It usually starts small. The telly creeps up a few notches. Conversations in a busy café turn to mush. One ear feels stuffed with cotton wool after a shower. Most people assume age-related hearing loss has arrived and quietly get on with it. Often it is something far simpler and entirely reversible: a plug of earwax sitting against the eardrum. Wax build-up is one of the most common and most fixable causes of reduced hearing after 50, and one of the easiest things to make worse with good intentions and a cotton bud.
TL;DR
- Earwax is not dirt. It is protective, and a healthy ear clears it out on its own.
- After 50 wax gets drier and harder and the canal narrower and hairier, so impaction becomes far more common, especially in hearing aid users.
- Cotton buds are the biggest cause of impacted wax. Ear candling has no evidence behind it and causes burns and blockages.
- Softening drops such as plain olive oil, used for several days, clear many cases without any procedure.
- Removal in Ireland is by irrigation or microsuction through GP practice nurses, audiology clinics or ENT. Availability varies hugely, so ring ahead.
- Sudden one-sided hearing loss, discharge, bleeding, severe pain or vertigo are not wax. See your GP promptly.
What earwax is actually for
Cerumen is produced by glands in the outer third of the ear canal and does a useful job. It stops the canal skin drying and cracking, it is mildly acidic and antibacterial, and it traps dust and debris before any of it reaches the eardrum. The ear is self-cleaning too: the skin lining the canal migrates slowly outwards like a conveyor belt, carrying old wax with it, helped along by chewing and talking. The problem after 50 is not that this system stops working. It is that it slows down.
Why it becomes a problem after 50
Several things change at once. Wax becomes drier and harder with age, so it moves less freely, the canal skin produces less moisture, and canal hairs grow coarser and longer, particularly in men, acting like a net.
Two groups are at much higher risk: hearing aid users, because the device blocks the canal, stops wax escaping and stimulates the glands to produce more of it, and regular users of earplugs or in-ear headphones, for the same mechanical reason. Impaction is also common among people living in residential care, where routine ear checks are easily overlooked.
How to tell it is wax
Typical signs include hearing that is muffled rather than distorted, a sense of blocked fullness, mild itch, ringing that comes and goes, and occasionally a tickly cough. That last one surprises people: a branch of the vagus nerve supplies the ear canal, so wax pressing against the wall can genuinely trigger a cough reflex. Symptoms build gradually, or arrive suddenly after water swells the plug, which is why so many notice them after a shower or a swim.
What wax does not do is cause sudden, severe, one-sided hearing loss out of nowhere. That pattern can indicate sudden sensorineural hearing loss, where treatment works far better when started within days. Do not sit on it hoping drops will help.
Two things to stop doing
Cotton buds. They take a little wax from the entrance and compress the rest into a firm plug against the eardrum. They also scratch the canal skin, which invites infection, and every ENT department in the country sees eardrums perforated by a bud and an unexpected nudge. The old advice holds: put nothing smaller than your elbow into your ear.
Ear candling. Burning a hollow cone in the ear canal creates no meaningful suction, and the residue left behind is candle wax rather than earwax. Documented harms include burns, blockage from dripped wax and perforation, and regulators including the US Food and Drug Administration have warned against it.
What to try at home first
For uncomplicated build-up, softening drops are the first step and they work more often than people expect. Plain olive oil at room temperature is the classic option and costs almost nothing: two or three drops into the affected ear, lie on your side for a few minutes, once or twice daily for three to five days. Pharmacies also stock sodium bicarbonate drops and proprietary softeners.
Give it time. Softened wax often works its way out over a week or two, and you may notice nothing more dramatic than a smear on the pillowcase. Do not use drops if you have a known perforation, grommets, ear pain or discharge. Skip the ear vacuum gadgets and spiral picks sold online: at best they do nothing, at worst they scratch the canal or push wax deeper.
Getting it removed in Ireland
If drops do not clear it, professional removal is straightforward. The two methods are irrigation, using a controlled electronic irrigator with body-temperature water, and microsuction, which uses a fine suction device under magnification and is generally safer for anyone with a history of ear surgery, perforation or recurrent infections.
Where you go depends on where you live. Many GP practices still offer wax removal through a practice nurse, but a good number no longer do it at all, so ring your surgery first and ask whether they remove wax and by which method. If not, the alternatives are an audiology clinic, a specialist wax removal service or, for complicated ears, an ENT referral. Private microsuction typically costs in the region of €50 to €80, though prices vary. Medical card holders should still start with the GP practice, since the consultation is covered even where removal is not available on site.
Tell whoever treats you if you have ever had a perforated eardrum, grommets, ear surgery, a discharging ear or hearing in one ear only. Irrigation is not appropriate then, and microsuction is used instead.
If you wear hearing aids
Wax is the leading cause of hearing aid failure, and the usual culprit is a blocked wax guard rather than a broken device. If your aid has gone quiet, sounds weak or whistles constantly, change the filter before assuming it is dead. Your audiologist will show you how. Regular ear checks matter more for hearing aid users than anyone else, because the aid both traps wax and hides the fact that it is building up.
Worth knowing: the Department of Social Protection’s Treatment Benefit Scheme contributes towards hearing aids for people with the required PRSI contributions, currently up to €500 per aid or half the cost, whichever is lower, once every four years. Rates change, so confirm the current position before buying.
When to skip the drops and ring the GP
Book promptly if you have sudden hearing loss in one ear, discharge or bleeding, significant pain, a high temperature with ear symptoms, tinnitus in one ear only, or dizziness alongside the hearing change. These point to something other than wax, and some are time-sensitive.
The wider point is worth holding onto. Untreated hearing loss is linked to social withdrawal, low mood and faster cognitive decline, and the Lancet Commission ranks it among the largest modifiable risk factors for dementia. When something as ordinary as a wax plug is quietly taking a share of your hearing, sorting it is not vanity. It is protecting your connection to the people around you.
At Críonna Health we cover the practical, unglamorous side of ageing well in Ireland, because the small things left unattended are usually the ones that shrink a life. If your hearing has changed, start with your GP. It might be a five-minute fix.
This article is for general information and is not a substitute for individual medical advice. Speak to your GP, pharmacist or audiologist about your own circumstances.
📷 Photo by Anshul Gurjar on Unsplash
