Juliet England: Why we need to talk about ear wax removal

Let’s face it, ear wax is hardly the most attractive substance.

Getting rid of the stuff, however, can be brilliantly satisfying. Every time I’ve presented myself at my surgery for syringing, I’ve walked away afterwards with my sparkling clean ears almost able to convey the sound of the proverbial dropping pin.

And I’ve always insisted on demanding to see those cardboard tubes which collect the water and wax post-flushing, so I could gaze at what my ears had produced. I find it oddly fascinating.

(When ‘researching’ this article, I came across the tale of one Neel Raithatha, aka ‘The Wax Whisperer’, who shared a photo of a mound of wax and dead skin which had built up over 16 years in just one ear of a patient of his at his practice in Leicester. To me, it was a thing of wonder, and I stared at it for ages.)

I admit I’m a bit of a slouch when it comes to applying drops (hydrogen peroxide-based or extra virgin olive oil if you’re interested). And I always leave it too late to get the old lugholes cleansed of the yellow stuff. But I am pretty sure hearing aids exacerbate wax production, and now that I am a fully signed up member of the cochlear implant-sporting fraternity, I believed it to be less of a pressing matter.

Over the last two years, though, I’ve really let things slide. I have vague memories of my surgery saying they ‘weren’t doing syringing’, and I assumed this was related to the lockdown. Fair enough, I reckoned. Global pandemic and all that – there are other things for my local surgery to worry about.

Then the other day I was in a branch of a well-known national chain of opticians with an aged relative who was having their first hearing aids fitted. Their ears were checked for wax, and we could see what the audiologist saw via a laptop screen. I reckoned I wanted a bit of that, so shamelessly blagged some of my poor aged relative’s precious, long-awaited appointment time for the audiologist to peer at my eardrum too.

Except that she couldn’t, at least the right-hand one. Even I, with the scientific ability of a houseplant, could see on the screen that it was fully covered by wax, although I could identify the dark hole of the drum in the image of my left ear. The rest of the image was taken up by a weird moonscape of the sticky stuff.

The audiologist warned me that it might be hard to get free syringing. And so it came to pass. My local surgery texted me a list of private providers offering this service. One I contacted quoted me £95 – remember, I’d previously had this done for free on numerous occasions. I squeaked ‘How much?’, mopped up the tea I’d spluttered down my front in horror at this figure, and swiftly bade them a good afternoon.

The same chain of well-known High Street opticians cleans out lugholes for £55 a pop (I sincerely hope that’s for both ears). Hardly a trivial sum when you consider post-pandemic struggles, not to mention the raging cost-of-living crisis. And I understand £80 is typical.

A friend advised candling, in which you seemingly insert ‘hopi’ candles to shift the wax. But the most cursory research into this practice found it widely described as unsafe and unproven, with potential problems ranging from hearing loss to (unsurprisingly) burns.

According to a BBC online news article from some months ago, if you have a build-up of ear wax, you’re not entitled to have your ears syringed on the NHS any more, as confirmed by government health minister Edward Argar. Ear wax removal is no longer a core service surgeries must offer. However, some groups of local surgeries may join forces to pay for them.

The National Institute for Clinical Excellence (NICE) says where the service is provided, surgeries should use electronic irrigators or suction devices rather than syringing with water. Some patients may also be referred to “a specialist ear care service, or ENT service”. What all this really amounts to is a postcode lottery.

RNID says: “We did a survey on earwax removal services last year and found it is a widespread problem, with provision varying greatly in different areas, even down to individual GP practices. We’re hoping to do some more research in 2022.”

And according to the organisation’s audiology adviser Franki Oliver: “‘Earwax is a normal substance that helps to protect ears, but too much can build up and cause discomfort and other ear problems such as temporary hearing loss. Too much wax can also cause hearing aids to whistle, and can prevent a hearing specialist from being able to examine the ear and carry out a hearing test.

“Earwax removal should always be provided on the NHS where there is a clinical need, in line with NICE guidelines. Whilst earwax can sometimes be managed at home using olive oil, many people will need it removed professionally. You should never put anything into your ear like fingers or cotton buds as this can push the wax further into the ears and cause damage to the eardrum.”

RNID agrees with the principle that unsafe practices should, of course, not be used to remove ear wax. But it urges those who are affected by the cutting of services to write to their MP – and it has a template for doing so.

My query on a Facebook group drew a raft of prompt replies, and reflected the ‘postcode lottery’ nature of provision. Some had been able to access this service via their GP’s surgery or hospital department. Others had not. Andrea C wrote: “Last time I paid £50 to have it done but I’m on a low income and can’t afford to keep paying that out.”

Alison commented: “The wait for ENT is so long that sometimes you have no choice but to pay privately.”

Christine McMillan added: “SpecSavers told my partner ear wax removal appointments had started to take over so much it was getting hard to fit in hearing tests, and even sight tests. But he prefers to get both done together.”

Funnily enough, since writing this piece I have become more aware of the mass of wax inside my ears, and can it feel it cracking or moving. I’ve dug out some drops but that will soften, not shift it. I can ask my local audiology team plus the department in Oxford that looks after my implant to see if they can advise – or simply dig into my pockets. I just don’t think they’re deep enough.