Intended for healthcare professionals

Practice Summaries of BMJ Clinical Evidence

Ear wax

BMJ 2015; 351 doi: (Published 28 July 2015) Cite this as: BMJ 2015;351:h3601
  1. Tony Wright, emeritus professor of otolaryngology1
  1. 1University College London Ear Institute, London, UK
  1. Correspondence to: T Wright anthony.wright{at}

The bottom line

  • Ear wax only needs to be removed if it causes hearing impairment, other symptoms, or if view of the tympanic membrane is required for diagnostic reasons or for taking impressions for hearing aids or ear plugs

  • Ear irrigation (syringing) is generally considered to be effective, but evidence is limited and it may be associated with adverse effects

  • There is insufficient data on other mechanical methods of wax removal or on use of wax softeners to draw robust conclusions on their effectiveness

Ear wax only becomes a problem if it causes a hearing impairment or other ear related symptoms. The accumulation of wax occurs for many different reasons, including overproduction or underproduction of its constituent components, a failure to self clear because of slow skin migration, or mechanical issues such as the use of cotton buds or hearing aids. Wax may obscure the view of the tympanic membrane and may need to be removed for diagnostic reasons or for taking impressions before fitting a hearing aid or making ear plugs.

If wax needs to be removed, there are various options available. These include: …

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