Olive Oil vs Sodium Bicarbonate vs Hydrogen Peroxide: Which Ear Drops Should You Use?
There are three common ear drops you can buy in any NI pharmacy: olive oil, sodium bicarbonate, and hydrogen peroxide (sold as Otex or Earex Plus). They look similar on the shelf and they're often used interchangeably, but they work in different ways, suit different ears, and can cause different problems if used wrong. Below I'll explain what each one does, which is right for you, and whether the dropper or the squirt-nozzle bottle matters.
What ear drops actually do
Ear drops don't remove wax by themselves. They soften it. The job is to make wax less sticky and less dense so that the ear's natural outward migration carries it out, or so that a clinician can remove it more easily and comfortably at the appointment.
That's it. If wax is already deeply impacted or blocking the canal entirely, drops alone usually won't shift it. You'll still need microsuction or irrigation. What drops do is make the procedure faster, gentler and more thorough.
Olive oil
The most widely used, the cheapest, and the gentlest. Pharmaceutical-grade olive oil drops (Earol is the common brand, but generic olive oil from any pharmacy works) are simply purified olive oil at body temperature.
How it works
Olive oil coats the wax, softens it gradually over several nights, and lubricates the canal. It's a passive softener. No chemical reaction.
When to use it
For most people, most of the time. Routine maintenance, preparation before a wax removal appointment, occasional softening of mild build-up. It's the default first choice.
Pros
Gentlest of the three. Almost never irritates the canal.
Safe with perforated eardrums (though always check with a clinician first if you're not sure).
Cheap. A bottle costs about £8.
Easy to find in any pharmacy.
Cons
Slowest acting. Needs 3 to 5 nights of use to make a meaningful difference.
Doesn't dissolve hard wax. Just softens and lubricates.
Can feel greasy. Some people don't like the sensation.
How to use it
3 to 5 drops in the affected ear at night, whilst lying on your side, hold position for 10 - 15 minutes. Do no plug with a cotton ball but use a towel on the pillow if you are concerned the oil will fall out as you sleep. Repeat for 3 to 5 nights before an appointment, or 1 night a week for routine maintenance. Don't use longer than a week at a stretch.
Sodium bicarbonate drops
A step up in activity. Sodium bicarbonate (baking soda dissolved in water, sold as Cerumol or generic versions) actively dissolves the keratin in wax rather than just softening it.
How it works
The solution breaks down the protein bonds that hold wax together. The wax becomes more liquid and starts to break apart rather than just softening on the surface.
When to use it
When olive oil isn't enough. People with chronically dense or hard wax, hearing aid wearers whose wax has compacted under the aid, or people whose ears need fast action before an appointment.
Pros
Faster than olive oil. Noticeable softening in 2 to 3 nights.
Better at breaking up dense or stubborn wax.
Not greasy. Water-based.
Cons
Slightly more drying. Some patients with sensitive canal skin notice mild irritation.
Should not be used long-term. Maximum a week, ideally a few days.
Still won't shift fully impacted wax. Needs professional removal afterwards.
How to use it
3 to 4 drops twice a day for 2 to 3 days. Same technique as with olive oil. Don't use for more than a week without clinical advice.
Hydrogen peroxide drops (Otex, Earex Plus)
The most active of the three. Hydrogen peroxide-based drops contain urea hydrogen peroxide that releases oxygen on contact with wax, causing a fizzing, foaming effect that physically lifts wax loose.
How it works
The peroxide breaks the chemical bonds in wax and the released oxygen creates bubbles that mechanically agitate the wax. You'll hear and feel a crackling, bubbling sensation in your ear for a few minutes after dropping it in. That's the active mechanism. Within minutes, much of the wax is loosened, however, it can also spread ear wax all over the ear canal making it more dofficult to remove.
When to use it
When you need fast action, when wax is very stubborn, or when prescribed by a clinician for specific reasons. Some patients swear by it. Some clinicians, including me, recommend it sparingly.
Pros
Fastest acting. Significant softening and partial dislodgement within hours.
Effective on hard, dense, long-standing wax.
Sometimes shifts mild impactions without needing professional removal.
Cons
Most irritant. Can dry, inflame or thin the canal skin with repeated use.
Not safe with perforated eardrums, grommets, recent ear surgery or known otitis externa.
The fizzing sensation is uncomfortable for some people.
Overuse can cause more wax production as the canal skin responds defensively to the irritation.
Should not be used regularly. A short course (2 to 5 days), then a clean break.
How to use it
5 drops in the affected ear, leave for 5 to 10 minutes, drain onto a tissue. Twice a day for up to 4 days. Stop sooner if you feel any burning, stinging or worsening discomfort. Don't use if you have any history of ear infection or eardrum problems without checking with a clinician.
Squirt nozzle vs dropper
The bottle matters more than people think.
Dropper bottles (olive oil, traditional sodium bicarbonate)
A small glass or plastic bottle with a separate pipette dropper. You squeeze drops into the canal one at a time. Slow, controlled, gentle. The drops sit in the canal entrance and gradually trickle down.
Best for: routine softening, gentle application, people who want to control exactly how much goes in.
Squirt nozzle bottles (Otex, some Earex products)
A bottle with a narrow plastic nozzle that you press into the canal entrance and squeeze a steady stream of liquid in. Delivers more drops at once, and pushes the liquid further into the canal under slight pressure.
Best for: getting drops deeper, faster results, situations where surface application doesn't reach the wax.
Why this matters
A squirt nozzle delivers active ingredient deeper. If you're using hydrogen peroxide or sodium bicarbonate and the wax is sitting near the eardrum, the squirt mechanism gets the medication to where it needs to be.
If you don't know whether your eardrum is intact, use a dropper, not a squirt nozzle. And if you're not sure whether your eardrum is intact, get an otoscopy before doing anything with active drops.
My honest recommendation
For most people, most of the time: olive oil drops, applied with a squirt nozzle, for 3 to 5 nights before your wax removal appointment. It does the softening job, costs almost nothing, irritates almost no one.
For stubborn wax: sodium bicarbonate drops with a dropper for 2 to 3 days, supervised by a clinician if possible. Faster than olive oil, gentler than peroxide.
For very impacted wax in confirmed-intact ears: hydrogen peroxide drops via squirt nozzle for a short course (max 4 days), only if your eardrum has been confirmed intact at otoscopy. Effective but not the routine first choice and only to be used when recommended by the clinician performing the ear wax removal.
Don't use any drops indefinitely. Drops are a treatment, not a daily habit. Long-term application of anything (including olive oil) macerates the canal skin and traps debris, which can paradoxically cause more wax build-up.
Before your wax removal appointment
If you've booked a microsuction or irrigation appointment with us, here's the simple protocol:
3 to 5 nights before: 3 to 5 drops of olive oil at night
Hold each application in for 10 minutes with your head tilted
Don't use anything else (no peroxide, no syringes, no online curettes)
Come in for the appointment. We'll handle the rest in 20 to 30 minutes
That single small habit makes the appointment faster, more comfortable, and more complete.
Microsuction ear wax removal at Hear Now Clinic is £50 for one ear and £70 for both ears, including a complimentary hearing screener. Appointments are 30 minutes, usually bookable within the week, often the same day for urgent cases.
Frequently asked questions
Can I use cooking olive oil from my kitchen? Best not to. Pharmaceutical-grade olive oil drops are filtered and sterilised. Cooking olive oil has trace impurities and can be irritating and cause fungal infections. The Earol-style spray or any pharmacy's "olive oil ear drops" is only £8 or so.
How many drops should I put in? 3 to 5 drops for olive oil and sodium bicarbonate. 5 drops for hydrogen peroxide. Don't be tempted to overfill the canal.
How long after using drops should I wait before my appointment? Use drops up until the night before. We prefer to see the wax in its softened state when you arrive.
Can I use ear drops if I wear hearing aids? Yes. Take the aids out before applying drops, leave for the recommended time, wipe the canal entrance, and put the aids back in once the ear feels dry. Don't put aids in over wet drops. Preferrably apply drops before bed so they are less likely to interfere with the hearing aids.
Is Otex safe to use regularly? No. It's designed for short courses (a few days at a time). Regular use irritates the canal and can paradoxically cause more wax. If you find yourself reaching for it monthly, book a proper wax management consultation.
Should I use drops before every microsuction appointment? For routine cases, 2 to 3 nights of olive oil is enough. For stubborn or long-standing wax, 4 to 5 nights makes a noticeable difference. We'll tell you the protocol when you book.
Can drops cause dizziness? Rarely. Cold drops can briefly trigger a caloric response (mild dizziness as the inner ear's temperature shifts). Warm the bottle in your hand for a minute before using to avoid this.
What about ear candles or ear vacuum tools? Don't. Ear candles have no evidence of effectiveness and a real burn risk. The FDA has issued warnings. Online vacuum and camera tools cause perforations regularly. I've removed several broken tips from canals. Use drops at home, then book a professional appointment if drops alone don't shift it.
