Wax is a normal secretion which protects meatal skin and its removal is only needed if it causes deafness or prevents view of the eardrum.

Wax can be softened by simple remedies such as sodium bicarbonate or olive oil. Preparations containing organic solvents irritate meatal skin and, like ear syringing, are best avoided.

Give drops for 3-5 days to soften wax and aid removal. If symptoms persist, consider ear irrigation unless there is ear pathology, history of tinnitus or previous ear surgery. If unsuccessful the options are to continue with drops and try irrigation again in 3-5 days or refer to ENT for microsuction.

NHS England (NHSE) has published new prescribing guidance for various common conditions for which over the counter (OTC) items should not be routinely prescribed in primary care (quick reference guide). One of these conditions is the build-up of earwax.

Many of these products are cheap to buy and are readily available OTC along with advice from pharmacies. Some self-care medicines are available from shops and supermarkets. Please click here for further information, exceptions, and a patient leaflet.

Olive oil

• Ear drops (in a suitable container)

Indications

• Removal of ear wax

Dose

• Apply 3 drops 2-3 times daily

Notes

1. Allow to warm to body temperature by holding bottle for a few minutes before use

Sodium bicarbonate

• Ear drops (£1.25 = 10ml)

Indications

• Removal of ear wax

Dose

• Apply 3 drops 2-3 times daily for maximum of 5 days. Gentle irrigation or microsuction should then be used to remove the softened debris.

Urea-hydrogen peroxide

• Otex ear drops 5% (£3.41 = 8ml)

Indications

• Removal of ear wax

Dose

• Apply 5 drops once or twice daily

Notes

1. Only to be used on the recommendation of ENT specialists