RNID: For deaf and hard of hearing people.

About this factsheet

This factsheet is part of RNID's medical range. You will find it useful if your GP has suggested that you have your ears syringed and you would like to find out more.

Read this factsheet to find out:

What is ear wax?

Ear wax is also known as cerumen. It is made up of oil and sweat secreted from glands in your outer ear canal, scales from your skin and dust particles.

Ear wax helps to keep your ears healthy. It is anti-fungal and anti-bacterial. Some people feel that they should have their ears cleared regularly, but there is usually no need for ear wax to be cleared. You do not need to wash, scrape or poke wax out of your ears because the wax, along with the skin, usually falls out without you noticing it.

Your external ear canal keeps itself clean using a natural process, involving ear wax. It takes about two weeks for skin to move outwards from your eardrum to your external ear. This process goes on all the time and means that your ear canal is continually developing a new lining.

What causes wax blockages?

Occasionally, wax can build up in your ear canal and cause a blockage. A number of things may cause this.

You may find that ear wax is more of a problem if you:

  • have narrow ear canals
  • work in a dusty or dirty environment
  • wear earplugs a lot.

If you use a hearing aid, the earmould may interfere with the natural process of skin and wax moving out of your ear. This can cause wax to build up in your ear canal.

Poking or scraping your ear canal with a finger, a cotton bud or towel can push wax further down your ear canal and actually encourages your wax glands to produce more wax.

Looking after your ears

You can help to prevent wax blockages forming in the first place by looking after your ears.

  • Never poke anything in your ears such as fingers, cotton buds or matches.
  • Try to avoid very dusty, dirty or smoky places as these things can combine with wax to form a blockage.

What is tinnitus?

Tinnitus is the word for noises that some people hear in the ears or in the head - buzzing, ringing, whistling, hissing and other sounds.

Is there a link between a wax blockage and tinnitus?

If you have tinnitus already, and your ear gets blocked with wax, you may notice your tinnitus more. Once the blockage is removed, your tinnitus should return to its previous level. This may take from a few days to a few weeks. If you were not aware you had tinnitus, the wax blockage may reveal a very mild tinnitus noise that you had not heard before. This normally goes away once the wax blockage has gone. Is there a link between a wax blockage and hearing loss?
A wax blockage may give you a mild, temporary hearing loss. For this to happen the wax has to completely block the canal or press on the eardrum.

Some people ask their GP to syringe their ears again and again, because their hearing is not what it used to be. In most instances, they do not have any wax blockage to remove. If you often have difficulty hearing the television or radio, or you miss words in conversation, you may have a hearing loss caused by a condition in the middle or inner ear, rather than excess wax in your ears. In this case, your GP can refer you for a hearing test.

Most people have some wax in their ear canals, but if it is not actually blocking the ear canal or affecting your hearing, it will not need to be removed.

Should I remove a wax blockage myself?

If you think you have a wax blockage in one of your ears, see your GP. Do not poke anything into your ear canals. Do not use eardrops, unless your GP or ear specialist has prescribed them.

It is possible to buy products designed to help soften your ear wax. Some of these products may actually irritate your ears and cause otitis externa (inflammation or swelling in the ear canal).

Never use drops if you know your eardrum is perforated. It is often difficult to tell if your eardrum is perforated, so if you are in any doubt, do not put drops into your ear.

Some people recommend using olive oil or sodium bicarbonate - which can be bought over the counter - to soften the wax, if you have a history of wax blockages. Again, if you suspect your eardrum is perforated then do not use these treatments.

If you do decide to use olive oil or sodium bicarbonate, they may help the wax to work its way out of your ear. Use two to three drops per day in the ear that is blocked, for a maximum of 10 days, and then contact your GP to have your blocked ear examined. If your GP suggests that you have your ears syringed, the wax may come out more easily because you have softened it.

What does ear syringing involve?

Ear syringing should be carried out with a pulsed water-jet system using a narrow tube connected to an electric pump, particularly the first time your ears are syringed.

You may find that some medical practitioners still use a metal or chrome syringe, which looks like a small bicycle pump. A nurse will use an auroscope before and after syringing to check the condition of the ear. The metal syringe and pulsed water-jet system both use water to try and move the wax and clear the ear. But the use of a metal syringe is no longer a recommended method, as it is much less controlled than using a pulsed water-jet system, and it has been known to damage people's ears.

Although you may find it difficult to question the doctor, make sure you find out what method they will use to syringe your ears before syringing takes place. If the doctor is going to use a metal syringe, you should say quite firmly that you want them to use the pulsed water-jet system. You should also feel free to get a second opinion.

Other ways of removing wax

A doctor or nurse using a 'dry' suction clearance method, wax hook, curette or probe can also remove wax. This is usually only done at the ear, nose and throat (ENT) department in a hospital and the nurse will normally use an auroscope before and after the procedure to be really safe.

You may find that alternative therapists suggest using "ear candles" to remove wax. There is no evidence to suggest that they work. You should also be aware that they could be dangerous because they involve a lighted candle burning very close to your ear.

It is important that before you have your ears syringed, you let the doctor or nurse know:

  • if you have had infections of, or injuries to, your ears
  • if you have had surgery on your ears in the past
  • if you have tinnitus or hearing loss
  • if you have a weak or perforated eardrum
  • if previous ear syringing was not straightforward
  • if you have any anxieties or questions about syringing.

Are there links between ear syringing, ear problems and tinnitus?

Unfortunately, very little research has been done into any links between ear problems, tinnitus and ear syringing. But in the vast majority of cases, having your ears syringed to remove a wax blockage is a painless, harmless and highly effective procedure. The wax is removed and if you have been experiencing a slight hearing loss, your hearing returns to normal.

Some medical practitioners feel that ear syringing should not be carried out unless strictly necessary. It is important to remember that your hearing loss or tinnitus might not be the result of a wax blockage but could be caused by something else.

Some people believe that their tinnitus either started or was made worse after having their ears syringed. Most doctors believe that if the correct syringing technique is carried out on healthy ears, it should not lead to tinnitus or make existing tinnitus worse.

Research also suggests that when the ear has been damaged by syringing, it is more likely to have been caused by medical practitioners who have not carried out syringing correctly and/or have failed to get a full medical history before syringing. Some possible causes of problems are:

  • poor technique, for example, if the water is directed at your eardrum, not at the roof of your ear canal
  • faulty equipment - for example, if the nozzle of the metal syringe is not checked before use, it could come off during syringing
  • failure by the person carrying out the syringing to get a full medical history, to examine you properly or to ask you about possible complications. For example, a doctor or nurse should not syringe your ears if you have otitis media, or if you have had a chronic middle ear disease or a perforated eardrum in the past. You should tell them if you have had any ear problems before they start the syringing, not afterwards.
  • very rarely, the tip of the syringe can scrape the skin of the ear canal. This can be painful and very occasionally can cause an infection of the skin in the ear canal (otitis externa).

If you think syringing has not cleared your wax blockage

If your ears have been syringed and you do not feel the wax blockage has cleared, go back to your doctor and discuss it. In a very few cases, ear syringing may not be effective in removing wax.

Where can I get further information?

British Tinnitus Association

The British Tinnitus Association campaigns for better services for people with tinnitus. It supports a network of local tinnitus groups around the country, has a range of publications and produces a quarterly magazine called Quiet.

British Tinnitus Association, Ground Floor, Unit 5, Acorn Business Park, Woodseats Close, Sheffield S8 0TB
Telephone: 0800 018 0527
Fax: 0114 258 7059
Email: info@tinnitus.org.uk
Website: British Tinnitus Association (external link, opens new browser window)

Further information from RNID

If you want to find out more about tinnitus, we have a range of publications available. Have a look at our tinnitus factsheets and our leaflet "The facts: tinnitus". We also sell a book "Understanding tinnitus – managing the noises in your ears or in your head" and a range of relaxation CDs and cassettes.

RNID Tinnitus Helpline

The RNID Tinnitus Helpline offers information and advice to people with tinnitus, their families and friends and the professionals who work with them. You can contact us for printed copies of this factsheet and the full range of RNID information factsheets and leaflets.

RNID Tinnitus Helpline, 19-23 Featherstone Street, London EC1Y 8SL
Telephone: 0808 808 6666
Textphone: 0808 808 0007
Fax: 020 7296 8199
Email: tinnitushelpline@rnid.org.uk

Acknowledgement

This factsheet was produced with the help and advice of:

  • Philip J Robinson FRCS, FRCS (Otol), Consultant Adult and Paediatric Otolaryngologist at the Department of Otolaryngology, Southmead Hospital, Bristol.
  • Anthony Wright, Professor of Otolaryngology, Institute of Laryngology and Otology, University College London, London.