Managing the ear-care category in community pharmacies has evolved far beyond ear drops or wax removal. Today’s pharmacy solutions extend to evidence-based protocols, targeted over-the-counter (OTC) products, and structured referral criteria, offering patient-centred approaches and powerful pharmacy benefits to both consumers and healthcare partners. This article provides strategic insights on category setup, product selection, clinical practices, and aftercare, helping pharmacy partners elevate the ear-care experience for patients across different markets, especially focusing on Europe and Latin America.
Pharmacy solutions for ear-care: Evidence-based OTC protocols (softeners vs. irrigation)
In a typical ear-care pathway, the primary interventions available in the OTC space are focused on earwax removal. Concretely, cerumen softeners and irrigation/microsuction procedures are the most popular. Clinical guidelines indicate that the majority of earwax management is safe to undertake in pharmacy care settings, but selecting the optimal protocol is key.
- OTC earwax removal protocols typically begin with cerumenolytic agents. These soften the earwax, facilitating a spontaneous elimination or making manual removal or irrigation easier, and are preferred in mild or moderate cases.
- Ear irrigation professional kits are reserved for more stubborn or impacted wax. Irrigation with saline or controlled water jets can support safe and complete wax clearance, but must follow strict hygiene and exclusion criteria, and must be done under professional supervision.
- The best earwax removal technique will depend on individual patient factors, such as previous blockages, personal history, current symptoms, or device use (e.g., hearing aids), and pharmacists should always assess risk before recommending products or interventions. This evidence-based approach to pharmacy innovations ensures both safety and efficacy for patients.
- OTC ear drops and sprays are among the fastest-growing OTC categories, and careful product positioning supports informed consumer choices and maximises category performance.
Category setup in community pharmacy: Planogram & SKU mix (ear sprays, kits, irrigation)
Setting up an effective category planogram in ear-care within a pharmacy demands an intelligent Stock Keeping Unit (SKU) mix and an aftercare framework. First, the product range should cover core drop and spray solutions, accessory kits and referral-capable services. Key elements for driving outcomes are:
- Feature a balanced SKU mix: offer a robust range including earwax softeners, ear wash system solutions, hearing-aid aftercare sprays, and moisture-control products.
- Position treatments containing topical antibiotics as prescription-only, ensuring pharmacists can counsel on symptom management and referral criteria.
- Showcase prevention strategies, responding to common consumer questions.
- Employ planogram compliance and staff training to maximise engagement and support medical devices or professional products approved by clinical guidelines.
This strategic approach to pharmacy solutions increases transaction rates, supports upselling, and establishes pharmacies as expert hubs for ear health.
Prevention in pharmacy: Cerumen management & moisture control protocols
Pharmacy innovations in ear-care increasingly focus on prevention and moisture management. For hearing-aid users, swimmers, and those with recurring ear problems, prevention protocols are essential:
- Routine self-care with OTC cerumenolytic agents reduces the risk of ear infection and supports comfortable hearing-aid use among patients prone to suffering from earwax blockage, but it is not recommended indiscriminately for everybody.
- Targeted moisture-control sprays, desiccants and aftercare for hearing-aid users help maintain a healthy canal environment and reduce the risk of irritation or microbial imbalance.
- Preventive advice on how to care for ears, especially among patients suffering from recurrent conditions, without going to the doctor, and what are the safest, most effective earwax removal methods, should be delivered alongside every ear-care product, leveraging the role of pharmacy partners in patient education.
Pharmacy care teams that educate on self-management and monitor for underlying symptoms can reduce unnecessary referrals and improve outcomes across diverse populations.
Safety & referral criteria: When to avoid irrigation and escalate to ENT
Based on clinical evidence and guidelines, earwax removal via irrigation should be avoided in patients with certain conditions, including perforated eardrums, a history of ear surgery, ongoing pain, diabetic and immunocompromised patients or active ear infections. Pharmacists must conduct careful assessments using triage questions to identify red-flag symptoms such as severe pain, sudden hearing loss, vestibular complaints like dizziness, or a history of chronic otitis, which necessitate referral rather than in-pharmacy interventions.
When ear irrigation using professional kits is deemed inappropriate, prompt referral to an ear, nose, and throat (ENT) specialist is advised in accordance with established practice guidelines. Patient safety is further ensured through meticulous documentation of assessments and treatments, scheduled follow-up contact, and comprehensive aftercare advice, communicating the risks and behavioural recommendations post-procedure. Pharmacies should also provide patients with up-to-date guidance on regulatory authorities-approved “ear cleaning” systems and commonly used clinical solutions, such as those employed by healthcare professionals to “clean” ears safely. This educational component supports informed consumer choices and adherence to regulatory standards, reinforcing pharmacy roles as centres of expert ear-care advice and safe patient management. Designing and implementing ear-care as a dedicated category within community pharmacy demands evidence-based protocols, an optimised SKU and planogram strategy, preventive education and a clear escalation pathway for referral. When executed well, this positions the pharmacy not only as a dispensing outlet but as a valued provider of holistic hearing-aid wearer support and minor ear-care services. At Mitelos, we provide specialised support to pharmacy partners seeking to build and launch ear-care adjunct categories within pharmacy networks, covering portfolio strategy, retail channel mapping and go-to-market frameworks. For market leaders looking to lead the next wave of ear-care innovation, our services can bring clarity, speed and impact. Contact us!
References Aaron K, Cooper TE, Warner L, Burton MJ. Ear drops for the removal of earwax. Cochrane Database Syst Rev. 2018 Jul 25;7(7):CD012171. doi: 10.1002/14651858.CD012171.pub2 Guideline for Ear Irrigation. Version 3, Nov 2022 [Internet]. Rotherham NHS Foundation Trust; 2022 [cited 2025 Oct 29]. Available from: https://www.earcarecentre.com/uploadedFiles/Pages/Health_Professionals/Protocols/Ear%20irrigation%20guidelines%202022.pdf Ear care and ear irrigation guideline [Internet]. Version 2. Glasgow: NHS Greater Glasgow & Clyde; 2018 Jun 29 [cited 2025 Oct 29]. Available from: https://rightdecisions.scot.nhs.uk/media/1634/ear_care_and_irrigation_guideline.pdf