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Is It Hearing Loss or Impacted Earwax? An Audiologist Explains the Difference (and How To Treat It)

"Impacted earwax can easily be remedied, which is why it’s important to rule out before buying a hearing aid."

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Impacted earwax is very common, and it gets even more common as you get older. The reason? Earwax becomes less pliant with age, and is therefore more likely to get stuck. It can also cause non-permanent hearing loss, making it hard to discern whether your difficulty hearing is caused by impacted wax or true hearing loss (or both).

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So, how can a person tell the difference, and why is it important to know? While men are almost twice as likely as women to have hearing loss before they reach 70, one out of eight women (at any age) have at least some trouble hearing. Losing the ability to hear puts mature adults at greater risk of social isolation, anxiety, and depression — and determining the cause of hearing loss is the first step to improving a person’s quality of life. To learn more, we reached out to Dr. Robin Carson, audiologist at Carson Hearing Care and expert for Eosera.

What are the most common causes of hearing loss?

A: The most common causes for hearing loss at any age are noise exposure, family history, illness, medication, and most often, the aging process. We recommend hearing testing for anybody over the age of 50. Just like the nerves and every other part of our body, our hearing becomes less sensitive as we age. It’s important to get a baseline audiogram from a hearing healthcare professional to determine next steps.

How can you tell if you have impacted earwax or true hearing loss?

A: Hearing loss caused by impacted earwax often feels like a sense of fullness in the ear canal. That sensation is sometimes accompanied by other symptoms like pain or irritation. It can easily be remedied, which is why it’s important to rule out before buying a hearing aid. To determine if it’s just wax causing your hearing loss, visit a professional or use an over-the-counter device like a Smart Otoscope, which gives you a look into your ear canal. 

Is it okay to remove impacted earwax at home?

A: There are great over-the-counter earwax remedies. My personal preference that I recommend to my own patients is Earwax MD, which dissolves wax and works as quickly as 15 minutes. Using these drops is an excellent way to clear the ear of earwax and works very well.

Do you recommend ear candling (i.e. ear coning)?

A: I’m not a big fan of ear coning. I’ve never actually seen results that are convincing enough to prove that it works well. Even in our office when wax is an issue, we use drops and a flushing technique to remove it. It should go without saying that Q-tips should also be avoided when cleaning out the ear canal, as they can cause further damage.

If you visit an audiologist for earwax removal, what does the procedure entail?

A: When patients come in with earwax impaction, the first thing we determine by looking in the ear is whether or not we can see the eardrum and if the issue is, in fact, earwax. If there is no wax present, we would then test the hearing to look for other concerns. There are several techniques we use in the office depending upon the type of wax that we see. Sometimes, we need to use drops to soften the wax, but we do use flushing to remove the wax after it is softened. We also use a curette [an instrument that gently scrapes out wax] in some cases. The earwax removal process is quick and easy. Sometimes, audiologists will send the patient home with instructions to take care of it on their own.

Why is it important to visit an audiologist, regardless of the cause of hearing loss?

A: We highly encourage a baseline audiogram for everybody over the age of 50. It’s important to get a baseline so we understand over time what changes and what is happening with an individual’s hearing. It’s so important to visit a professional, because occasionally there is hearing loss present that’s due to something more significant than earwax or the aging process. A hearing care professional is well-equipped to identify any significant underlying concerns and/or mechanical issues with the ear that would require a referral to a physician.

It’s always surprising to me that our local physicians don’t require a baseline audiogram as a part of a routine annual physical examination. Hearing healthcare professionals can quickly identify if ear wax is the concern. If not, they can continue with audiometric testing to determine which part of the ear may need further attention. If hearing loss is sensorineural in nature, being appropriately fitted with amplification sooner rather than later is so important. An audiologist is very well trained, and [an appointment] is a great place to start to understand what’s going on with your ears, and why you might be experiencing hearing loss.

If an audiologist determines that a hearing aid is necessary, there’s also quite a bit that goes into the fitting and aftercare process to make sure everything is working correctly. This can be hard for a patient to do on their own if they’re new to the process.

If you need a hearing aid, can an audiologist recommend an OTC one?

A: Your provider can guide you as to whether or not an OTC product is a viable option, or if something prescriptive is best for you. There are many options and an auditory health care provider should be able to offer affordable solutions under their care.

While people with mild to moderate hearing loss might be excellent candidates for OTC hearing aids [with or without an audiology visit], anything more severe should be treated by a professional. It’s also important to understand that finding a provider is equally if not more important than the device itself. Routine follow-up care and monitoring of hearing on an annual basis is critical for a successful outcome with hearing instruments.

What should you do if your hearing aid causes impacted earwax?

A: Hearing aids (along with any ear device) can increase the chances of earwax impaction, itch, and pain. Users should develop a regular earwax softening routine, and treat irritation with OTC products. If hearing devices are fit poorly, there is a chance of further damage to your hearing.

We must not forget the significant consequences of untreated hearing loss, such as cognitive decline, social isolation, and fatigue. These can be avoided or improved when devices are fit properly, using best practices from a professional hearing healthcare provider.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

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