Do you need ear wax removed before a hearing test?

Usually not, unless the wax is blocking your ear. A thin layer of ear wax makes no difference to a hearing test, and the audiologist will look in your ears before they start. If wax is filling the ear canal, though, it can make your hearing look worse than it is, stop some tests being done and get in the way of impressions for hearing aids. If your ears feel blocked, or you've needed wax removed before, have them checked a week or two before the test.

Does ear wax affect a hearing test?

Only if there's enough of it to block the canal. Sound needs a clear path to your eardrum. A plug of wax soaks some of it up, so the quietest tones you can pick up during the test have to be a little louder than they otherwise would. The result is either a hearing loss on paper that isn't really there, or a real hearing loss that looks worse than it is.

A light coating of wax on the canal walls, or a little near the opening, lets sound straight through. Most people booked in for a hearing test don't need to do anything beforehand.

Wax in one ear only can make your two ears look different on the results. Audiologists take a difference between the ears seriously, so a blockage could lead to extra tests you don't need. For how much difference wax can make, see ear wax and hearing loss.

What the audiologist checks first

Before any test, the audiologist looks into both ears with an otoscope or a small camera. They're checking that the canal is clear, that they can see your eardrum and that nothing looks inflamed or infected. If wax is hiding the eardrum or blocking the canal, they'll tell you, and may suggest having it removed before some or all of the tests.

How much wax matters depends on which tests you have. The NHS describes several, and you may not need all of them:

Ear impressions for hearing aids and earmoulds

If you're being fitted with a hearing aid that uses a custom earmould, or one that sits inside the ear, the audiologist will take an impression of your ear canal. They place a small foam or cotton block in the canal to protect the eardrum, then fill the canal with a soft silicone paste that sets in a few minutes.

Wax causes two problems here. The block and the paste can push it further towards the eardrum, and the finished impression takes the shape of the wax rather than your ear, so the mould may not fit well. That's why NICE guidance for the NHS recommends removing wax when it prevents an ear impression being taken. The same goes for impressions for custom swim plugs, musicians' earplugs and in-ear monitors.

After a hearing aid is fitted, some audiologists check how it performs with a thin probe tube placed in your ear canal. Wax gets in the way of that too. If you already wear aids, our guide to ear wax and hearing aids covers keeping both in good order.

When to have ear wax removed before the test

It's worth having your ears checked before the test if:

If your ears feel clear, you've never had trouble with wax and nobody has mentioned it, you can usually go straight to the test. The audiologist will tell you if they see a problem.

Drops aren't a last-minute fix. They work slowly, and it can be a couple of weeks before softened wax clears. If you plan to use them, start in good time and mention it to the audiologist.

How to plan wax removal and a hearing test

A little planning saves a wasted trip:

1. Ask the hearing service first. When you book the test, ask whether they check for wax and whether they can remove it on the day. Some hearing centres offer both in one visit, usually charging separately for the removal.
2. If not, book removal separately, a few days to two weeks before the test. That leaves time to go back if the wax is too hard to clear in one visit, and for any tenderness to settle.
3. Soften the wax if you're asked to. Some clinicians want a few days of olive oil drops first, particularly before irrigation. Our guide on how to use ear drops explains the technique.
4. Leave your ears alone in between. No cotton buds, and follow any advice about keeping water out.
5. Tell the audiologist when and how the wax was removed, and mention any ringing, dizziness or soreness.

The removal visit itself is described step by step in what happens at an ear wax removal appointment, and microsuction vs irrigation compares the two main methods.

NHS and private hearing tests: who removes the wax?

On the NHS, you're usually referred for a hearing test by your GP, who may look in your ears first. If there's wax, you may be asked to have it removed before the audiology appointment. Many GP practices no longer offer ear wax removal, so that can mean a community service or a private clinic. Our guide to ear wax removal on the NHS explains what's still available.

Adults can also have a hearing test with an audiologist at many large pharmacies and opticians, often without charge. Some of these offer wax removal as a separate paid service. Private prices vary a great deal, and our guide to ear wax removal costs has typical ranges. Microsuction is widely offered, and you can find ear wax removal clinics near you or browse by town.

If removing the wax brings your hearing back

Sometimes the whole reason for booking a hearing test turns out to be a plug of wax. If your hearing is back to normal and you had no other symptoms, ask the audiologist if you still need the test. Keep the appointment if your hearing still isn't as clear as you'd like, if one ear seems different from the other, or if you have ringing or buzzing that hasn't gone away. Ringing that lingers is covered in ear wax and tinnitus.