From the Guidelines
Ear wax removal can be safely done at home using over-the-counter ear drops like Debrox, Murine, or generic carbamide peroxide solutions, as recommended by the most recent clinical practice guideline update on earwax (cerumen impaction) 1. To remove ear wax, place 5-10 drops of the solution in the affected ear, remain on your side for 5-10 minutes to allow the solution to soften the wax, then gently flush with warm water using a rubber bulb syringe. Some key points to consider when removing ear wax include:
- Repeat the process twice daily for 3-4 days if needed
- Alternatively, mineral oil, baby oil, or glycerin drops can be used to soften wax before irrigation
- Never insert cotton swabs, hairpins, or other objects into the ear canal as these can push wax deeper or damage the ear canal or eardrum
- If you experience ear pain, drainage, hearing loss that doesn't improve after treatment, dizziness, or have a history of eardrum perforation or ear tubes, seek professional medical care Ear wax is actually protective, containing antimicrobial properties that help prevent infection, so removal is only necessary when excess wax causes symptoms like hearing difficulty, fullness, itching, or tinnitus. Manual removal of cerumen is often preferred in patients with abnormal otologic findings, and can be performed by a healthcare provider using specialized instruments and visualization tools 1. Additionally, self-irrigation with bulb syringes at home can help reduce symptoms from cerumen impaction and need for intervention, as shown in a randomized trial with 237 symptomatic patients with cerumen occlusions 1.
From the FDA Drug Label
Directions FOR USE IN THE EAR ONLY Adults and children over 12 years of age: ... Any wax remaining after treatment may be removed by gently flushing the ear with warm water, using a soft rubber bulb ear syringe Directions FOR USE IN THE EAR ONLY. Adults and children over 12 years of age: ... Any wax remaining after treatment may be removed by gently flusing the ear with warm water, using a soft rubber bulb ear syringe
Ear wax removal can be done by gently flushing the ear with warm water, using a soft rubber bulb ear syringe, after treatment with urea (OTIC) 2 or hydrogen peroxide (OTIC) 3.
- Use warm water
- Use a soft rubber bulb ear syringe
- Flush the ear gently
From the Research
Ear Wax Removal Methods
- Ear drops are a common method used to remove ear wax, with various types of liquids available, including oil-based and water-based compounds 4.
- The effectiveness of ear drops in removing ear wax has been studied, with some studies showing that active treatment is more effective than no treatment 4, 5.
- However, there is no conclusive evidence to show that one type of ear drop is more effective than another, or that ear drops are more effective than other methods of ear wax removal, such as irrigation or mechanical removal 4, 5, 6.
Comparison of Ear Wax Removal Methods
- A study comparing ear drops with no treatment found that ear drops were more effective in removing ear wax, with a higher proportion of patients achieving complete clearance of ear wax 4.
- Another study compared the use of softeners followed by irrigation with self-irrigation and found that softeners followed by self-irrigation were more cost-effective 5.
- A systematic review of ear wax removal methods found that there was limited good-quality evidence to support the use of one method over another, and that further research is needed to improve the evidence base 5, 6.
Adverse Effects of Ear Wax Removal
- Adverse effects of ear wax removal, such as discomfort, irritation, or pain, are generally mild and rare 4, 5, 6.
- No serious adverse effects have been reported from the use of ear drops or other ear wax removal methods 4, 5, 6.