Do I need to use ear drops before ear wax removal?
It is not a manadatory requirement to use ear drops prior to seeing us, but using them for 2-3 days can help the procedure. Overuse can make the procedure messier.
We ask patients at our Dorking and Horsham clinics to use ear drops in advance only because we are limited to one day a week per clinic.
If you have had previous problems with irrigation please do not use ear drops prior to your appointment.
If you have been told you have hard impacted wax then you may wish to try Otex to help break the impacted wax apart.
Should I use ear drops ongoing?
Use of ear drops is not normally recommended. However, if you have very dry ears it can help the natural cleansing process of the ear – called ‘epithelial migration’.
For very dry ears NHS guidelines advise that you can use a few drops of olive oil every 2 or 3 weeks just to assist the process of skin migration (epithelial migration) from the ear drum outwards.
Note – this table is for guidance only – you should consult your GP if you are experiencing ongoing difficulties, or discuss with a chemist to see what would be most appropriate for your own needs.
Please read the instructions of each ear-drop product before use – especially if you are pregnant, have allergies, have grommets or a perforated ear drum, have dry skin or ongoing skin problems / irritation, have had a recent infection, or wish to avoid alcohol usage.
The website links shown are example websites only.
2. Otex Express
|1. Urea hydrogen peroxide 5%
2. Urea hydrogen peroxide
8-hydroxyquinoline and glycerol
|Is especially good for breaking down hard compacted ear wax.
May fizz in the ear and may make you more blocked until the wax can be removed.
Otex is bought at pharmacies / Otex Express is likely weaker and can be bought at many other standard retail outlets.
Urea Hydrogen Peroxide 5%
|For softening ear wax – similar to above.
|Olive Oil - by Otex
|EP medicinal grade virgin olive oil.
|Is good for softening ear wax but is not as effective
as Otex for penetrating very hard compacted ear wax.
Olive oil may well be better for those who have dry skin
problems. As an alternative to buying expensive small bottles
dedicated to ear wax you could buy a pipette from
the chemist for about £1 and use your standard virgin olive oil.
See also Earol below.
|Bi-Carbonate of Soda
|Sodium Bicarbonate BP 5% w/v.
|We prefer patients to use Otex for very hard ear wax.
Bi-carbs contains alcohol which is not good for dry ears.
|Earol is just a trade name for an olive oil product.
See olive oil above.
|Acetic Acid (Glacial)
|Used for minor ear infections & ear irritations.
|Compound Mycia Spirit
|Claims to soothe itching ears - some reviews support this.
Is expensive for the simple ingredients it contains.
|All-natural botanical solution
|A natural solution giving relief for dry itchy ears.
|Tea Tree Oil
|Essential oils from tea tree leaves
|Tee tree oil has antibacterial properties
and can help fight infections / fungal infections –
but in high concentrations can cause damage
to the inner ear and burning of skin.
EP grade olive oil means virgin olive oil which meets a special quality standard intended for medicinal use. It apparently has a low moisture content to ensure the product remains suitable for its shelf-life.
Notes on OTEX:
Clinical evidence to support the use of Otex ear drops for hardened ear wax.
An explanation of the mode of action of the active ingredients, urea hydrogen peroxide and glycerol, in Otex ear drops is provided in the product SPC, which is shown below and can also be found from the following link to the eMC website, Otex Ear Drops – Summary of Product Characteristics (SmPC) – (emc) (medicines.org.uk).
“After insertion of the drops into the ear, the urea hydrogen peroxide complex liberates oxygen which acts to break up the hardened wax. The hydrogen peroxide component is also a cerumenolytic. Its action as an antiseptic, especially in sites with relative anaerobiosis, is well known. The glycerol and urea assist in softening the wax, so that it may more easily be removed from the ear, either with or without syringing. The urea also acts as a mild keratolytic, helping to reduce the keratin-load in the debris. With less debris, the other components are able to reach the skin under the debris and exert their action.”
The Otex ear drop formulation has been used for a number of years to help remove hardened wax from the ear canal. The formulation of Otex ear drops is based on Exterol ear drops, a product which was manufactured by our Company for healthcare professionals to prescribe as an aid in the removal of hardened ear wax.
The Otex formulation is clinically proven and a controlled clinical trial designed to assess the effectiveness of the formulation found that it was significantly superior to both a control and a comparator product at dispersing ear wax completely, or to facilitate syringing.1 Further information is provided below.
The Otex formulation was assessed in 3 separate studies:
- A double-blind comparison between the Otex formulation and a glycerol control
- A comparison between the Otex formulation and Cerumol ear drops
- A multicentre General Practitioner trial comparing the Otex formulation with Cerumol
In the first study in 40 patients (80 ears), when compared with a glycerol control, a statistically significant number of patients using the Otex formulation did not require ear syringing or the wax syringed easily compared to the control group. In the second study 50 patients (100 ears) completed the study, 25 for each preparation. A statistically significant number of patients did not require ear syringing after treatment with the Otex formulation compared to patients using Cerumol. In the final study, 160 patients (286 ears) completed the study with 157 ears treated with the Otex formulation and 129 ears with Cerumol ear drops. The need for syringing was avoided in 40% of cases using the Otex formulation and the wax was syringed easily in a further 52% of cases. Patient acceptability of the Otex formulation was excellent, as in the 135 patients treated with this product, no incidence of irritation or contact sensitivity was reported.