Safe ear wax removal is not only recommended - it’s a vital part of hearing care. Read our latest blog on RNID’s new ear wax removal campaign.
Ear wax (also known as cerumen) is your ear’s natural protectant. It’s a natural lubricant with an antibacterial substance which protects the inner ear from dust, dirt, and debris. Typically the ear self-cleans by shedding skin of the ear canal, simultaneously pushing ear wax out – it’s an impressive system!
However, for some people, ear wax can build up. The result can be painful and disorienting, potentially impacting hearing health and, at times, resulting in tinnitus (a hearing problem which manifests through a ringing sound in the ears).
When this happens, the recommendation is to have ear wax safely checked and removed by a hearing care professional. For many years, people could go to their GP surgery for ear wax removal, but increasingly, GP practices are no longer able to offer this service. Instead, people are required to seek private ear wax removal services or attempt to manage their ear wax themselves.
This brings with it some potential issues. Firstly, attempting to remove ear wax yourself – or visiting someone who is not an adequately trained professional and specialist – can be dangerous and can cause long-term complications, such as hearing loss and infections. In addition, not visiting a qualified practitioner contradicts guidance from the National Institute of Health and Care Excellence (NICE) – the body that recommends which services should be available on the NHS. NICE guidelines state that GP surgeries or community clinics should offer to remove earwax, if build-up is contributing to someone’s hearing loss or causing other symptoms.
This is why RNID have launched a new campaign calling on anyone who has a medical need for professional ear wax removal to have access to an NHS service when they need it. They are also advocating for clearer information on how to manage excess ear wax safely at home with ear drops, when appropriate.
Safe ear wax removal is a growing concern
For some time there have been conversations across the industry about how to manage safe ear wax removal. Currently, after completion of a short course, anyone can offer removal services and many high street outlets are doing just that. Beauty therapists and even tattoo studios have been seen to add ear wax removal to their treatment list, creating concern among audiology professionals.
Paul Surridge, BIHIMA Chairman, said: “The lack of industry regulation means that people without any prior hearing or ear care experience can offer these services. In many cases, ear wax removal may be a straightforward procedure, but for people whose hearing loss is not caused by ear wax build up or those who have other underlying hearing problems, or for whom the procedure goes wrong, what should they do?
Last year the National De-Wax Access group formed to try and agree a way forward for the industry, through regulation or other means. The group includes representatives from the British Academy of Audiology (BAA), the British Society of Audiology (BSA), the British Society of Hearing Aid Audiologists (BSHAA), the Association of Independent Hearing Healthcare Professionals (AIHHP), National Health Service England (NHSE), the Royal National Institute for Deaf People (RNID), the British Society of Hearing Aid Audiologists (BSHAA), and Ear, Nose, and Throat UK (ENT UK). Currently there has been no formal announcement from the group.
Why is safe ear wax removal so important?
With so few opportunities to access ear wax removal through the NHS, many people are resorting to their own ear cleaning techniques at home – from cotton buds to toothpicks, their fingers and toilet paper. These methods come with serious sanitation risks and, in some cases, can severely damage the inner ear and cause hearing impairment. It is vital that sufferers visit a trained professional to guarantee that blockages and buildups are safely managed, while any underlying health issues are identified and treated.
“We recently surveyed a selection of audiologists in the private sector across the UK, most of whom had direct experience with ear wax removal, either for themselves or within their practice. The main challenge that came up in their comments was the lack of regulation around ear wax removal which can cause side effects when unsafe and inadequate ear wax removal takes place. It’s a worrying situation.” said Paul Surridge.
Research by the University of Manchester audiologists found that over two million people in the UK need ear wax removal every year. The study also found that – of the 500 adults surveyed – the most common symptom of blocked ears was hearing difficulty. Reassuringly, it reported that after removal of ear wax, 8 out of 10 respondents experienced an immediate improvement.
Dr Donal Collins is a Clinical Director at BarlowCollins and worked as an NHS GP for 27 years. He now specialises in ear wax removal services and told us why he decided to make this a primary focus in his new practice.
“Around two or three years ago, all GP practices stopped offering ear wax removal and generally it is no longer provided by the NHS; unless there is a serious medical problem.
“I wanted ear wax removal to be an important part of my practice because I know the difference it can make to someone’s hearing. Hearing loss has many causes, and generally speaking professionals can do something to improve the situation. It’s what makes the job so rewarding.”
What is the RNID hoping to change about ear wax removal services?
To ensure that everybody with a clinical need for ear wax removal can access this vital service, RNID is calling for:
- Government intervention to ensure patients with a clinical need for ear wax removal have access to timely local NHS provision, regardless of where they live.
- Local NHS commissioners to investigate ways they can deliver this service in a cost-effective way.
- Commissioners to ensure their ear wax removal providers are meeting contractual obligations, and that patient-facing staff are aware of what services are available to who.
- NHS England to publish improved patient information about ear wax, so people can manage their ear wax safely from home.
- NHS England to ensure that GP surgeries share consistent, safe, and evidence-based information with their patients.
The topic of how ear wax removal can be better integrated into hearing care services was a common theme across BIHIMA’s audiologist survey respondents, with feedback including:
“Ear wax removal needs proper regulation, lay people with no previous ear care knowledge should not be allowed to train. I think that people wanting to train should also have a minimum of two years’ experience in an ear care related role and a minimum of working under supervision for three months or 30 wax removal procedures.”
“It should be offered on the NHS in primary or secondary care by qualified professionals who have at least several years’ experience of otoscopy and referring to ENT or GP as needed. It really concerns me that some people removing wax privately in my area have little experience and I don’t know what qualifications. This needs to be much more open about the qualifications and experience of anyone removing wax.”
“We need strict regulations governing wax removal and hearing assessment so that private companies cannot train non-medical staff to perform these procedures after very limited training and no supervision afterwards.”
When should I see a hearing care professional about my ear wax?
There are common signs you should look out for if you are wondering whether you have your ears professionally cleaned. These include:
- Excess ear wax
- Ringing in your ears
- Itchy sensations
- A strong odour
- A change in your ability to hear
- Swimmer’s ear
In addition, if you know that you have been using your own ineffective cleaning techniques for years, it could be of benefit to visit your audiologist for a professional cleaning procedure. They are the experts, and only use professional medical devices that will not damage any of your nerves, cells, or ear structure.
To get involved with RNID’s new campaign, you can visit the website.
