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10-minute clinic: Earwax

Use this reference guide when advising customers with earwax.

This handy 10-minute clinic is designed to act as a quick reference guide that will help you when advising customers in different category areas. The flowchart will lead you through the decision-making process to help you respond to customer queries. This month, we look at the advice you can offer and the products you can recommend to customers suffering with earwax 

At a glance

Otitis externa (swimmer’s ear)

Otitis externa is a bacterial or fungal infection that affects the ear canal. It is often caused when water removes the ear’s protective earwax coating, leaving it prone to bacteria and infection.

Often referred to as ‘swimmer’s ear’, symptoms include pain, itching, dulled hearing and ear discharge.

Mild cases can be treated with an OTC solution of acetic acid, which works as an antifungal and antibacterial. Not suitable for children under 12. Severe cases should be referred to a GP.

Whenever you talk to any customer, remember WWHAM:

Who is it for?

It may not be the customer who needs the treatment. Anyone with severe pain and children under 12 should be referred to the pharmacist.     

What are the symptoms?

Discharge from the ear might indicate infection.    

How long have the symptoms been present?

Prolonged hearing difficulties or tinnitus might indicate a more severe condition.  

Action already taken?

Find out if the customer has already tried to remove earwax with a cotton bud or another object, as this may have pushed the wax further down the ear canal.   


It is important to refer customers who have established hearing problems, or are taking any other medication, to the pharmacist. 

You don’t have to ask these questions in order, and a customer might give you some of this information without you asking. As long as you get them into the conversation, you should be able to find out the information you need in order to make a recommendation. The golden rule to remember is: if in doubt, refer to the pharmacist. Don’t be embarrassed to ask for their advice as they have a lot of information about products and symptoms to hand that you may not be aware of.

Self care tips 

  • Advise that customers avoid using cotton buds to remove earwax as it can push wax further into the ear canal, compacting it and making it difficult to remove
  • Customers should avoid putting anything smaller than their elbow in their ears.

When to refer to the pharmacist

  • Children under 12 years
  • An earache develops
  • No improvement after three days of treatment
  • Earache with fever, nausea, vomiting, ear discharge, dizziness or severe deafness.
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