How to get rid of earwax at home

What? … say that again. While a blocked nose can be annoying, blocked ears stuffed up with wax is maddening. Not just for you but for everyone you’re conversing with. One in five people suffer from an overproduction of earwax, leading them to spend hours of their lives digging into their lugholes to claw out lumps of the stuff. 

For those people (and those who’ve been swimming lately or suffered an ear infection) sometimes a professional is needed to clean out the ears. Unfortunately, it’s nigh on impossible to get help from your GP nowadays.

In fact, in 2019, earwax removal services, formerly free to access at GPs practices, were removed from the roster of ‘core services’ GPs were obliged to provide. And now, five years later, the Royal National Institute for Deaf People (RNID) has uncovered a postcode lottery as to whether those who need the treatment can get it. 

The charity estimates 10 million people in England have lost access to earwax removal services, with seven areas in England (Birmingham and Solihull, Cornwall and Scilly Isles, Dorset, mid and south Essex, north-west London, south-west London, Suffolk and north-east Essex) entirely without the service. 

NHS commissioners have argued that the practice is too expensive to continue with, though some doctors disagree and say the small cost of ear cleaning could save the NHS a fortune in the long run. 

“People with excessive amounts of earwax lose their balance, so you get a lot of people falling. They can lose their hearing which affects their social wellbeing, and we all know there is a strong link between hearing loss and the progression of dementia,” says Dr Riaz Rampuri, an ear, nose and throat (ENT) doctor and owner of Auris Ear Care, a private London-based at-home ear care service. “It’s a small cost, yes, but the savings to the NHS in the long-term could be enormous.”

More pressingly, the RNID has shared its concerns that those who can’t afford private earwax removal – which can cost up to £100 – may turn to “dangerous self-removal methods”. 

But earwax is nothing to fear. It’s a perfectly natural and rather helpful bit of human biology which protects our ears and hearing. Given that our ears are one of the most delicate parts of the human anatomy (the smallest bones of the body are found in the inner ear) it’s vital that we all take care to look after our lugs, and wax is their natural means of doing so. 

What is earwax and why does it build up? 

“Earwax and skin debris are produced naturally by the outer part of the ear canal and is pushed out of the ear by the action of chewing and the hairs of the ear canal pointing outwards,” explains Paul Montgomery, a consultant ENT surgeon at King Edward VII’s and the Cromwell hospitals. 

The substance, which is a combination of fat, cholesterol, and oil is perfectly healthy. “Earwax is good for your ears because it traps dirt and dead skin and moves it out of the ear, lubricates the ear canal to prevent the skin from drying out and the acidity of earwax gives it anti-bacterial and anti-fungal properties,” Montgomery continues. “Nevertheless, if you have too much wax in your ears it is irritating and makes you feel slightly deaf.”

For most people, earwax is something best left to nature, but for around 20 per cent it can become a problem. Genetic factors can cause some people to produce more earwax than others, while skin conditions such as psoriasis and eczema in the ear can stop it from being pushed out as effectively. Additionally, those with narrow ear canals can face a build up.

If you’re one of the one in five who may need extra help, you’ll know about it. “People who complain of excess amounts of earwax typically have symptoms such as itchiness, a degree of hearing loss, some balance issues, and when it gets really severe, they’ll complain of pressure symptoms, in either the left, right or both ears. That may be associated with tinnitus which is like ringing in the ear – that happens especially if you have earwax sitting on your ear-drum – and even some pain and increased ear infections,” explains Dr Rampuri.  

How to get rid of earwax

It’s important to be exceedingly careful when treating ear wax build up “because the structure of the ear is so delicate,” says Dr Rampuri. “You can perforate your ear drum which can cause infections and permanent deafness. Also, if you keep using cotton buds, fingers, or keys to itch and clean your ears, then a layer of squamous epithelial cells which exists to push out ear wax gets damaged and those will stop your ‘conveyor belt’ from functioning.”

If ear wax builds up it can dry out and get lodged in the ear. The aim of most treatments is to soften it so the cells which line the ear can push it out. There are various means of doing so, but their efficacy varies. 

Warm oil

“Warm olive oil has historically been thought of as the best way to soften ear wax,” says Dr Rampuri. “It will work and shouldn’t cause too much harm, but it does need to be used for two to four weeks. Over that time you see some patients develop ear infections because it creates a warm, moist environment in the ear which can cause bacteria to grow.

“It can also expand the wax and if you don’t remove it straight away it can cause pressure symptoms and deafness. While I’ve never seen someone using oil that’s too hot, it could easily burn the ear and destroy the cells which make earwax if it was.” 

Ear candling, warm water, or hot compresses

“These are among the cheapest means of removing wax from your ears in theory,” says Dr Rampuri. “The idea is that the heat will melt the wax and allow it to be removed naturally. Anecdotally, I know patients who find these things therapeutic, particularly those for whom the build-up of wax is causing them pain, but there’s no evidence to say they actually work.”

Over-the-counter medications

There are various over-the-counter medications which have been used to soften ear wax. Historically, uric acid was used to melt the wax but nowadays, these tend to be drops of olive oil, sodium bicarbonate, or hydrogen peroxide. Dr Rampuri advises against the latter, in spite of some GPs recommending it. 

“Hydrogen peroxide is very corrosive so it does a great job of breaking down the wax, but it also breaks down the skin so I often see patients who’ve used it with very inflamed ears which lead to ear infections.” 

Both Montgomery and Dr Rampuri and say they personally use sodium bicarbonate drops. “I’d use three to four drops, twice a day, for five days,” recommends Montgomery. 

“Lie down on your side with your ear facing upwards, pull the outer ear backwards and upwards (just backwards in children). Put three to four drops into the ear canal and then massage the skin just in front of the entrance to the ear canal to enable the drops to run down the ear canal more easily. Stay lying down for five to 10 minutes and then get up and wipe away any excess fluid with a tissue. Do not put cotton wool in the ear following the drops as this absorbs the fluid and prevents the wax coming out.”

When to see a professional 

If you have really narrow ear canals, typically any softening agent won’t work,” says Dr Rampuri. “If your earwax is complicated by a recurrent ear infection or it’s just very, very tough or hard in nature, then softening drops won’t work. For the general patient, I’d recommend three to five days of trying a softening agent like sodium bicarbonate before getting some professional help.” 

There are two main techniques used by professionals to remove ear-wax: electronic irrigation and micro-suction. 

“With an electronic ear irrigation system, a tube is placed into the outer part of the ear canal and an electric motor irrigates water, at body temperature, into the ear under low pressure to soften and irrigate out the earwax,” says Montgomery. “Micro-suction involves a very small suction tube placed into the ear canal using a microscope and “Micro-suction involves a very small suction tube placed into the ear canal using a microscope and the wax is ‘hoovered’ out.”