Can ear wax cause hearing loss?

Yes. Ear wax is one of the most common reasons for hearing loss, and one of the easiest to put right. A plug of wax that fills the ear canal stops sound reaching the eardrum properly, so everything sounds muffled, usually in one ear. Hearing normally comes back as soon as the wax is removed. If it doesn't, you need a hearing test.

How ear wax affects your hearing

To hear, sound has to travel down the ear canal to the eardrum, which vibrates and passes those vibrations through three tiny bones to the inner ear. Anything that blocks sound on its way through the outer or middle ear causes what is called conductive hearing loss. Wax is the most familiar example. You will find this and other terms explained in our ear care glossary.

The good news is that the inner ear, where sound is turned into nerve signals, isn't affected. That is quite different from the hearing loss that comes with age or years of loud noise, which is caused by wear to the delicate hair cells of the inner ear and can't be reversed.

How much hearing can ear wax take away?

It depends how much of the canal is blocked. Surprisingly little sound needs to get through for you to hear fairly normally, so a canal can be mostly full of wax without you noticing anything. The effect usually shows up when the last small gap closes, often after water gets in and the wax swells.

At that point hearing on the blocked side can drop quite noticeably. People describe it as like wearing a foam earplug: quiet voices disappear, the television needs turning up and phone calls on that side become hard work. Even with one good ear, following a conversation in a busy room gets harder.

If you already have some age-related hearing loss, wax on top can make a surprising difference. Someone who was coping well may suddenly start to struggle, and a hearing aid may stop helping, because the wax is blocking the sound it produces. As the NHS points out, someone else may notice a hearing problem before you do.

Even a mild loss in one ear is tiring. The NHS lists feeling tired or stressed from having to concentrate while listening among the common signs of hearing loss, and people with a blocked ear often say exactly that: conversations take more effort, and busy places become draining. That alone is a good reason not to put up with a blocked ear for weeks on end.

Is it wax or another kind of hearing loss?

The pattern of symptoms gives some useful clues. The NHS describes wax as typically causing difficulty hearing in one ear with itchiness and a blocked feeling, while gradual loss in both ears is usually down to ageing or noise damage.

Many people have both. NICE guidance for the NHS says that anyone who comes to a GP with hearing difficulties for the first time should have impacted wax and ear infections ruled out before being sent for a hearing assessment.

Does hearing come back after ear wax removal?

In most cases, yes, and straight away. Many people are startled by how loud and clear things sound as they leave the appointment. Your own voice, the rustle of your clothes and the sound of chewing can all seem strangely sharp for a day or so while your brain gets used to hearing properly again.

Sometimes hearing doesn't come back fully, for one of a few reasons:

• Some wax is left behind. A very hard plug may need a few more days of drops and a second visit.
• The canal is a little swollen or damp after removal. This usually settles within a day or two. Our guide to aftercare after wax removal explains what is normal.
• There is fluid behind the eardrum, for example after a cold.
• The wax was hiding another hearing loss that you hadn't noticed, often the gradual, age-related kind.

The NHS advises seeing a GP if you have had treatment for an ear wax build-up and your hearing hasn't come back.

When to get your hearing tested

Wax removal and a hearing test do different jobs. Removal clears the canal. A hearing test measures how well your ears and hearing nerve are working, and it is the only way to find out whether there is something else going on.

It is worth arranging a test if your hearing still seems poor after the wax has gone, if you have noticed a slow change over months or years, or if people keep telling you the television is too loud. A GP can refer you to an NHS audiology service, and the NHS notes that some pharmacies and opticians offer free hearing tests.

If you know you tend to build up wax, have it cleared a week or so before the test. Wax can affect the results, and it has to come out before anyone can take impressions of your ears for hearing aids. Our guide to ear wax and hearing tests covers the timing.

Hearing aids and ear wax

Hearing aids and wax don't get on. An aid or earmould sitting in the canal stops wax working its way out and pushes some of it back in each time you put it in. The result is a cycle many wearers know well: wax builds up, the aid starts whistling or sounds weak, and hearing seems to be getting worse when the real problem is a blockage.

Cleaning the aid every day, changing wax guards when they look clogged and having your ears looked at whenever the aid seems to lose power will save a lot of frustration. Our guides to ear wax and hearing aids and ear wax in older adults have practical routines.

If you do need wax removed, clinicians most often use microsuction or electronic irrigation. Our comparison of microsuction and ear irrigation explains the difference.