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Ear Wax Management

Female placing ear drops in child
What is ear wax?

Ear wax is naturally produced by a gland in the ear canal to keep ears clean and free from germs and infections. It is composed of old skin cells, dust, and oil from glands in the ear.


What should I do about ear wax build up?

If ear wax is not causing you any problems, it is best left alone. The ear is self-cleaning and often the wax will come out without you needing to do anything.

Sometimes ear wax can build up enough to cause hearing loss and other problems.

Wax build-up is more likely to happen to people who naturally have narrow ear canals, people who work in dusty environments, those who need to use ear plugs to protect their hearing at work, and hearing aid users.

The first step in treating problematic ear wax is to soften the wax to see if it comes out by itself, and to make removal by a health professional easier if that is required. If softening the wax is unsuccessful, you may decide to seek wax removal by a healthcare professional.

This service is available free from NHS Wales – please seek further advice.

Symptoms or problems that may require ear wax management include:
  • Discomfort / earache / itching
  • Your ear feeling blocked or full
  • Hearing loss
  • Tinnitus (noise in your ears)
  • For hearing aid users, wax that prevents examination or treatment, or causes your hearing aid to “whistle”.
When should I seek immediate help?

Sometimes sudden and significant changes in hearing loss can be caused by things other than ear wax build up. If you experience a sudden significant change in hearing that you feel is not related to ear wax build up, please contact your GP practice.

DO NOT self-manage if:
  • You have sudden or rapid hearing loss (see previous point on when to seek immediate help)
  • You have significant pain or discharge from either or both ears
  • You have a past history of perforation of the ear drum
  • You have had an ear infection within the last 6 weeks (unless otherwise advised by a clinician)
  • You have a history of cleft palate or ear surgery
  • You have ever been advised by healthcare professional to avoid getting water in your ear.

If you are in one of the above groups please contact your GP practice.

Parents and/or guardians of children five years of age or older should supervise and carry out treatment on children, using the self-management advice below.

Babies and children four years of age or younger should be referred to their local health board audiology department.

DO NOT follow self-management for babies and children four years of age or younger.

Self-management of ear wax

DO NOT try to remove with a cotton bud or any other object as this can damage your ear and push the wax further down the ear onto the ear drum, making the problem worse. Using cotton buds, matchsticks or other items to try to clean out the ear canals is one of the most common causes of impacted wax. Using cotton buds or other objects can also damage the ear canal, and can even cause perforation of the ear drum.

DO NOT purchase or use wax removal devices or ear candling kits – these are not effective at treating problematic ear wax, and can cause serious injuries.

DO use olive oil ear drops once a day for seven days in order to soften wax.

To use ear drops:

Allow the olive oil to come to room temperature naturally.

DO NOT heat the oil.

Lie on your side with the affected ear facing upwards. Pull the ear gently backwards and upwards to open and straighten the ear canal. This will allow the drops to enter deeper into the ear.

Carefully let three droplets of olive oil fall into your ear. You may find it helpful to have somebody help you.

Gently massage the area directly in front of the ear.

Lie still for at least five minutes to ensure the ear drops have penetrated properly.

If you need to treat both ears, turn over onto your other side and repeat the process.

DO NOT insert cotton wool or tissue paper into your ears as this can absorb the oil, leaving the wax dry and hard.

If your symptoms persist after seven days, contact your local health board for advice on booking an NHS appointment to have your ears examined and appropriately treated.


Wax Removal Self-Referral Form

Downloadable Self-Referral Forms