Have you been told that you have ear wax, or do your ears feel blocked? Have you been told to use ear drops but not which ones? Read on to find out exactly which ones are the most and least effective!
There are so many different types of ear wax removal drops, or cerumenolytics as they are scientifically referred to. This post is just an overview of the different products, as well as a brief comparison between them. At the end, I have included my personal opinion of which is the best to use for ear wax removal.
1. Olive oil
Olive oil is the go-to product recommended by most GPs to help with ear wax removal. It’s function is to soften the ear wax. Now it’s important to know if that there are little bits of ear wax in the canal, olive oil may help it migrate out of the ear. If there is a lot of ear wax in the ear, olive oil may not remove it. It can only soften it in this case. You don’t have to warm it up before use, and yes you can use the olive oil in your kitchen cupboard.
PROS: Natural product, can help lubricate the ear canal walls, relatively inexpensive, very accessible
CONS: Not the most pleasant odour. As an alternative, you can use almond oil which also acts as a great way of clearing dead skin cells.
Essentially, it’s just olive oil in a bottle that has a nozzle to safely deliver the olive oil into the ear canal.
PROS: Easy to administer, relatively inexpensive
CONS: More expensive than just olive oil in your kitchen
Gladys’ free advice: Just buy it once, and then fill it up with ordinary olive oil! You can thank me later.
The active ingredient is urea hydrogen peroxide (5% w/w).
The other ingredients are 8-hydroxyquinoline and glycerol.
Here we have (probably) the current most marketed ear drops in the UK. If you haven’t seen them on the TV, you will notice now that you’ve read this. It’s probably the most common product bought and used by my clients prior to seeing me for ear wax removal, which is interesting because it is sold as a product that “removes ear wax” and solves all of your problems. I can imagine if there were tiny amounts of wax, it would help move it out of the ear canal (but so could olive oil). The main reason someone would be going to their local chemist or Boots is because their ear already feels blocked .. so I highly doubt that there will be small amounts of wax. So what they fail to mention in their TV advert is that you will most likely still need to see an specialist to remove the wax (although it is stated somewhere in the small print of their package leaflet).
I’m not a fan of Otex (at all!) mainly because it tends to expand the wax and make you feel more blocked up, which can cause further hearing impairment and/or pain. It also leaves the wax very sticky making it more difficult to remove with microsuction or irrigation. It’s a product which consists of urea hydrogen peroxide which causes a bubbling sensation in your ear as it attempts to break down the wax. It now also comes with a syringe advocating that patients should flush out their own ears with warm water. I can’t emphasise how dangerous this could end up being particularly if you already have a perforation or inflammation, or worse still, you may cause this yourself. Remember you cannot see in your own ear. It’s a lot easier to treat ear wax compared to an infection or perforation.
PROS: Pretty accessible, used by many people
CONS: Makes the wax sticky, not uncommon to make your symptoms worse, not inexpensive
4. Sodium bicarbonate
Yes – this is literally baking soda! Regularly recommended by GPs. I’m not sure why some recommend it over olive oil, but clients have reported that they were told it would help “dissolve” the ear wax. It will do no such thing. It does come with a little dropper, so easy to administer. However my main issue with it is that it dries out the ear canal. When the ear canal is dry, this increases the risk of itchiness and if this is scratched, can end up producing more wax!
PROS: Easy to administer, relatively inexpensive
CONS: Causes dryness of the ear canal.
My favourite. Why? It loosens up the wax. Ok – it still often needs to be professionally removed by it softens the wax without making it sticky. It is 100% natural microbiologically controlled hypertonic sea water solution.
It comes in a bottle with a nozzle, and the spray can be a little forceful. I countdown from 3 before I spray it in the ear. However, I find it to be the most successful pre-wax removal ear drops out of them all. It also works well as a method to slow down the rate of wax build up. But as far as I am aware, I don’t believe you can get it in most chemists – it may need to be purchased online.
PROS: Super effective, No bubbling sensation (as there is no hydrogen peroxide), it is made out of natural products, the water is absorbed by the wax to try and soften it making it easier for removal
CONS: Not easily accessible (have to order online).
A Cochrane review (which is a high-quality piece of independent research) conducted by Aaron et al. (2018) found that there is insufficient evidence available to use one type of ear drops over the other. So I’ll share my opinion from my clinical experience. My go-to product is Audispray for preparation of ear wax removal. 2-3 days beforehand is ideal. Otherwise, it is something I always use in my clinic. However, I always recommend using olive oil/Earol 1-2 times a month just to keep the ear canal lubricated. Remember, dry ear canals cause itching which cause you to scratch them which causes over-production of wax as the ear tries to protect itself.
Also remember that none of these products will prevent the build up of wax, and none are a fool-proof method of getting rid of wax. You may still need to have the ear wax professionally removed but give yourself the best chance of that happening by softening it beforehand.