Blocked ears after flying: wax, pressure or both?

If your ears feel blocked after flying, pressure is almost always the reason. As the plane comes in to land, the air pressure in the cabin rises faster than the space behind your eardrum can adjust, and your ear feels full, muffled or sore. For most people it clears within a few hours. When the blocked feeling hangs on for days, or you already had a build-up before you flew, wax may be part of the problem.

Why your ears block on a plane

Behind your eardrum is the middle ear, a small air-filled space linked to the back of your nose by a narrow channel called the Eustachian tube. Every time you swallow or yawn, the tube opens briefly and lets a little air in or out. That keeps the pressure the same on both sides of the eardrum.

Take-off is usually easy on the ears. The cabin pressure falls, air escapes from the middle ear without much effort, and you might feel a pop. Landing is harder. As the cabin pressure rises, the eardrum is pushed inwards and the tube has to open to let air back in. If it is slow to do so, the eardrum stays stretched, which is what causes the full, muffled and sometimes painful feeling. Doctors call this ear barotrauma, and you may see it called airplane ear.

Anything that swells the lining of your nose makes the tube harder to open: a cold, hay fever or sinusitis, for example. Sleeping through the descent doesn't help either, because you swallow less. Children are more prone to it, as their Eustachian tubes are shorter and narrower than an adult's.

Is it pressure or ear wax?

The two feel surprisingly alike. Both give you a full ear and dull hearing. The differences lie mostly in when it started and what happens when you try to clear it.

Sometimes it is both. A flight can simply draw your attention to wax that was already there: the pressure settles, but the muffled hearing doesn't. Some people with a wax plug also find flying more uncomfortable than usual, possibly because a small pocket of air is trapped between the wax and the eardrum. Wax doesn't stop the Eustachian tube working, though, so a pressure problem and a wax problem each need dealing with in their own way.

How to unblock your ears after flying

Most people can clear airplane ear themselves. Try these, gently, in roughly this order:

1. Swallow and yawn. Sipping water, chewing gum or sucking a sweet makes you swallow more often, and each swallow opens the Eustachian tube a fraction.
2. Try the Valsalva manoeuvre. Close your mouth, pinch your nose and breathe out gently, as if blowing up a balloon, until you feel a pop. Keep it gentle: blowing hard can hurt your ear.
3. Ease any pain. A warm flannel held against the ear, and paracetamol or ibuprofen if they are suitable for you, can take the edge off while things settle.
4. Treat a blocked nose. If you have a cold or hay fever, ask a pharmacist whether a decongestant or steroid nasal spray would help. These aren't suitable for everyone, so check first.

Don't put cotton buds or anything else in your ear to try to pop it, and don't start ear drops for a pressure problem, because oil does nothing for the Eustachian tube. The NHS advice on earache is also clear that you shouldn't try to remove ear wax while your ear is painful.

How long should blocked ears last after a flight?

For most people the blocked feeling goes within a few hours of landing, often all at once with a pop. With a cold or congested sinuses it can drag on for a few days while the swelling settles.

The NHS advises getting medical help if earache hasn't started to improve within 2 to 3 days. If it is the blocked feeling rather than pain that lingers beyond a few days, have the ear examined. The eardrum may still be pulled inwards, there may be fluid behind it, or there may be wax in the canal. Only someone looking in your ear can tell these apart, and each is treated differently.

Occasionally a sudden change in pressure tears the eardrum, and the NHS lists flying among the causes of a perforated eardrum. Symptoms usually start suddenly and include pain, muffled hearing, ringing and sometimes fluid or blood leaking from the ear. Most perforations heal on their own within about 2 months. Don't put drops in an ear that might be perforated.

When wax is part of the problem

If you know you are prone to wax, or an examination shows a build-up, the approach is the same as for any blocked ear. Soften the wax for a few days with olive oil or pharmacy drops (our guide on how to use ear drops explains how), and if that doesn't shift it, have it removed.

Microsuction is often preferred when there is any doubt about the eardrum, because nothing wet goes into the ear. Our comparison of microsuction and ear irrigation explains who suits which method.

A good clinician looks at the eardrum before removing anything. If it looks bruised, pulled in or damaged after a flight, they may suggest waiting, or send you to a GP, instead of taking the wax out there and then. That is a good reason to book with someone who examines your ear properly first.

How to protect your ears on your next flight

A few habits make a real difference, especially if blocked ears after flying are a regular thing for you.

Some people find pressure-regulating earplugs made for flying helpful, although there is little good evidence that they work.

If you have a heavy cold, a sinus infection or an ear infection, ask a pharmacist or GP whether it is sensible to fly. After any ear surgery, check with your surgeon before booking. Water can cause similar problems to flying, making wax swell overnight; our guide to swimming, showering and ear wax covers that side of things.

When to see a GP or get urgent help

Pressure problems after flying are usually uncomfortable rather than harmful. A few symptoms are worth acting on quickly, though, whether you think the cause is pressure, wax or something else.

For anything less urgent, a pharmacist is a good first stop. They can look at your symptoms, suggest what might help and tell you whether you need a GP. Our guide to whether a blocked ear is wax or an infection may also help you decide who to see, and the signs of ear wax build-up will tell you whether wax is the likelier explanation.