Last Updated on 28th July 2023 by Admin
What Is Micro Suction?
Microsuction earwax removal is the removal of ear wax from the ear using a medical suction unit using an illuminating microscope. It is around 100 times safer than the old syringing method. A microsuction practitioner must be an appropriately trained, registered and insured professionally. Typically, microsuction is performed by a doctor, ENT surgeon or an Audiologist. Our clinics are staffed by Audiologists or Assistant Audiologists under the supervision of an HCPC Registered Hearing Aid Dispenser.
How Safe Is Micro Suction?
Micro suction introduces no water into the ear and only removes wax from the ear using gentle suction. Our Audiologists use a portable Vorotek O-Scope ENT microscope to see into your ear canal in great detail. This way, they can see exactly what they are doing inside your ear. The suction wands are sterile, so the risk of infection is virtually zero. For these reasons, microsuction is considered the safest method of removing wax from the ear, and about 100 times safer than the old irrigation or syringing methods.
Is Microsuction 100% Effective?
Our success rate is the best in the industry at 99.8%… The consistency of ear wax varies from individual to individual and is genetically determined. Some people have soft earwax, which is very easily removed using microsuction, whereas other people have very sticky or hard ear wax, which may need a combination of methods to remove. For very sticky or very hard ear wax, all of our Audiologists have been trained to use manual instruments as well as microsction. Manual instruments are very effective for removing hard and sticky ear wax. , and our Audiologists are only unable to remove ear wax in 0.2% (1 in 500) of cases when it is too uncomfortable for the patient (because they haven’t softened the way using our Waxbusting Protocol™), or the wax is attached to the ear drum and our Audiologist deems it unsafe to continue the procedure (and in all likelihood it could have been removed if the patient followed our Waxbusting Protocol™).
What Are Manual Instruments?
Manual instruments include the Jobson Horne probe, earwax hook, Rosen hook and crocodile forceps. Often when ear wax is especially hard or sticky, suction alone will not be enough, while manual instruments will be able to remove it. Many ear wax removal clinics only use microsuction or when microsuction is ineffective they give up and use irrigation (a modern version of syringing). However, the combination of microsuction and manual instruments is superior as it is safer and more effective.
Do You Use Syringing Or Irrigation?
No. Syringing and irrigation used to be used widely by nurses in NHS GP practices to remove ear wax. Syringing was literally using a large metal syringe with a blunt tip to squirt water into the ear. Irrigation is a modernised method using an electric water pump like a “mini jet wash” to blast the wax from the ear. Both methods use the principal of “displacement”, where if enough water pressure is used, the ear wax will be “displaced” from the ear canal. One obvious flaw in this method is we want the ear wax to come out, but water is being squirted in – so in many cases the ear wax is pushed further into the ear canal!
Irrigation has been withdrawn as a service in most GP practices, partly because of a lack of funding, but also because irrigation has a high incidence of complications, which can include pain, bruising and bleeding of the canal at one end, and infection, hearing loss, tinnitus, facial paralysis and ear drum rupture (perforation) at the other end. This has been reported in the BMJ.
We believe that taking the easy way our and syringing or irrigating someone’s ear is not worth the risk, which is why at Hearing First we NEVER syringe (or irrigate).
Does Micro Suction Hurt?
Normally microsuction is completely painless. Our Audiologists are highly trained, and will gently draw the wax from your ear using a CE-certified medical suction unit. Bear in mind that as the machine is sucking wax through a thin tube, depending on the consistency of your wax it can sound like a child joyfully slurping a milkshake through a straw, tiny firecrackers crackling, or it may be almost silent. We recommend that you use a couple of squirts of Earol sterile olive oil spray or a few drops of olive oil in both ears, 4 times a day for 5 days before your appointment, or better still follow our Waxbusting Protocol™. This is to soften the earwax, reducing the chances of hard wax scratching or grazing the ear canal, ultimately making the procedure painless. If ear wax is very hard or sticky and microsuction is not effective, then manual instruments will need to be used, and you may feel a certain amount of pressure as the instrument pulls the wax out of your ear. Most important is the relief you will feel when the wax is gone and you can hear again!
How Soon Can I Be Seen?
We recommend that you use a couple of squirts of Earol 4 times a day for 5 days prior to your appointment. If you have already softened the wax we may be able to see you sooner, depending on how busy our clinics are. If you need treatment urgently because, for example, you are in pain, you’re attending an important event, or you’re going away on holiday and you need to be seen in less than 5 days, then we will do our utmost to clear your ears. We recommend that you soften your wax as much as you can before your appointment. We may need to use manual instruments if your wax is hard, but chances are if anyone can remove your ear wax, we can.
Guaranteed Results With Our Waxfree Guarantee™!
We’re the only national independent ear wax removal specialists that offer our unique Waxfree Guarantee™. Just follow our simple guide and we guarantee to get your ear wax out on the first visit, or your next visit is free. You can find out more about our Waxfree Guarantee™ here: The Hearing First Waxfree Guarantee™ (opens in a popup).
Where Can I Get Microsuction?
We directly run a number of our own private ear wax removal clinics. Please visit our ear microsuction locations page for further details.
What Happens In A Microsuction Ear Wax Removal Appointment?
Here is a video which explains what happens when you book an ear wax removal appointment with Hearing First:
Can I get a microsuction even after ear surgery?
The short answer is “Yes”. After ear surgery, you may have been told to keep your ear dry and never have it syringed (irrigated), as there may be a risk of perforating your ear drum or causing an infection. Fortunately, microsuction doesn’t introduce any water into the ear, and providing that your surgery has healed, there should be no problem. As always, please check with your surgeon that he or she is happy for the procedure to be carried out.
Is microsuction safe for people with perforated ear drums?
The same applies as for the previous question. However, we recommend that you don’t use any ear drops or sprays prior to your appointment. Microsuction or manual instrument removal are the only two methods that are recommended if you have a perforation or have had ear surgery.
How Can I Book A Microsuction Ear Wax Removal Appointment?
Click on the “Book Microsuction Ear Wax Removal Now” button below, or click on the link to the booking page.
What Is The Difference Between Microsuction And Endoscopic Earwax Removal?
Microsuction is the removal of ear wax using suction and either the operating microscope or portable ENT microscope. Normally a 2 mm Zoellner tube is used, but a 1 mm fine end may be used when working close to the ear drum. Some ear wax removal clinics only employ people trained to use microsuction, but we train our Audiologists to use microsuction as well as manual instruments. Manual instruments include the Jobson Horne probe, earwax hook, Rosen hook and crocodile forceps. Often when ear wax is especially hard or sticky, suction alone will not be enough, while manual instruments will be able to remove the ear wax.
Endoscopic Earwax Removal is the removal of earwax using an otoendoscope or video-otoendoscope to view the ear canal and ear drum, and removal tools such as suction and manual instruments. Each ear wax removal method requires different skill sets and further training under an ENT consultant is recommended if ear wax will be removed endoscopically.
The greatest drawback with endoscopic earwax removal is the lack of depth perception. When an operating microscope or portable ENT microscope are used, the Audiologist is using both eyes and can judge the depth of the ear drum, the wax and the instrument. A video endoscope uses a single lens and the picture is viewed on a screen, and therefore cannot give any feeling of depth to the Audiologist, meaning that an important safety feature is non existant with this method.
Another drawback with endoscopic ear wax removal is that the 2.8mm endoscope and 2mm suction tube have to both fit in the ear canal at the same time. Patients with narrow ear canals may find having so much equipment in their ear quite uncomfortable, and the Audiologist may have difficulty manoeuvring the instruments to remove the wax due to the lack of space. When using a Vorotek O-Scope instead of an endoscope, the patient with narrow canals feels little to no discomfort, and the Audiologist is able to manoeuvre the suction tube without the endoscope getting in the way.
Several of our Audiologists have been trained in endoscopic ear wax removal and have extensively used both endoscopic and portable microscope methods, and all agree that the endoscopic method is great for making YouTube videos, but using the Vorotek O-Scope is safer, more comfortable and more effective.
More Frequently Asked Questions
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Why should I choose Hearing First as my ear wax removal provider?
Here are six reasons why Hearing First is the best choice for safe and professional ear wax removal:
✔ Waxfree Guarantee™ – We are the only ear wax removal provider to offer this exclusive guarantee.
✔ In-House Clinicians – All of our Audiologists are directly employed by Hearing First—we are not a referral service.
✔ Audiology Experts – Our clinicians are qualified Audiologists who specialise in hearing—we do not employ pharmacy assistants, podiatrists, or beauticians.
✔ Ongoing Professional Training – Our Audiologists undergo regular professional development to stay at the forefront of audiology advancements.
✔ Advanced Equipment – We use the Vorotek O-Scope, which provides superior depth perception up to the eardrum, making it safer than loupes, video-endoscopes, or the Tympa system.
✔ Safe & Effective Techniques – All of our Audiologists are trained in both microsuction and manual instrument methods, the most precise and comfortable ear wax removal techniques available.
With Hearing First, you’re in the hands of dedicated registered professionals who prioritise your well-being and hearing care. -
What are the four methods of ear wax removal?
The four methods of ear wax removal are:
1. Irrigation (aka syringing)
2. Endoscopic ear wax removal
3. Microsuction
4. Manual instruments -
Do you use all four methods of ear wax removal?
There are four recognised methods of ear wax removal, but while each has its own merits, they are not equal in terms of effectiveness and safety. No method is completely risk-free, but some are significantly safer than others. The key factor in ensuring a safe and successful procedure is the expertise and training of the practitioner. Is the person treating you a qualified Audiologist with in-depth knowledge of the ear, or are they a beautician, podiatrist, or pharmacy assistant with limited ear care training?
The Four Methods of Ear Wax Removal
❌ Irrigation (Not Used at Hearing First)
We have never used irrigation due to its higher risk of complications, including eardrum perforation. This method, sometimes referred to as “spray and pray”, involves flushing the ear with water without direct visualisation of the ear canal. The force of the water jet can unintentionally strike the eardrum, particularly if an undiagnosed infection has weakened it.❌ Endoscopic Microsuction (Not Used at Hearing First)
We conducted a year-long evaluation of this method and found several significant drawbacks:
✗ The endoscope is bulky, making it uncomfortable in narrow ear canals.
✗ 2D imaging lacks depth perception, increasing the risk of accidental injury.
✗ The heavy battery pack causes hand fatigue, making it impractical for all-day clinic use.
✗ It is better suited for video demonstrations than clinical precision.✅ Microsuction (Preferred Method at Hearing First)
✔ Widely regarded as the safest method for ear wax removal.
✔ Performed using a fixed or portable ENT microscope (e.g. Vorotek O-Scope) for superior depth perception.
✔ Ideal when wax has been properly softened.
✔ If wax is deep, we use a fine end suction tube, reducing airflow by 75% for a quieter, more comfortable experience.✅ Manual Instrument Removal (Used When Necessary)
✔ Effective when wax is too firm or sticky for microsuction.
✔ Used if wax is adhering to the ear canal wall (often due to insufficient softening).
✔ While patients may feel temporary pressure, the instant relief when the wax is removed makes it worthwhile.A Tailored Approach for the Best Results
In many cases, our clinicians use a combination of microsuction and manual instruments, as wax can vary in consistency depending on how long it has been in the ear and how well it has softened.
No matter which method is used, as long as you follow our Waxbusting Protocol™, you are covered by our Waxfree Guarantee™—if we can’t remove your wax at the first appointment, your second visit is free!
Why do I need to soften my ear wax?
Our audiologists are highly trained professionals, and your safety is their top priority. The skin lining your ear canal is extremely delicate—it ranges from 1mm thick at the entrance to just 0.1mm (4 thousandths of an inch) at the eardrum.
Ear wax is often hard and sticky—if it weren’t, it would naturally work its way out, as the ear is self-cleaning for most people. When wax becomes impacted, it can stick to the delicate ear canal lining, increasing the risk of scratches, irritation, or damage during removal.
Pre-softening the wax is highly recommended because:
✔ It makes removal safer and more comfortable
✔ It reduces the risk of irritation or injury to the ear canal
✔ Clinical research confirms it lowers the chances of dizziness or discomfort during the procedure
For the safest and most effective treatment, we always recommend following our pre-softening guidelines before your appointment.
When I use drops or spray my hearing gets worse. Should I stop?
No, don’t stop! We normally expect this to occur.
When you apply ear drops or spray, the liquid fills the tiny gaps around the wax, temporarily reducing your hearing. If the wax is dry, it will also expand as it absorbs the softener—much like a raisin plumping up in water.
This is a sign that the wax softener is working, helping to break down the wax for a smoother, more comfortable removal.
For the best results, continue following the Hearing First Wax Busting Protocol™ or apply Earol olive oil spray 4 times a day for 5 days until your appointment.
I’m unable to soften both ears due to my work or caring duties. What can I do?
This is a common challenge, and is one of the reasons why we offer a discount for single-ear procedures.
We recommend booking an appointment for one ear first, following the Hearing First Wax Busting Protocol™ for that ear. Once it has been treated, you can then repeat the process for your other ear at a later appointment.
This approach ensures both ears receive the proper care while fitting around your schedule.
I need ear wax removal urgently and don’t have time to soften it. What should I do?
If you can book at least one day in advance, we recommend speaking to a pharmacist and purchasing Waxsol or sodium bicarbonate with glycerol ear drops over the counter. Use them in both ears the night before and again on the morning of your appointment. While this isn’t as effective as the Hearing First Wax Busting Protocol™, it’s better than nothing and can improve the chances of successful removal.
If you book on the same day and haven’t softened your wax at all, you’ll need to agree to a disclaimer. We will do our best to remove the wax, but unfortunately, we cannot guarantee success in these cases.
I can’t find Earol, but I found something called Cl-ear Olive Oil Ear Spray – is that ok?
Yes. Cl-ear Olive Oil Ear Spray is almost equivalent to Earol, and can be used as part of our Waxbusting Protocol™. The difference between them is that Earol is in a sealed sterile container and can be used for up to 6 months, while Cl-ear Ear Spray is good to use for up to 28 days.
The Pharmacist says ordinary pharmacy grade olive oil with a dropper is just the same as Earol. Can I use that and still take advantage of the Hearing First Waxfree Guarantee™?
No, it must be an olive oil spray rather than drops.
Earol uses a micronised spray, which breaks the oil into tiny droplets that penetrate ear wax far more effectively than standard olive oil drops. Additionally, Earol (and other olive oil sprays) should be applied with the head upright, encouraging wax to move towards the ear canal entrance.
In contrast, olive oil drops require you to tilt your head to the side, which can cause wax to shift closer to the eardrum, making removal more difficult.
Other brands, such as Cl-ear Olive Oil Spray, can be used as an alternative to Earol.
At Hearing First, we have performed over 60,000 ear wax removal procedures, refining the Hearing First Wax Busting Protocol™ to ensure safe and effective treatment. To qualify for the Hearing First Waxfree Guarantee™, only this protocol can be used.
The Pharmacist says Otex Express is the best ear wax softener. Can I use that and still take advantage of the Hearing First Waxfree Guarantee™?
No, unfortunately, you can’t. While Otex Express is heavily marketed—even to pharmacists—our clinical experience tells a different story.
We’ve treated many patients who have used Otex Express and experienced sore, red ear canals and peeling skin due to the hydrogen peroxide it contains. This can cause unnecessary irritation and discomfort during the wax removal procedure.
At Hearing First, we’ve carried out over 60,000 ear wax removal procedures, refining our approach to ensure the best results with maximum comfort. Our Hearing First Wax Busting Protocol™ is a safe, effective method designed to prepare your ears for wax removal without causing irritation.
To qualify for the Hearing First Waxfree Guarantee™, we require patients to follow this protocol exclusively, ensuring the best possible outcome.
The nurse / doctor / pharmacist recommended sodium bicarbonate ear drops as a cheap and effective wax softener. Can I use that and still take advantage of the Hearing First Waxfree Guarantee™?
Yes, you can. Be careful to only use sodium bicarbonate for two days at the beginning of the Waxbusting Protocol™, followed by three days of using Earol olive oil spray. The ear canal surface is designed to be acidic in order to discourage the growth of bacterial and fungal spores. While sodium bicarbonate is indeed effective at softening ear wax, it is alkaline and can neutralise the acidity of the canal surface, sometimes causing the upper layer of skin to peel off, especially when used for more than a few days. This can increase the chances of a painful outer ear infection (otitis externa), and make make the ear canal swollen and sensitive, making for an unnecessarily uncomfortable ear wax removal procedure.
Over the course of more than 60,000 ear wax removal procedures, we have developed the Hearing First Wax Busting Protocol™, which is safe and effective, and only this protocol will be accepted for the Hearing First Waxfree Guarantee™
Do you have any advice for ear care after ear wax removal?
When you use the Hearing First Wax Busting Protocol™, it greatly reduces the chances of scratches or damage to the ear canal surface. However, there may be microscopic scratches that we cannot see. We therefore recommend that you keep your ears dry for 4 to 5 days to allow the skin surface to start to recover. During this period, when you shower or wash your hair, you will need to get some cotton wool balls and Vaseline (or other petroleum jelly), saturate two cotton wool balls with the Vaseline, squish them up and place one in the outer bowl of each ear – this will prevent water from entering the ear canal.
Moving forwards, in order to reduce wax build up our advice has changed to keeping your ears dry as much as possible, rather than regularly applying olive oil. Our Director, Mary Levy studied this phenomenon over the course of 6 months and her research is published here.
I get itchy ears, especially after swimming or showering, and they sometimes get sore – what should I do?
We would always recommend booking an ear examination with an Audiologist or doctor before trying self-treatment, but a good product is Otinova, which can be purchased online in our web shop here. It contains several ingredients which are antibacterial and antifungal and reduce itching. If the itching continues despite 7 days treatment, we recommend you seek medical advice, as a prescription strength medicine may be necessary.
I’ve seen a plumber / beautician / nurse offering wax removal much cheaper – aren’t they just as good?
When choosing a provider for ear wax removal, it’s important to consider more than just price. Since ear wax removal is an unregulated procedure in the UK, you should be extremely cautious about who you trust with your ears. Here’s why:
✔ Medical expertise matters – NHS GP surgeries have largely stopped using nurses for ear wax removal, as it requires specialised skills.
✔ Your ears are delicate – Your eardrum is just 0.1mm (4 thousandths of an inch) thick. While surgery can repair damage, success isn’t guaranteed. You only have one set of ears—protect them.
✔ Training makes a difference – Lay people offering wax removal typically complete only a one- or two-day course. They lack in-depth knowledge of ear anatomy, physiology, and potential complications. Without ongoing supervision under an ear specialist, their experience is extremely limited.
✔ Our expertise – At Hearing First, all our audiologists have studied Audiology for at least six months, with most having three years of formal education in ear anatomy, physiology, and pathology. Most also hold a Postgraduate Diploma in Pathology of the Auditory System and ENT Emergencies, equipping them to recognise and manage complex ear health issues.
Choosing a provider with the right expertise ensures not just effective treatment, but also your long-term ear health and safety.
Who should be allowed to perform ear wax removal?
This is an important question, especially since ear wax removal is currently unregulated in the UK. In reality, anyone can call themselves an “ear wax removal practitioner” after just a one- or two-day course, obtain indemnity insurance, and start a business—with little to no experience.
However, the ear is an extremely delicate organ, and improper wax removal can cause serious damage. The eardrum, for example, is only 0.1mm (4 thousandths of an inch) thick, and while surgery can sometimes repair it, the risks of permanent harm are significant.
For public safety, we strongly recommend that anyone performing ear wax removal should have at least six months of formal training in:
✔ Ear anatomy (understanding the structure of the ear)
✔ Physiology (how the ear functions)
✔ Pathology (identifying conditions that may appear to be wax but could indicate a more serious issue)
At a minimum, this level of training corresponds to roles such as Associate Audiologist or Audiologist Assistant. Even then, these individuals should only operate under the supervision of a Registered Hearing Aid Dispenser—an experienced audiologist registered with the Health and Care Professions Council (HCPC), the only statutory professional regulator of Audiologists. The list therefore includes:
🔹 HCPC-Registered Hearing Aid Dispensers
🔹 Audiologists
🔹 Associate Audiologists / Audiologist Assistants
Other suitable professionals include:
🔹 ENT surgeons
🔹 ENT nurses with a minimum of three years of experience working under an ENT specialist
We strongly advise that anyone carrying out ear wax removal should either:
✔ Be registered with a relevant statutory professional body (e.g., HCPC, GMC)
✔ Work under the supervision of a qualified professional on such a register
This ensures they adhere to strict professional codes of conduct, ethics, and safety standards—giving you confidence that your ear health is in expert hands.
What if I haven’t been able to follow the Wax Busting Protocol™ for the full five days or couldn’t find the recommended products?
You’re still in excellent hands. Hearing First’s audiologists are highly trained in microsuction and manual instrument ear wax removal and have an industry-leading first appointment success rate of 99.8%.
In the unlikely event that your wax is too hard or too impacted to be fully removed in one session, we offer a 40% discount on a follow-up appointment. While we always aim for complete removal in one visit, your long-term ear health is our priority.
Your ears and hearing are delicate and precious, and our audiologists will always err on the side of caution. In some cases, it’s better to remove the wax comfortably and effectively over two appointments rather than risk discomfort by forcing it in one go.
