There are some scenarios where earwax should be treated proactively, such as earwax totally blocking the ear canal. Other symptoms that should lead to earwax treatment are if there is vertigo, hearing loss, earache, ringing in the ear (tinnitus), or a cough that is thought to be caused by earwax.
Earwax should not be treated if there is any possibility that there could be a perforated eardrum. Normally this would be suspected if there were symptoms of sudden pain, hearing loss and fluid draining from the ear.
Self-treatment can start with ear drops such as olive oil used up to four times a day. Another option if this has not helped after one week is to stop the oil drops and change to sodium bicarbonate drops for a further 3 to 5 days.
You should lie on your side with the ear facing the ceiling, and insert room temperature ear drops and remain in position for five minutes. You should not put cotton wool in the ear after olive oil has been inserted, as it can soak up the oil and reduce the effectiveness of the drops.
When instilling the ear drops, there are possible side effects, such as mild pain, dizziness, short-term hearing loss, and irritation to the skin.
If after 2 weeks there is little improvement, then the next step would be ear syringing or micro-suction which can be done to get the softened wax out. Although ear syringing is performed by many doctors, Healthwords prefers micro-suction due to reduced risks of complications.
Micro-suction is performed by looking at the wax and sucking it out of the ear canal, whereas syringing is performed without visualisation during the procedure, and some studies have shown an increased risk of eardrum perforation and complications (thought to be around 1 in 1000 rate of complications for syringing when performed in primary care). Micro-suction would be available if your doctor referred you to the Ear, Nose and Throat hospital team, or alternatively, it is available privately.
You should book a routine appointment with your doctor or practice nurse if you have tried 1 - 2 weeks of ear drops and think you may need another intervention to get rid of the wax. If you would like the wax removed under direct vision via micro-suction, you can book this privately and it is usually performed by highly experienced audiologists.
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