Synopsis
Distinguish routine wax obstruction from foreign-body hazards and tympanic injury, select safe ear-care methods, and arrange appropriate urgent assessment and follow-up when hearing or the membrane remains abnormal.
- Wax is protective and should be removed when it causes symptoms or prevents necessary examination, testing or an ear impression.
- For uncomplicated wax with an intact drum, NHS advice includes olive-oil drops two to three drops three to four times daily for three to five days.
- NICE supports trained use of electronic irrigation, microsuction or manual removal where appropriate, but advises against manual syringing.
Key red flags
A suspected button battery in the ear needs immediate emergency ENT review; do not leave it for a routine foreign-body appointment.
Investigation priorities
Distinguish wax, retained material and membrane injury before intervention.
Management branches
Wax contributes to symptoms or prevents necessary examination and no relevant contraindication has been identified.
- Offer an appropriate softener; NICE allows softening immediately before electronic irrigation or for up to five days beforehand.
- Use a trained practitioner with suitable equipment for electronic irrigation, microsuction or manual extraction, choosing according to ear anatomy and risk. Manual syringing should not be offered.
Key medicines
Olive oil for uncomplicated earwaxInstil two to three drops into the affected ear three to four times daily for three to five days. Keep that ear uppermost for five to ten minutes after application.