Sudden hearing loss: when to get urgent help

Why does a sudden hearing change matter?

Hearing can reduce for many reasons. A plug of wax is one possibility, but a problem in the inner ear can also cause a rapid change. You cannot reliably tell the difference from the sensation alone. The NHS therefore advises urgent assessment for sudden hearing loss rather than waiting to see whether it clears or assuming that wax is responsible.

“Sudden” may mean that hearing changed at once, when you woke up, or over a short period. It can affect one ear or both. Some people first notice it while using the telephone, listening with headphones or covering the better-hearing ear. Others notice new tinnitus or a full feeling at the same time.

Which hearing symptoms need urgent advice?

Follow NHS advice and seek an urgent GP appointment or NHS 111 help when:

• hearing has suddenly reduced in one ear or both ears;
• hearing has become worse over the last few days or weeks; or
• hearing loss is accompanied by earache or fluid coming from the ear.

Explain the timing clearly when asking for help. Say that the hearing change was sudden or has rapidly worsened, rather than simply saying the ear feels blocked. This helps the service understand why the request needs prompt attention.

Can earwax cause reduced hearing?

Yes. A wax plug can reduce sound reaching the eardrum and may cause fullness, tinnitus or discomfort. Wax-related change is often gradual, but symptoms alone cannot confirm the cause. An examination can show whether the canal is blocked, while further medical or hearing assessment may be required if wax does not explain the problem.

Do not delay urgent advice in order to try cotton buds, home instruments or repeated courses of drops. Objects can push wax deeper or injure the canal and eardrum. Drops may be unsuitable when there is a perforated eardrum, previous surgery, pain or discharge.

What can a private earwax service assess?

A clinical earwax service can ask about symptoms and ear history, visually check the ear canal, identify visible wax and decide whether removal appears appropriate. If wax is safely removed, the ear can be checked again and your symptoms reviewed.

A routine microsuction service cannot replace:

• urgent assessment of sudden or rapidly worsening hearing loss;
• medical diagnosis and treatment of an ear infection;
• a full hearing test where hearing loss persists; or
• emergency care for severe or rapidly developing symptoms.

What information should you give the GP or NHS 111?

Be ready to explain:

1. exactly when you first noticed the hearing change;
2. whether it happened at once or worsened over several days;
3. whether one or both ears are affected;
4. any earache, discharge, tinnitus, dizziness or balance change; and
5. recent ear problems, surgery, injury, illness or new medicines.

If another person noticed the change, ask them to help describe the timing. Do not be reassured only because there is no pain: the NHS urgent-hearing-loss advice does not require pain to be present.

What about gradual hearing loss?

Hearing that has gradually reduced over months or years still deserves attention, particularly when it affects conversation, television volume, safety or social confidence. The NHS advises seeing a GP if hearing has been gradually getting worse. Wax can be checked, but a hearing assessment may also be appropriate.

If hearing remains reduced after wax has been appropriately removed, follow the clinician's signposting rather than repeatedly booking removal. Persistent hearing difficulty needs the cause investigated.