What is the treatment for a clogged ear?

Treatment for Clogged Ear

The most effective treatment for a clogged ear due to cerumen impaction is to use a cerumenolytic agent such as carbamide peroxide or hydrogen peroxide drops twice daily for up to 4 days, followed by gentle irrigation if needed. 1, 2

Causes of Clogged Ear Sensation

A clogged ear sensation can result from several conditions:

1. Cerumen impaction - Most common cause
2. Acute otitis externa (swimmer's ear)
3. Otitis media with effusion (especially in children)
4. Eustachian tube dysfunction

Treatment Algorithm for Cerumen Impaction

Step 1: Cerumenolytic Agents

• First-line treatment: Apply ear drops to soften and break down earwax
  • Options:
    • Carbamide peroxide 6.5% - Apply 5-10 drops twice daily for up to 4 days 2
    • Hydrogen peroxide 3% - Apply 5-10 drops twice daily for up to 4 days 1
    • Other options: Mineral oil, olive oil, sodium bicarbonate 3

Step 2: Proper Application Technique

• Tilt head sideways with affected ear upward
• Place 5-10 drops into ear canal (do not insert applicator tip into canal)
• Remain in position for 3-5 minutes
• Use gentle to-and-fro movement of the ear or press with in/out movement on the tragus 4
• For best results, have someone else apply the drops when possible 4

Step 3: Irrigation (if needed)

• After using drops for the recommended period, any remaining wax can be removed by:
  • Self-irrigation: Using a soft rubber bulb syringe with warm water 3, 5
  • Professional irrigation: Performed by a healthcare provider if self-irrigation is unsuccessful 4

Special Considerations

For Acute Otitis Externa

If the clogged sensation is accompanied by pain, itching, or discharge:

• Topical antibiotic eardrops (e.g., ofloxacin or ciprofloxacin-dexamethasone) are recommended 4
• Apply drops twice daily for up to 10 days
• Keep ear dry during treatment 4
• Clean external ear canal of debris before applying drops 4

When to Avoid Self-Treatment

Do not attempt self-treatment with drops or irrigation if:

• Ear pain is severe
• Discharge or bleeding is present
• History of tympanic membrane perforation
• Previous ear surgery or ear tubes 3
• Child is under 12 years of age (consult doctor first) 1, 2

Prevention of Recurrence

• Avoid using cotton-tipped applicators in the ear canal 4, 3
• For hearing aid users, schedule regular ear checks every 3-6 months 3
• Consider periodic use of cerumenolytic agents for prevention in high-risk individuals 3

When to Seek Professional Care

• Symptoms persist after 4 days of treatment
• Severe pain, fever, or hearing loss develops
• Dizziness occurs
• Discharge from the ear is present
• Child is under 12 years of age

Evidence Quality

The evidence for cerumenolytic agents is of moderate quality, with multiple studies showing similar effectiveness between oil-based and water-based preparations 5, 6. The American Academy of Otolaryngology-Head and Neck Surgery guidelines provide the strongest recommendations for proper ear hygiene and cerumen management 4, 3.