Sudden hearing loss, hearing that is worsening over days or weeks, or hearing loss with earache or discharge can need urgent medical assessment. Ask for an urgent GP appointment or contact NHS 111.
Before your microsuction appointment
Read the preparation advice sent by the clinic. Depending on your ears and the service's protocol, you may be advised to use an appropriate wax softener before attending. This can make hard or impacted wax easier to remove. Use only the product and timing advised, and follow its instructions.
Mention ear surgery, a known or suspected perforated eardrum, current pain or discharge, previous difficulties with wax removal, tinnitus, dizziness, hearing aids and any sudden change in hearing. Ask for professional advice before using drops if any of these may make them unsuitable.
Bring your hearing aids if you use them. They can help explain how your hearing has changed and whether wax may be affecting the fit or sound. You may also want to note when your symptoms started, whether one or both ears are affected, and any questions you want answered.
Step 1: questions and a visual ear check
The clinician first listens to your symptoms and ear history. Both ears can then be examined with a lighted viewing instrument. This matters because a full sensation, tinnitus or reduced hearing is not always caused by wax.
The assessment should answer three practical questions:
- Is earwax present, and does it appear to explain the symptoms?
- Can the ear canal and eardrum be assessed safely?
- Is microsuction an appropriate option for this person and this ear today?
The clinician should explain the findings in ordinary language. If the canal is clear, there is no reason to carry out a wax-removal procedure. If something else needs attention, you should be given a suitable next step.
Step 2: treatment, when it is suitable
Microsuction removes wax using a fine suction tube while the clinician looks into the ear. Unlike irrigation, it does not flush water into the canal. Direct vision helps the clinician see the position of the suction tip and monitor progress.
You remain seated and should be asked to keep your head still. The clinician works in short stages and may pause to recheck the canal. Some wax can be removed quickly; very hard, deep or tightly impacted wax may take longer or may not be sensible to remove fully in one visit. Safety and comfort are more important than forcing completion.
In some situations, the clinician may use a small instrument as well as suction, or may advise more softening before another attempt. The plan depends on what can be seen and how the ear responds.
What does ear microsuction feel and sound like?
The suction creates sound inside the ear, so it can seem louder than expected. You may notice a pulling, tickling or cool sensation. Dry skin and hard wax can be more uncomfortable than soft wax. Experiences vary, and no responsible service should promise that every procedure will be painless.
Tell the clinician immediately if you feel pain, dizziness or need a pause. You do not have to tolerate discomfort to complete the appointment. The clinician can stop, reassess and discuss whether to continue.
You can ask questions before treatment and can withdraw consent at any stage. A clear explanation of what is proposed should come before the procedure begins.
Step 3: recheck, explanation and aftercare
After removal, the clinician can look again and explain what the canal and eardrum look like. If wax was the main cause of reduced sound, you may notice an immediate change. Hearing does not always change straight away, and persistent symptoms need an appropriate follow-up rather than an assumption that more wax remains.
Follow the individual aftercare advice you receive. Avoid inserting cotton buds or other objects. If the ear feels irritated, do not add unadvised drops. Seek medical advice if you develop significant or persistent pain, discharge, worsening dizziness or a new hearing change after the appointment.
What if all the wax cannot be removed?
Hard wax may need more softening, and a sensitive canal may need time to settle. In other cases, the safest choice may be referral to a different service. A partial result is not a reason to continue when the view, comfort or clinical situation makes treatment unsuitable.
How to choose an earwax-removal service
Before booking, look for a service that makes the following clear:
- an ear history and visual assessment come before treatment;
- the clinician will explain whether wax is present and removal is suitable;
- you can ask for a pause or stop;
- you will receive clear aftercare or onward signposting; and
- the location, booking provider and relevant premises details are transparent.
East London Ear Care offers appointments within Letter Box Pharmacy at 4 Brick Lane, London E1 6RF, in Whitechapel. The host pharmacy premises registration number is shown on the website and links to the General Pharmaceutical Council register.
Sources and editorial note
This guide was prepared from public NHS and NICE information and the service pathway described by East London Ear Care. It does not replace an individual assessment.
Last reviewed: 29 July 2026.