Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Earwax - Management
What methods of earwax removal are not recommended?

  • Advise people against inserting anything in the ear. Cotton buds, matchsticks, and hair pins can:
    • Damage the wall of the canal and increase the likelihood of otitis externa.
    • Cause the wax to become impacted by pushing it further into the canal.
    • Perforate the tympanic membrane.
  • Advise that the use of ear candles has no benefit in the management of earwax removal and may result in serious injury.
Clarification / Additional information
  • Ear candling should never be used: a hollow candle is burned with one end in the ear canal. The intention is to create a negative pressure which draws the earwax out of the ear canal.
Basis for recommendation
  • The basis for these recommendations is expert advice [Clarke et al, 2004].
  • A small study aimed to evaluate the efficacy and safety of the use of ear candles found the following [Seely et al, 1996]:
    • It is claimed that ear candling works by creating a vacuum which draws earwax from the ear. To investigate this two different sorts of candles were burnt in 20 ears. Tympanometric measurements in the ear canal demonstrated that ear candling did not produce a negative pressure at any time during the trial.
    • A small trial (n = 8 ears, 4 with no wax and 4 with impacted wax) did not show that any earwax was removed from the canals of the ears with impacted wax. Instead candle wax was deposited into the ear canal in some of the participants.
    • A survey of 122 otolaryngologists identified 21 injuries resulting from the use of ear candles: 13 burns of the auricle and external auditory canal, seven partial or complete occlusions of the ear canal with candle wax, and one perforation of the tympanic membrane.

© NHS Institute for Innovation and Improvement