Ear wax, also known as cerumen, is a natural substance produced by the ear with a crucial role. It helps to lubricate the ear canal, protecting the inner ear from dirt, dust, and bacteria, thereby reducing the risk of infections. When ear wax accumulates, it can cause discomfort, hearing loss, and a ringing sensation in the ears, a common symptom of tinnitus. So, does ear wax cause tinnitus? Yes, a build-up of ear wax can indeed lead to tinnitus, as it blocks the ear canal and interferes with normal hearing. The brain may interpret the pressure or blockage as sound, resulting in the perception of ringing or buzzing. This sound is internal, meaning it’s not audible to others. ear wax-related tinnitus is not uncommon, particularly among older adults, and it typically resolves once the excess wax is safely removed by a healthcare professional. Tinnitus affects around 15-20% of people and is more common as we age.
There are several reasons why ear ringing can be caused by ear wax, primarily due to the stimulation of nerves in the ear canal, which is linked to tinnitus. It's essential to understand that tinnitus itself is not a disease but a symptom indicating an issue with your auditory system. This system includes the auditory nerve, which connects the inner ear to the brain, and the parts of the brain that process sound, like the auditory cortex. When cerumen (ear wax) accumulates and becomes impacted, it can put pressure on the ear canal, stimulating the surrounding nerves. This nerve activity may be interpreted by the brain as sound, leading to the sensation of ringing in the ears. In some cases, the brain may even generate internal sounds to compensate for the blockage, causing what is known as cerumen tinnitus.
Common causes of ringing in ears related to ear wax include:
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Technically, yes, ear wax removal can help with tinnitus. If the ear wax is the primary cause of the tinnitus, the symptoms should subside once the wax is removed. However, it's important to note that tinnitus may also be a sign of an underlying issue, so the removal of ear wax may not always resolve the problem entirely.
If self-treatment for ear wax build-up doesn’t resolve the issue, it may need to be removed by a qualified healthcare professional. The NHS guidelines recommend two main methods for ear wax removal: electronic irrigation and micro suction ear wax removal. Some practitioners may also use specialised tools for manual wax removal and a combination of methods may be employed to ensure all the wax is safely cleared. It’s advisable to use wax-softening drops for up to five days before your appointment. If any part of the procedure causes pain or discomfort, inform the clinician immediately. In the past, manual syringing was commonly used to remove ear wax, but it is no longer recommended due to potential risks. Instead, electronic irrigators with controlled pressure are now used, which are gentler and safer.
In this procedure, warm water is used to flush out the wax. The water and wax are collected in a dish held under the ear. While it may create some noise, it shouldn’t be uncomfortable. However, it’s not suitable for those with a history of ear surgery, infections, or a perforated eardrum.
Microsuction has become a preferred method for ear wax removal in recent years. Using a high-powered microscope, the clinician gently suctions the wax out without the need for liquid. It’s generally safe and painless, even for those with a perforated eardrum, but can be noisy or slightly uncomfortable for some.
Clinicians may also remove wax manually with a headlight and handheld instruments. However, you should never attempt to remove ear wax yourself, as this could push the wax further in or cause injury.
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To remove ear wax blockage quickly and safely, it is essential to use methods recommended by medical professionals. The most effective and widely used method is the use of over-the-counter ear drops, typically containing hydrogen peroxide or carbamide peroxide. These ear drops help soften the wax, allowing it to naturally exit the ear. It is important to follow the instructions carefully to avoid irritation or further blockages. Another common method is irrigation, which involves gently flushing the ear canal with warm water using a bulb syringe or ear irrigation kit. This method can effectively remove wax, but it should be done carefully to prevent damage to the eardrum or ear canal. Irrigation should not be attempted if there is any sign of an ear infection or perforation in the eardrum. In cases where over-the-counter solutions do not work, seeking medical assistance is advisable. Healthcare providers can perform professional ear cleaning using specialized tools, such as a curette or suction device. These methods are quick and efficient but should only be performed by trained professionals to avoid injury.
It is important not to use cotton swabs or other objects to remove ear wax, as this can push the wax deeper into the ear canal and cause more significant blockages or damage.
Tinnitus and ear ringing after ear wax removal are common concerns. Tinnitus refers to the perception of sound, such as ringing, buzzing, or hissing, in the absence of an external noise source. Ear ringing after ear wax removal may occur temporarily due to the sudden change in the ear's environment. When ear wax is removed, the ear canal is exposed to more sounds, and the sudden removal of blockage can lead to an increased awareness of inner ear activity, causing temporary tinnitus. Tinnitus after ear wax removal can also occur if the ear wax was compacted and its removal caused minor irritation to the ear canal or eardrum. This irritation might stimulate the auditory nerves, leading to ringing or buzzing sounds. In most cases, this type of tinnitus subsides within a few hours to a few days as the ear adjusts to its normal state. However, if ear ringing persists for longer periods after ear wax removal, it may be a sign of an underlying issue, such as infection or preexisting hearing conditions. In such cases, it is recommended to consult a healthcare professional to assess the situation and determine if further treatment is needed.
The duration of tinnitus after ear wax removal can vary significantly from person to person, depending on the root cause of the tinnitus and the extent of the wax build-up. For some, the tinnitus may lessen or disappear entirely soon after the wax is removed, with improvement happening within hours to a few days as the ear canal clears and normal hearing is restored. However, if the tinnitus is not solely caused by ear wax (for example, if it’s related to other factors such as prolonged exposure to loud noise or age-related hearing loss), it may persist even after the wax has been removed. In such cases, the tinnitus may last longer and may require further treatment or management. If your tinnitus continues after wax removal, it’s important to seek further advice. Feel free to contact us and schedule an appointment to explore other potential causes and treatments.
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If your tinnitus began alongside other symptoms typically associated with ear wax build-up, the ear wax is likely the cause of your tinnitus. However, it’s always best to consult a qualified audiologist to confirm whether ear wax build-up is responsible for your tinnitus.
Should I try to clean the wax out myself?
If you have too much ear wax, you might be tempted to use a cotton bud or another object to clean your ears. This is risky and can lead to serious issues, such as perforating your eardrum or increasing the risk of infection. Inserting objects into the ear often pushes the wax deeper into the canal, potentially causing impacted wax. The pressure from impacted wax can stimulate nerve cells in the inner ear, causing the brain to misinterpret these signals as sound, resulting in tinnitus. Before reaching for the cotton buds, reconsider. Instead, refer to our guide on how to safely clean your ears without using cotton buds, and always seek professional help for proper ear wax removal.
You can treat ear wax at home, provided you don’t have any of the following conditions, in which case you should see your GP:
While it may be tempting to use cotton buds to remove ear wax, this can irritate the ear canal, stripping it of natural oils and causing itchiness. Cotton buds can also push the wax further in, potentially causing serious injury to the ear canal or eardrum.
Ear Wax Softening
Most people start with ear wax softening drops, which may help the wax move out naturally. There are many drops available, but some can be harsh, especially if you have sensitive skin or conditions like eczema or psoriasis.
Alternatively, olive oil can be used. Standard cooking olive oil works well, and it doesn’t need to be warmed before use. Using a dropper, tilt your head to one side and place a few drops into the ear, allowing them to move down the canal. Use a tissue to absorb any excess oil from the outer ear.
Two or three drops in each ear, twice a day for one to two weeks, is usually enough to clear the wax. Olive oil sprays are also available, offering better coverage and preventing the dropper from going too far into the ear. If you frequently experience ear wax build-up, using a couple of drops of olive oil once a week may help.
The National Institute for Health and Care Excellence (NICE) recommends that ear wax removal should be offered within the community. However, it is no longer a core service that GP practices are required to provide. It’s advisable to contact your GP to check if this service is still available in your area.
Many people are now directed to seek assistance from private providers. Costs can vary, and some private clinics may not offer all available methods of ear wax removal. If you choose to use a private service, ensure that the clinician is properly trained, qualified, and adheres to professional guidelines.
That said, it is important to see your GP first if:
In such cases, your GP may refer you to a specialist Ear, Nose, and Throat (ENT) service for further evaluation and treatment.
The clinician performing your ear wax removal will be fully trained and will follow best practice procedures to minimise any potential risk. However, it’s important to note that no medical procedure is entirely without risk.
Although complications from ear wax removal are very uncommon, they can include:
While these issues are rare, it's important to be aware of them when considering treatment.
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