Every once in a while, children and adults feel a lot of pressure or pain in their ears, and thick wax clogs their ear canal and needs to be removed. Doctors can try to scoop or rinse it out, but many over-the-counter drops can soften it up. But which one works best? This was reviewed by the Cochrane group, the world’s leading reviewer of evidence-based medicine. Their perhaps unsurprising finding was that none of the major drops worked much better than the other; even water-based or saline-based drops worked. However, they weren’t too happy with the overall quality of the studies they reviewed in their literature search. Here’s their “plain language summary” from their review (Ear drops for the removal of ear wax):

Using ear drops to remove impacted ear wax is better than no treatment, but no particular sort of drops can be recommended over any other. Impacted ear wax is one of the most common reasons that people visit their general practitioners (family doctors) with ear problems, as it can cause reduced hearing, discomfort, and sometimes pain and dizziness. Ear drops (either oil- or water-based) are often prescribed to clear the wax or to aid subsequent ear syringing if necessary. The review of trials found that ear drops (of any sort) can help to remove ear wax, but that water and saline drops appear to be as good as more costly commercial products. The quality of the trials was generally low, however, and more research is needed.

The Bottom Line?

You should certainly try some type of wax softener before coming to the doctor, who would probably prescribe something just as effective as an OTC product. For more information, you can read this patient handout from American Family Physician.

By the way, you should never routinely use cotton swabs to clean your ears! There’s no need at all to routinely clean your ear canal, as mother nature does it just fine. I see many patients who have outer ear infections, and most have a story of routinely cleaning their ears with something, usually Q-tips. Remember that earwax is normal and protective; daily messing around in your ear canal sets you up for infections as well as risks of puncturing your eardrum.