Natural history Progressive hearing loss and the feeling of a blocked ear are insidious features and provoking factors may provide valuable clues to the cause of these symptoms. This potential problem should be checked by a doctor. Young children should not be affected. They should be referred. In infants, the use of cotton buds may be the cause of excess impacted cerumen.
Referral is essential.
There are many reports of allergies to earwax removal agents and caution should be exercised when recommending a product to see if the patient has had any previous experience of it. Reaction of proposed medication The warning above applies to reactions to proposed medication. Establish patient preference All treatments involve placing drops in the ears so there is little patient choice. Product selection Local anaesthetics are no longer included in OTC preparations to treat ear problems. Analgesics should not be used for any ear problem without prior medical consultation.