Ear wax and hearing aids: keeping both working

Hearing aids and ear wax don't get on. An earmould or dome sitting in the ear canal all day stops wax moving out and pushes some of it deeper, so hearing aid users are more likely than most people to get a build-up. That wax then finds its way into the aid itself and clogs the tiny opening where the sound comes out. It's why a weak, whistling or silent hearing aid so often turns out to be a wax problem rather than a fault. A simple cleaning routine for the aids, and regular checks of your ears, prevent most of it.

Why hearing aids make wax build-up more likely

Left alone, your ear canals clear wax without any help. The skin lining them moves slowly outwards, taking old wax with it. A hearing aid interrupts that. The earmould, dome or shell sits in the outer part of the canal, which is exactly where wax is made, and blocks its route out. Each time you put the aid in, it presses on the wax in front of it and moves some of it deeper.

Age plays a part too. Wax tends to become drier and harder as we get older, so it clears more slowly, and hearing aid users are more often in older age groups. There's more on this in ear wax in older adults.

The style of aid matters. Behind-the-ear aids with a custom earmould and tubing keep the electronics outside the ear, so wax mainly affects the mould and tube. Receiver-in-canal aids, and aids that fit inside the ear, put the speaker in the canal itself, where wax can get straight into it. Most of these have a small, replaceable wax guard (a filter) to catch it before it does any harm.

Is it your hearing aid or your ear?

Wax causes trouble in two places, your ear canal and the aid, and the signs overlap:

Working through a few checks in order sorts out most of these:

1. Power first. Put in a fresh battery or give the aid a full charge.
2. Look at the sound outlet. If there's any wax on the wax guard or dome, change it.
3. Check the tubing on a behind-the-ear aid for drops of moisture or wax, and clean it as you were shown.
4. Still weak or whistling? The wax may be in your ear rather than the aid. If your ear also feels full or blocked, that's more likely still.

If you have NHS hearing aids, batteries and repairs are free from the service that fitted them, and many services will post batteries to you. For private aids, contact the provider you bought them from.

A cleaning routine for your hearing aids

Always follow the instructions for your own model, and ask your audiologist to show you again if you're not sure. As a rough guide:

Every day

• Wipe the aid, mould or dome with a dry, soft cloth or a hearing aid wipe when you take it out.
• Brush the microphone openings and the sound outlet with the small brush that came with the aid. Hold the openings facing down so the wax falls away.
• Store the aids in their case or on the charger overnight. If they take disposable batteries, leave the battery doors open so moisture can escape.

Every week or so

• Change the wax guard if it looks blocked, or as often as your audiologist suggests.
• If you have earmoulds and have been shown how, take the mould and tubing off the aid and wash them in warm, soapy water. Blow the water out of the tube with the puffer supplied and leave everything to dry overnight before reconnecting.

Every few months

Tubing stiffens and discolours with time, and domes lose their shape. Replace them as often as your hearing service recommends. Whatever the schedule, keep water, alcohol and cleaning sprays off the aid itself, and never poke the sound outlet with a pin or cocktail stick.

Looking after your ears as well as your aids

Clean aids are only half of it. Your ear canals need a little care too. Take your aids out at night so your ears get a rest, and make sure your ears are dry before the aids go back in after a shower. Don't clean inside your ears with cotton buds or the aid's cleaning brush: both push wax further in, for reasons explained in why cotton buds make ear wax worse.

Mention any soreness, itching or rubbing to your audiologist. Ears change shape slowly over the years, and a mould that no longer fits well can irritate the skin of the canal as well as letting sound leak out.

How often should hearing aid users have their ears checked?

There's no interval that suits everyone. Some hearing aid users need wax removed every few months, while others go years without a problem. After your ears have been cleared, notice how long it takes for the signs to come back, and plan your next check a little before that. For more on finding the right interval, see how often ear wax should be removed.

Some moments are worth a check whatever your routine:

NICE guidance for the NHS recommends removing ear wax when it stops a clinician taking an ear impression, and wax can make a hearing test look worse than your hearing really is. If you have both coming up, read how to plan ear wax removal before a hearing test.

Having wax removed when you wear hearing aids

Many GP practices no longer remove ear wax, and what your NHS hearing service can offer varies from area to area. Hearing aid users are often pointed towards community services or private clinics instead.

Private clinics commonly offer microsuction, which lifts the wax out with a fine suction tube while the clinician watches through magnification. Some also offer ear irrigation. Take your hearing aids with you. You'll need them to talk to the clinician, who can also tell you when it's fine to put them back in.

Once the wax has gone, more sound reaches your eardrum, so your aids may seem louder or sharper than you're used to. Give it a few days. If they still sound wrong, or start whistling, contact your audiologist, as the fit or settings may need checking.