematic Reviews Aaron, 2018
Stop using cotton buds today. They push wax deeper into the canal and are the most common reason it becomes impacted in the first place. Nothing smaller than your elbow goes in your ear is an old line and it is correct.ENT UK ENT UK position paper, 2023
Check one thing before booking. If the hearing went suddenly, over hours or a day or two, do not wait for a wax appointment. Sudden hearing loss in one ear needs assessing urgently, and treated early it does better than treated late.NICE NG98, 2018
Do not buy ear candles. They do not remove wax, they have caused burns and canal damage, and the residue people point to afterwards is the candle rather than the ear.ENT UK ENT UK position paper, 2023
Do not book a removal before trying 5 days of drops. A proportion of blocked ears clear on drops alone, and telling you that costs us the £195 appointment more often than it does not.Cochrane Database of Systematic Reviews Aaron, 2018
Step 1
The canal and the drum, before anything is done, so wax is separated from infection, from a perforation and from hearing loss that is not in the canal.
Step 2
Microsuction with the canal in view throughout, no water, about 20 minutes for both ears.
Step 3
If it has not come back, that is followed up rather than left. The wax not being the whole answer is the finding that matters most.
Ask before you book if you are not sure this is the right appointment.
Microsuction is £195 and covers both ears in one appointment, including the examination before and the check afterwards. A child’s appointment is £245 because more time is allowed. Treating an infected canal is £295.
No, though it is loud. A fine suction tube is used under a microscope with the canal in view throughout. Most people describe it as noisy rather than painful, and it takes about 20 minutes for both ears.
Yes. Olive oil or sodium bicarbonate drops twice a day for 3 to 5 days soften the wax and shorten the procedure. A proportion of ears clear on drops alone, which is a bottle of oil instead of an appointment.
It is done under direct vision without water, so it can be used where the drum is perforated, where there has been ear surgery, and where the ear is infected. Irrigation cannot be used in any of those and is done without seeing what is being removed.
Hearing that went suddenly over hours or a day or two is not wax and needs urgent assessment, because treated early it does better than treated late. Ear pain with discharge, fever, or swelling behind the ear also needs seeing the same day.
Because the wax was not the whole problem. That is why the drum is examined after the procedure as well as before it, and why persistent hearing loss on one side is followed up rather than watched. It is better found in the room than at home.
Some people produce a lot of wax and need it once or twice a year, and no procedure changes that. More often than that is worth a conversation about what is driving it, including earphones, hearing aids and cotton buds.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
Cochrane Database of Systematic Reviews
Ear drops for the removal of ear waxAaron, 2018
ENT UK
Ear wax removal, position paper and patient informationENT UK position paper, 2023
General Medical Council
Decision making and consentGMC guidance, 2020
NICE
NICE
World Health Organization
World report on hearingWHO report, 2021
Written by the clinical team at The Wellness. Awaiting clinical sign off.
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