From the Guidelines
No, it is not safe to use hydrogen peroxide (H2O2) to remove ear wax. According to the clinical practice guideline update on earwax (cerumen impaction) published in 2017 1, hydrogen peroxide drops or irrigation are not advised for ear wax removal due to potential risks. The guideline recommends safer alternatives, such as topical earwax-softening agents or irrigation with bulb syringes, which have been shown to be effective in reducing ear wax accumulation and symptoms.
Risks of Hydrogen Peroxide
Using hydrogen peroxide to remove ear wax can cause irritation, inflammation, and even damage to the ear canal and eardrum. The bubbling action of hydrogen peroxide can be uncomfortable and potentially harmful, especially if you have an ear infection, perforated eardrum, or ear tubes.
Safer Alternatives
Instead of hydrogen peroxide, over-the-counter ear drops specifically designed for wax removal that contain carbamide peroxide, mineral oil, or glycerin can be used as directed. Additionally, self-irrigation with bulb syringes has been shown to be effective in reducing ear wax accumulation and symptoms, with a randomized trial finding that ear irrigation with bulb syringes significantly reduced self-reported symptoms in symptomatic patients with cerumen occlusions 1.
Recommendation
It is recommended to avoid using hydrogen peroxide for ear wax removal and instead opt for safer alternatives, such as over-the-counter ear drops or self-irrigation with bulb syringes, under the guidance of a healthcare provider if necessary. If you're experiencing significant ear wax buildup, it's best to consult a healthcare provider who can safely remove the wax using proper techniques and equipment rather than attempting to clear it yourself with potentially irritating substances like hydrogen peroxide.
From the FDA Drug Label
Directions FOR USE IN THE EAR ONLY. Uses for occasional use as an aid to soften, loosen, and remove excessive earwax Active ingredients Carbamide peroxide 6.5% Purpose Earwax removal aid
Hydrogen peroxide can be used to remove ear wax, but it is recommended for occasional use as an aid to soften, loosen, and remove excessive earwax 2, 2. The directions for use specify that it should be used in the ear only, and any wax remaining after treatment may be removed by gently flushing the ear with warm water, using a soft rubber bulb ear syringe 2. Children under 12 years should consult a doctor before using hydrogen peroxide to remove ear wax 2.
From the Research
Safety of Using Hydrogen Peroxide for Ear Wax Removal
- The use of hydrogen peroxide (H2O2) for ear wax removal is a common practice, but its safety and effectiveness are not well established 3.
- A systematic review of ear drops for ear wax removal found that carbamide peroxide, a hydrogen peroxide-urea compound, was one of the active treatments used, but there was no evidence to show that it was more effective than other treatments 3.
- Another study found that ear irrigation with water or saline was not more effective than no treatment in removing ear wax, and the use of ear drops, including those containing hydrogen peroxide, did not show a significant difference in efficacy compared to water or saline 3.
Risks and Complications
- The use of hydrogen peroxide or other ear drops can cause adverse effects such as discomfort, irritation, or pain, although these effects are usually mild and temporary 3.
- A study on the safety and effectiveness of different methods of earwax removal found that complications such as perforation, canal lacerations, and failure of wax removal can occur, especially if the procedure is not performed properly 4.
- It is essential to follow proper instructions and precautions when using hydrogen peroxide or other ear drops to minimize the risk of complications 5, 6.
Alternative Methods
- Ear irrigation with a bulb syringe is a safe and effective method for removing ear wax, and it can be performed by patients themselves with proper instruction 5.
- Manual removal of ear wax by a healthcare professional is also a safe and effective method, especially for patients with impacted ear wax or other complications 7, 6.
- The use of ear drops, including those containing hydrogen peroxide, may be recommended as a preliminary step before irrigation or manual removal, but their effectiveness and safety should be carefully evaluated 3, 6.