Build up of ear wax is common. It can be uncomfortable for the patient and can cause hearing problems. Ear drops have been studied as a potential tool to soften the wax, preventing the need for further treatment such as syringing. This review looks at which treatment (oil- and water-based drops or sprays) can help resolve wax build up.
In March 2018 we searched for clinical trials where ear drops were used to help soften and remove build up of ear wax in patients’ ears. We found and included 10 studies with a total of 623 participants. However, only six of these studies provided data with which we could analyse our primary outcome, the proportion of patients with complete ear wax clearance. These six studies included a total of 360 participants, both children and adults (of all ages), with partial or full blockage of the external ear canal with ear wax.
The 10 included studies looked at either oil-based drops (triethanolamine polypeptide, almond oil, benzocaine, chlorobutanol), water-based drops (docusate sodium, carbamide peroxide, phenazone, choline salicylate, urea peroxide, potassium carbonate), saline (salty water) or water alone, or no treatment.
Only one study compared using drops with an active ingredient to not using drops at all. The drops may help increase the proportion of ears cleared of wax from 1 in 20 (if you do nothing) to about 1 in 5 (if you use drops).
We did not find any evidence that water-based or oil-based drops were any different to saline or water. However, we also did not find any evidence that water or saline were better than doing nothing.
Adverse (side) effects were not common. Fewer than 30 patients reported any adverse events when using the drops and these were mild (such as slight irritation or pain, or unpleasant smell). No serious side effects were reported by any participant.
Quality of the evidence
We rated the quality of the evidence from studies using four levels: very low, low, moderate or high quality. High-quality evidence means that we are very confident in the results. Very low-quality evidence means that we are very uncertain about the results. For wax clearance, we rated the quality of the evidence as low. For adverse effects we rated the quality of the evidence as low.
We have found that using ear drops when you have a partially or completely blocked ear canal may help to remove the ear wax in your ear. It is not clear whether one type of drop is any better than another, or whether drops containing active ingredients are any better than plain or salty water.