Ear Wax
What is Ear Wax?
Earwax is a normal build-up of dead cells, hair, and foreign material such as dust, and natural wax which forms a protective coating on the skin in the ear canal.
The amount of earwax produced varies greatly from person to person. The movement of your jaw while eating and talking naturally movesthe wax along the canal. A plug of earwax is not a serious problem. You only need to remove earwax if it is causing symptoms suchas dulled hearing or when fitting a hearing aid.
Ear Wax build-up
You can’t prevent earwax. It’s there to protect your ears from dirt and germs. However, you can keep using ear drops to soften the wax. This will help it fall out on its own and should prevent blocked ears.
Try and keep your ears dry. When washing your hair, showering or swimming, put some Vaseline on a ball of cotton wool and gently place in your ear, or place Vaseline around the inner part of your ear. Do not put your head under the water when bathing.
Do not clean the ear canal with cotton wool buds. This can make things worse, as you will push some earwax deeper inside. It may also cause an ear infection. Do not use objects such as hair grips, knitting needles, keys etc. this can cause trauma and possible infection.
If your ears are itchy do not scratch or rub them with your fingernails or any other objects.
Ear drops
Olive oil ear drops are the best way to treat ear wax. These are available in supermarkets, high street shops and pharmacies. Speak to your pharmacist for advice.
Ear drops should be administered 2-3 times a day with 4-5 drops in the affected ear(s). You can continue this for up to 3 weeks with most cases resolving in 2 weeks.
If olive oil does not work or you would like an alternative, speak to your pharmacist. You can buy sodium bicarbonate drops or Cerumol® from the pharmacy if it’s right for you. The pharmacist may also be able to give you some additional information.
Do not use any ears drops if you have a hole in your eardrum called a perforated eardrum.
There may be some stinging or discomfort at first, this is normal and should go away after a few seconds. If it persists, speak to your pharmacist. You may not see wax come out, but symptoms should improve.
Your carer, care home staff or family member can help you use ear drops correctly.
Visit https://www.northerncarealliance.nhs.uk/our-services/ear-care-service for patient information leaflet and videos demonstrating how to correct use ear drops.
Ear Irrigation
First line treatment should be self-care with olive oil. Only in the event of this not clearing the problematic earwax should ear irrigation be considered.
If symptoms persist after using ear drops for up to 3 weeks, your GP may feel that ear irrigation is appropriate. It is important to soften the wax with olive oil ear drops for up to 5 days before ear irrigation for the best possible results. See above section on how to use ear drops.
Olive oil ear drops are available in supermarkets, high street shops and pharmacies. Speak to your pharmacist for advice.
When to see your GP
If you are experiencing pain, discharge or bleeding from the ear, sudden deafness or dizziness contact your GP.
Further information can be found at NHS website or dial 111 for any emergency concerns.
Steroid Nasal Drops
Read the manufacturer's printed information leaflet from inside the pack.
This will give you a step-by-step guide of how to use the drops. It will also provide you with a full list of common side-effects and important information. Speak to your pharmacist for advice or if you’re not sure.
Nasal drops contain an active steroid ingredient to reduce inflammation of the nose. Follow your doctor’s instructions about how often and how many drops to apply.
How to use it
First, choose a position comfortable – see below
- Blow your nose gently to clear it.
- Shake the bottle and remove the protective cap.
- Make yourself comfortable in your chosen position
- Insert tip into nostril and apply as per directed
- Stay in this position and continue to breathe in gently and wait for 3 minutes
- Repeat the process in your other nostril if you need it.
- You can now sit upright. Wipe the nozzle and reapply the cap.
Some drops come in single application vials, so use the vial and dispose of after use. Read the information leaflet or speak to your pharmacist if you are unsure.
Getting the most from your treatment
Do not apply whilst standing with your head tipped back. The drops flow along the floor of the nose and into the throat. This will reduce the effectiveness and may give an unpleasant taste.
Sniffing hard when applying the drops will draw the medicine into the throat which will reduce the effectiveness and may give an unpleasant taste.
Nasal drops often take several weeks of regular use to be effective. They can be used for up to one month for chronic symptoms. Use the drops regularly, even if your symptoms are controlled.
Speak to your pharmacist for advice or if you are unsure.
Further information can be found at NHS website or dial 111 for any emergency concerns.
Steroid Nasal Spray
Read the manufacturer's printed information leaflet from inside the pack.
This will give you a step-by-step guide of how to use the spray. It will also provide you with a full list of common side-effects and important information. Speak to your pharmacist for advice or if you’re not sure.
When you first start using a nasal spray, it is usual to use two sprays into both nostrils twice a day. Once your symptoms are controlled, you may be able to reduce this to just one spray into each nostril twice a day. Do not use more than 4 sprays per nostril in 24 hours.
How to use it
Before you use the spray for the first time, point the spray away from your face and activate it a few times until you can see a fine mist in the air.
- Blow your nose gently to clear it.
- Shake the bottle and remove the protective cap.
- Close one nostril by placing a finger gently against one side of your nose.
- Tilt your head forwards slightly and insert the nozzle of the spray. Aim towards the ear on the same side keeping the bottle upright.
- Breathe in through your nose and push down on the collar of the nozzle to administer one spray
- Breathe out through your mouth. Repeat steps 4-6 if you are using two sprays for each dose.
- Repeat the process in your other nostril if you need it.
Wipe the nozzle with a clean tissue and replace the cap. If the nozzle becomes blocked, remove and rinse under warm water.
Getting the most from your treatment
Do not spray towards the middle of the nose (septum). This can cause irritation to the lining in this part and may stimulate a nosebleed. It also means the medicine is not being delivered effectively to the area of most need.
Sniffing hard rather than breathing in through your nose will draw the medicine into the throat which will reduce the effectiveness and may give an unpleasant taste.
Nasal sprays often take several weeks of regular use to be effective. (This can be up to 6-8 weeks). They can be used for up to three months for chronic symptoms. Use the spray regularly, even if your symptoms are controlled.
If you are using the spray for hay fever, it may help to start using it 2-3 weeks before the hay fever season starts. This is because it takes a few days of treatment before you feel the full effect, so starting before the pollen count rises will help prevent symptoms from developing.
If your symptoms get worse after reducing your dose, you may want to increase it again.
Decongestant nasal sprays
If you use a nasal decongestant spray, such as xylometazoline (e.g. Otrivine®) or pseudoephedrine (e.g. Sudafed®), it is important you do not use this for more than 5-7 days.
Nasal decongestant sprays used for long periods of time or regular use, are likely to cause rebound, severe congestion of the nose. They can also cause more severe irreversible damage to the inside of your nose. Always follow the instructions on the patient information leaflet.
Speak to your pharmacist for advice or if you are unsure.
Further information can be found at NHS website or dial 111 for any emergency concerns.