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Blocked ears (wax) self-care guidelines for patients

Earwax

Earwax is a normal build-up of dead cells, hair, foreign material such as dust, and natural wax which forms a protective coating on the skin in the ear canal. The quantity of earwax produced varies greatly from person to person.

A doctor or nurse can look into the ear canal and confirm a plug of earwax has formed, though this isn’t always necessary. A plug of earwax is not a serious problem, more a nuisance. You only need to remove earwax if it is causing symptoms such as dulled hearing or when fitting a hearing aid.

Do not put anything in your ear if you have pain or if you are aware that you have a perforation (hole in the ear drum)- see your nurse/GP.

Do not try to remove wax using a cotton bud or any other small item – this only stimulates the wax secreting glands – to make more wax – and gives a serious risk of infection and perforation! Nothing smaller than your elbow should go into your ear!

Illustration of the anatomy of the ear

Note: If you think you have ear wax, do not try to clean the ear canal with cotton wool buds. This can make things worse, as you will push some earwax deeper inside. It may also cause an ear infection.

Ear drops alone will clear a plug of earwax in most cases. Put 2 or 3 drops of ordinary olive oil down the ear 2 or 3 times a day for 2-3 weeks. This softens the wax so that it then runs out of its own accord without harming the ear. You can continue for any length of time, but 3 weeks is usually enough. Surprisingly, you will not necessarily see wax come out. It often seems to come out unnoticed.

If you are prone to repeated wax built up you can continue to use olive oil drops twice a week to prevent recurrence.

If olive/almond/coconut oil does not work you can buy drops from pharmacies.

How to use ear drops:

  1. Warm the drops to room temperature before using them
  2. Pour a few drops into the affected ear
  3. Lie with the affected ear uppermost when putting in drops
  4. Stay like this for 10 minutes to allow the drops to soak into the earwax.

Bulb syringing is a safe, alternate way to remove ear wax. Bulb syringes can be easily purchased from a pharmacy and allow you to clear your ears from wax in your own home.

If your ears are painful or have fluid coming out of them, or if you have a hole in their ear drum (perforation) or have recently had surgery on your ear you should see a doctor or nurse and don’t use this method.

Bulb Syringing:                     

Instructions for Bulb Syringing:

Use olive oil drops twice a day for at least 14 days prior to bulb syringing. Or alternatively use sodium bicarbonate ear drops purchased from your pharmacy (please read the manufacturers leaflet.)

  1. Wash your hands.
  2. Use a bowl of cooled, boiled water that is warm to the touch, not too hot or too cold. You can use 50% water 50% vinegar if you would like as this has an anti-inflammatory effect due to acetic acid in the vinegar.
  3. Prepare the syringe by squirting water in and out of it a few times.
  4. Gently pull your outer ear “up and out” to help straighten out the canal, which will allow better access for the water
  5. Tilt your head so the ear to be treated is upmost.
  6. Place the tip of the syringe into the opening of the ear.- Do NOT push the syringe further into the ear and gently squirt one or more bulb syringes of water into your ear. (This might be best done in the shower so that the excess water will run into the bathtub and not on your floor)
  7. Allow the water to remain in your ear for at least 60 seconds. Gently tilt your head in the opposite direction and wiggle your outer ear

Ear irrigation is only recommended in the rare occasions where ear drops and bulb syringing has failed to work. Ear syringing can lead to ear infections, perforated ear drum and tinnitus (persistent noise) and therefore it is only performed in exceptional circumstances. If you think you have persisting wax despite taking the above measures please make an appointment with your doctor or nurse to discuss.

For patients who are not physically able to self-manage please discuss with the surgery.

Hay Fever

Hay Fever

Hay fever is a common allergic condition that affects up to one in five people at some point in their life. 

Symptoms of hay fever include:

  • sneezing
  • a runny nose
  • itchy eyes

You’ll experience hay fever symptoms if you have an allergic reaction to pollen.

Pollen is a fine powder released by plants as part of their reproductive cycle. It contains proteins that can cause the nose, eyes, throat and sinuses (small air-filled cavities behind your cheekbones and forehead) to become swollen, irritated and inflamed.

Woman blowing nose

There’s currently no cure for hay fever, but most people are able to relieve symptoms with treatment, at least to a certain extent.

The most effective way to control hay fever would be to avoid exposure to pollen. However, it’s very difficult to avoid pollen, particularly during the summer months when you want to spend more time outdoors.

It’s sometimes possible to prevent the symptoms of hay fever by taking some basic precautions, such as:

  • wearing wraparound sunglasses to stop pollen getting in your eyes when you’re outdoors
  • taking a shower and changing your clothes after being outdoors to remove the pollen on your body
  • staying indoors when the pollen count is high (over 50 grains per cubic metre of air)
  • applying a small amount of Vaseline (petroleum gel) to the nasal openings to trap pollen grains

Treatment options for hay fever include antihistamines, which can help to prevent an allergic reaction from occurring and corticosteroids (steroids), which help to reduce inflammation and swelling.

Hay fever can often be controlled using over-the-counter medication from your pharmacist.

If your symptoms are more troublesome, it’s worth speaking to your GP as you may require prescription medication.

Cough (adults)

Cough (adults)

A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke. It’s rarely a sign of anything serious.

A “dry cough” means it’s tickly and doesn’t produce any phlegm (thick mucus). A “chesty cough” means phlegm is produced to help clear your airways.

Glass cup with hot honey and lemon

Most coughs clear up within three weeks and don’t require any treatment.

Some things you can try to help ease your cough are:

  • Drink lots of water (6-8 glasses a day)
  • Drink honey and lemon ( Lemon juice and a teaspoon of honey in hot water)
  • Suck lozenges or hard boiled sweets
  • Stop smoking
  • Try an over-the-counter cough mixture
  • Take Paracetamol to help relieve symptoms

 

Your local Pharmacy can recommend treatments to help ease your cough.

There’s usually no need to see your GP if you have a mild cough for a week or two. However, you should seek medical advice if:

  • you’ve had a cough for more than three weeks
  • your cough is particularly severe or is getting worse
  • you cough up blood or experience shortness of breath, breathing difficulties or chest pain
  • you have any other worrying symptoms, such as unexplained weight loss, a persistent change in your voice, or lumps or swellings in your neck
  • If your GP is unsure what’s causing your cough, they may refer you to a hospital specialist for an assessment. They may also request some tests, such as a chest X-ray, allergy tests, breathing tests, and an analysis of a sample of your phlegm to check for infection.

Sore Throat

Sore Throat

Sore throats are very common and usually nothing to worry about. They normally get better within a week. Most are caused by minor illnesses such as colds or flu and can be treated at home.

Packet of throat lozengers

The following can often help soothe a sore throat:

  • taking ibuprofen or paracetamol – paracetamol is better for children and for people who can’t take ibuprofen (note that children under 16 should never take aspirin)
  • drinking plenty of cool or warm fluids, and avoid very hot drinks
  • eating cool, soft foods
  • avoiding smoking and smoky places
  • adults can try gargling with a homemade mouthwash of warm, salty water (not recommended for children)
  • sucking lozenges, hard sweets, ice cubes or ice lollies – but don’t give young children anything small and hard to suck because of the risk of choking

Antibiotics aren’t usually prescribed for a sore throat, even if it’s caused by a bacterial infection, as they’re unlikely to make you feel better any quicker and they can have unpleasant side effects.

You can visit your local pharmacy who may be able to offer advice and over-the-counter medicines to help combat a sore throat. 

You can find your nearest pharmacy and check their opening hours at www.nhs.uk 

Headaches

Headaches

Most headaches aren’t serious, and are usually relieved by medicines, relaxation techniques and lifestyle changes.

A male holding his head in pain

You can self-care for a common headache.

  • Paracetamol usually works well to relieve a tension-type headache. It’s best to take a full dose as soon as the headache starts. A second dose of paracetamol can be taken after four hours if necessary. No more than eight 500mg paracetamol tablets should be taken in one day.
  • Anti-inflammatory painkillers, such as ibuprofen, can also help with headaches.
  • Regular exercise and relaxation may help prevent tension headaches.

Be aware that taking painkillers more than two or three times a week can actually cause headaches. Read more about painkiller headaches.

Most headaches will clear within a few hours.

Contact your GP or call NHS 111 if your headache gets worse, if you get them more often, or you develop other symptoms, such as a stiff neck or sensitivity to light.

Constipation

Constipation

Constipation is a common condition that affects people of all ages. It can mean that you’re not passing stools regularly or you’re unable to completely empty your bowel.

If you’re constipated, changing your diet may be all that’s needed to ease it.

There are some self-care techniques that you can do at home to help: 

  • If your constipation is causing pain, take a painkiller, such as paracetamol.
  • Add more fibre to your diet, such as fruit, vegetables, wholewheat pasta, wholemeal bread, seeds, nuts and oats. This can take anything from a few days up to four weeks to have an effect.
  • If you have irritable bowel syndrome (IBS) and get constipated, it’s recommended that you increase the amount of soluble fibre you have. Foods that contain soluble fibre include oats, barley, bananas, apples, carrots, potatoes and golden linseeds.
  • Make sure you’re drinking enough water – Water, drinks and your health.
  • Regular exercise will reduce your risk of getting constipation.
  • If diet and lifestyle changes don’t help, try an over-the-counter laxative. Ask your pharmacist’s advice and follow the instructions on the packet or leaflet carefully.

Find more information on treating constipation.

If changes to your diet don’t help and the problem continues, you should see your GP.

Also speak to your GP if you think your child might be constipated.

Heartburn and Indigestion

Heartburn and Indigestion

Indigestion is a general term for pain or discomfort felt in the stomach and under the ribs. 

Heartburn is when acid moves up from the stomach into the gullet (oesophagus) and causes a burning pain behind your breastbone. 

Indigestion and heartburn can occur together or on their own.

It’s a common problem that affects most people at some point. In most cases it’s mild and only occurs occasionally.

Some simple self-care techniques are:

  • Lose weight – being overweight can contribute to heartburn.
  • Stop or cut down smoking and/or alcohol.
  • Have your last meal of the day at least three hours before going to bed.
  • Try raising the head of your bed by a few inches – simply raising your head by using an extra pillow won’t have the same beneficial effect.
  • Make a note of any food or drink that seems to make your indigestion worse, and try to avoid them.

For short-term relief, your pharmacist can recommend antacid medicines to neutralise stomach acid, or alginates to protect your food pipe (oesophagus) from acid.

There’s usually no need to seek medical advice for indigestion as it’s often mild and infrequent and specialist treatment isn’t required.

However, you should see your GP if you have recurring indigestion and any of the following apply:

  • you’re 55 years of age or over
  • you’ve lost a lot of weight without meaning to
  • you have difficulty swallowing
  • you have persistent vomiting
  • you have iron deficiency anaemia
  • you have a lump in your stomach
  • you have blood in your vomit or blood in your stools

These symptoms may be a sign of a more serious underlying health problem, such as a stomach ulcer or stomach cancer.

Also see your GP if you get indigestion regularly, if it causes you severe pain or discomfort, or if your regular anti-reflux remedies stop working.

Conjunctivitis

Conjunctivitis

Conjunctivitis is also known as red or pink eye.

It usually affects both eyes and makes them:

  • bloodshot
  • burn or feel gritty
  • produce pus that
  • sticks to lashes
  • itch
  • water
Close up of a blue eye

There are things you can do at home to help ease the symptoms of Conjunctivitis.

Use clean cotton wool (one piece for each eye). Boil water and then let it cool down before you:

  • clean off crusts on your lashes by rubbing them gently
  • make a cold compress to press on your eyes for a few minutes to cool them down

Do

  • wash hands regularly with warm soapy water
  • wash pillows and face cloths in hot water and detergent

Don’t

  • wear contact lenses until your eyes are better
  • share towels and pillows
  • rub your eyes

Your local Pharmacist can give you advice and suggest eye drops or antihistamines to help with your symptoms. Find your nearest Pharmacy at NHS Choices.

You should see your GP if:

  • your baby has red eyes – get an urgent appointment if your baby is less than 28 days old

  • you wear contact lenses and you have conjunctivitis symptoms as well as spots on your eyelids – you might be allergic to the lenses

  • your symptoms haven’t cleared up after 2 weeks

You don’t need to avoid work or school unless you or your child are feeling very unwell.

If there are a few children with conjunctivitis at your child’s school you might be asked to keep yours at home.

Advice for nurseries and schools can be read here.

Vaginal thrush

Vaginal Thrush

Vaginal thrush is a common yeast infection that affects most women at some point.

Typical symptoms of vaginal thrush include:

  • itching and soreness around the entrance of the vagina (itchy labia)
  • vaginal discharge – this is usually odourless and may be thick and white or thin and watery
  • pain during sex, which may make you worry about having sex
  • a stinging sensation when peeing

Sometimes the skin around the vagina can be red, swollen or cracked. 

Vaginal thrush is part of the ‘Think Pharmacy Minor Ailments Scheme’ so your local Pharmacist can recommend and prescribe treatments.

You can find your nearest pharmacy and check their opening hours at NHS Choices.

Cystitis

Cystitis

Cystitis is inflammation of the bladder, usually caused by a bladder infection. It’s a common type of urinary tract infection (UTI), particularly in women, and is usually more of a nuisance than a cause for serious concern. Mild cases will often get better by themselves within a few days.

The main symptoms of cystitis include:

  • pain, burning or stinging when you pee
  • needing to pee more often and urgently than normal
  • urine that’s dark, cloudy or strong smelling
  • pain low down in your tummy
  • feeling generally unwell, achy, sick and tired

Women don’t necessarily need to see their GP if they have cystitis, as mild cases often get better without treatment.

Until you’re feeling better, it may help to:

  • take paracetamol or ibuprofen
  • drink plenty of water
  • hold a hot water bottle on your tummy or between your thighs
  • avoid having sex

Cystitis is part of the ‘Think Pharmacy Minor Ailments Scheme’ so your local Pharmacist can recommend and prescribe treatment.

You can find your nearest pharmacy at NHS Choices.

You should see your GP if your symptoms are severe or don’t start to get better in a few days, you get cystitis frequently, or you’re pregnant.

Children and men should always be seen by a GP if they have symptoms of cystitis, as the condition is less common and could be more serious in these groups.