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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment and routing online; hearing tests and ear examination happen in person, and sudden hearing loss needs urgent specialist referral, which the online doctor arranges without delay.
- What it is: reduced hearing from a blockage or damage in the ear canal or middle ear (conductive) or in the inner ear or hearing nerve (sensorineural); over 1.5 billion people worldwide live with some degree of hearing loss.
- Sudden loss: sudden sensorineural hearing loss, usually in one ear and often noticed on waking, is treated with corticosteroids that work best started within 72 hours; about half of people recover some or all hearing, more with early treatment.
- Gradual loss: age-related hearing loss affects about 1 in 3 people over 65 and noise exposure is the other main cause; earwax, fluid after a cold or ear infection, and some medicines are the reversible causes.
- Earwax: wax that muffles hearing often clears with softening drops such as olive oil used for 3 to 5 days; a sudden drop in hearing is never assumed to be wax.
- Emergency: call 112 if sudden hearing loss comes with facial drooping, limb weakness, slurred speech or severe spinning dizziness; sudden hearing loss on its own needs urgent assessment on the day it is noticed.
If hearing in one or both ears has dropped suddenly, over minutes, hours or the last day or two, treat it as an emergency, not a wax problem. Sudden sensorineural hearing loss is most treatable in its first days: steroid treatment is usually started as soon as possible, ideally within about 72 hours of onset. Book the fastest consultation available today or go straight to urgent in-person care, and do not wait to see whether it comes back. If sudden hearing loss comes with facial drooping, limb weakness, slurred speech or severe spinning dizziness, call 112 now.
Can an online doctor help with hearing loss?
Yes, in a specific and honest way: fast sorting. A video consultation can establish quickly whether hearing loss looks like sudden sensorineural loss needing emergency steroid treatment, a blocked or infected ear that can be treated, or gradual loss needing formal hearing tests. A video call cannot measure hearing or see the eardrum, so examination and audiometry are arranged where needed.
That sorting is worth more than it sounds, because the three situations run on completely different clocks. One is measured in hours, one in days, and one in months. A video consultation on Mobi Doctor exists to get you onto the right clock as soon as you notice the problem, rather than after two weeks of assuming it is wax.
Sudden hearing loss: why the first 72 hours matter
Sudden sensorineural hearing loss is the emergency hiding inside an ordinary-feeling "blocked ear". The inner ear or hearing nerve stops working over minutes to a few days, almost always on one side, sometimes noticed on waking or when the phone goes to the wrong ear. Corticosteroids are the standard treatment, and outcomes are best when they start early, ideally within about 72 hours of onset, which is why guidance treats recent sudden hearing loss as an urgent same-day referral rather than a routine appointment.[1][2]
The cruel part is how mundane it feels. There is often no pain, just one ear gone dull, frequently with new tinnitus, a blocked feeling or slight unsteadiness, and every instinct says "wax, it will pass". Sometimes it is wax; the two cannot be reliably told apart without examination, and only one of them forfeits its treatment window while you wait. So the rule is blunt: hearing that has dropped suddenly within the last few days gets assessed the same day, full stop. Where loss is confirmed sensorineural, specialists can offer oral corticosteroids, and in some centres steroid injections through the eardrum.[1] Even hearing loss that started up to a month ago still warrants urgent referral, though earlier is decisively better.[1]
What the doctor checks in an online hearing loss consultation
The consultation is built to place you on the right clock. The doctor will typically assess:
- Speed and side, first and always: sudden or gradual, one ear or both, and exactly when it started, documented precisely because the referral pathway runs on that timestamp.
- The story around it: a cold or ear infection, swimming or water exposure, a flight or dive, loud noise or an explosion, recent cotton-bud use, or a head injury.
- Companions: ear pain or discharge point to infection; new tinnitus or fullness often ride along with sudden sensorineural loss; spinning vertigo raises inner-ear and, rarely, neurological causes.[2]
- Medicines: some antibiotics, chemotherapy agents, high-dose aspirin and certain diuretics can injure hearing, and the doctor screens for them.
- Noise and work: years of loud work, gigs or headphones shape both the diagnosis and the prevention advice.
- Function on the call: how you manage conversation, which ear you favour, what happens in background noise: crude signals, never a substitute for audiometry, and not treated as one.
- The red-flag screen: one-sided loss with one-sided tinnitus, hearing loss with facial weakness or other neurological signs, and persistent smelly discharge, all of which change the referral.
Is it just earwax?
Sometimes, and it is the most fixable cause on this page. Wax typically builds gradually: muffling, itch, fullness, often worse after showers or swimming when it swells. Softening drops such as olive oil used for three to five days often clear it; when they do not, the fix is physical removal by irrigation or microsuction, which is an in-person procedure.[4][5]
The honesty here is simple: an online doctor can tell you when wax is the likely story, prescribe nothing you do not need, advise on drops and warn you off cotton buds, which pack wax deeper and scratch the canal. What no online service can do is remove wax, so if drops fail, you will be pointed to a local clinic that removes it, and told which findings would change the plan. The one thing wax must never be allowed to do is serve as the comfortable explanation for a sudden loss that was never examined.
What causes gradual hearing loss?
Gradual hearing loss usually comes from ageing of the inner ear, cumulative noise exposure, or a mechanical problem such as wax, fluid behind the eardrum or stiffening of the middle ear bones. It typically affects both ears, creeps in over years and shows up first as difficulty following speech in noise. WHO estimates over 1.5 billion people live with some degree of hearing loss.[3]
The pattern matters more than the label. Both ears fading symmetrically over years, conversations manageable one-to-one but lost in restaurants, the television creeping louder: that is the classic picture of age- and noise-related loss, and its pathway is a formal hearing test with an audiologist, then a hearing-aid discussion. Modern aids are small, effective and dramatically underused; the average delay between noticing loss and doing something about it is measured in years, and none of that waiting improves anything.[3] One-sided gradual loss plays by different rules: hearing fading in a single ear, especially with one-sided tinnitus, needs specialist assessment to rule out rarer causes, including benign growths on the hearing nerve.[2] After ear infections, muffled hearing usually reflects fluid that clears over two to four weeks; in children, persistent fluid ("glue ear") with hearing difficulty is a standard reason for audiology referral, covered in the children’s section of the ear infection page.
Which hearing loss pathway might the doctor recommend?
Assessment follows the speed of onset and the company the hearing loss keeps. This is the decision framework the doctors use, aligned with the cited guidance:[1][2]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Sudden loss in one ear within the last few days, with or without tinnitus | Same-day assessment; steroid treatment works best started early, ideally within about 72 hours | Yes, as urgent triage | Always: urgent specialist referral is the outcome, and loss within the last month is still urgent |
| Gradual muffling with fullness or itch, worse after water, little pain | Likely wax: softening drops for 3–5 days, then removal in person if still blocked | Partly: advice and drops online, removal in person | No improvement after drops, pain or discharge, or any doubt that onset was truly gradual |
| Muffled hearing during or after a cold or ear infection | Treat the infection where needed; fluid usually clears over 2–4 weeks | Usually yes | Hearing not recovered within about 4 weeks, or persistent glue ear in a child: hearing test and specialist review |
| Both ears fading gradually over years, speech hard to follow in noise | Formal hearing test (audiometry), then a hearing-aid discussion with audiology | Yes for assessment and routing | Testing and fitting are in-person; one-sided or unexplained patterns go to a specialist |
| Hearing loss with severe vertigo, facial weakness, head injury or other neurological signs | Emergency in-person assessment | No | Always; call 112 for stroke-like symptoms |
Not sure which row is your hearing? A doctor can tell you in one consultation.
See available times →Treatment options for hearing loss
What you can do yourself
For sudden hearing loss, the only correct self-care is speed: note the exact time it started and get medical advice the same day. For everything else, the useful habits are quieter: softening drops for suspected wax, nothing smaller than your elbow in the ear canal, volume discipline with headphones, and proper ear protection for loud work, concerts and power tools, because noise-related loss is largely preventable and entirely irreversible.[3] After a cold or flight, give a muffled ear a couple of weeks and the pressure tricks (swallowing, yawning, gently blowing against a pinched nose) a fair chance before worrying.
Prescription treatment
A prescription is never issued without a consultation, and for hearing loss the honest version is that medicines help specific situations only: corticosteroids for confirmed sudden sensorineural loss, started urgently through a specialist referral;[1] antibiotics or drops when an infection is the cause, prescribed against the criteria on the ear infection page; and treatment of contributing conditions. No tablet, drop or supplement restores age-related or noise-related hearing, and anyone selling one is selling something else. What genuinely works there is a hearing aid fitted after audiometry, and the consultation’s job is to route you to that testing without a detour.
When hearing loss is assessed online, and when you need in-person care
Assessed online: urgent triage of sudden hearing loss with an urgent, documented referral; assessment and treatment of infection-related and pressure-related muffling; wax advice and softening-drop plans with clear instructions on when removal is needed; and routing gradual loss to audiometry with a summary you can take with you.
In-person care: every suspected sudden sensorineural loss, urgently and the same day; one-sided loss or one-sided tinnitus without an obvious cause, to specialist assessment; hearing loss with vertigo, facial weakness or after head injury, to emergency care; persistent smelly discharge with hearing loss, to an ear specialist; children with hearing concerns, to audiology, because childhood hearing shapes speech and school; and anyone whose muffled ear has outlived its innocent explanation. Related symptoms have their own guides: tinnitus and earache and ear pain.
When to get in-person care
Sudden hearing loss in one or both ears needs urgent same-day assessment even if nothing else feels wrong. If hearing loss comes with facial drooping, weakness or numbness, slurred speech, severe spinning dizziness with vomiting, a first seizure, or follows a head injury, call 112 immediately: sudden deafness can occasionally be part of a stroke, and minutes matter.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about hearing loss: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave knowing your next step: an honest assessment, a clear plan, and a direct referral when in-person care is the right call, or a full refund.
No sign-up needed
Hearing loss can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about hearing loss
What causes hearing loss?
Hearing loss has two families of causes. Conductive loss is a blockage or problem in the outer or middle ear: earwax, fluid behind the eardrum after a cold or ear infection, a perforated eardrum or stiffened middle ear bones. Sensorineural loss is damage to the inner ear or hearing nerve: ageing, loud noise, some medicines, viral infections, Ménière's disease, head injury and, rarely, a growth on the nerve.
What are the first signs of hearing loss?
Early signs of hearing loss are asking people to repeat themselves, struggling to follow conversation in noisy rooms, turning the television up, finding that others seem to mumble, missing the doorbell or phone, and tiredness after listening. Muffled or blocked hearing, ringing in the ears, and hearing that is worse on one side are also common first signs and deserve a test.
Can an online doctor treat sudden hearing loss?
An online doctor's role in sudden hearing loss is recognition and speed: confirming the picture promptly, documenting exactly when it started, and arranging the urgent specialist referral through which steroid treatment is given. That treatment works best started early, ideally within 72 hours, so if the fastest slot is not soon enough, go straight to urgent in-person care.
Why does sudden hearing loss in one ear need treating within 72 hours?
Sudden sensorineural hearing loss is usually an injury to the inner ear or nerve from a viral or circulatory cause, and the hair cells that are still recoverable respond to corticosteroids only in the first days. Treatment started within 72 hours gives the best chance of recovery; after two to four weeks the chance falls sharply. This is why a muffled ear that appeared overnight is never left to see if it clears.
Is my blocked ear just earwax?
Quite possibly, if the muffled hearing built up gradually, itches, feels full and worsened after water. Softening drops for three to five days often clear it, and if not, wax removal is a quick in-person procedure. The one rule that has no exceptions: hearing loss that arrived suddenly is not assumed to be wax, because a treatable inner-ear cause would be missed.
Can hearing loss after a cold or ear infection become permanent?
Usually not. Muffled hearing after a cold or middle ear infection reflects fluid behind the eardrum, which typically drains over two to four weeks as the tube reopens. It needs review if it persists beyond about a month in an adult, keeps recurring, or affects only one ear, because persistent one-sided fluid in an adult needs the back of the nose examined.
Can hearing loss be reversed?
Conductive hearing loss is often reversible: earwax is removed, fluid drains, a perforation heals or is repaired, and stiffened bones can be operated on. Sensorineural hearing loss from age or noise is permanent, because inner-ear hair cells do not regrow, but it is very treatable with hearing aids; sudden sensorineural loss treated early recovers in about half of people.
Do online hearing tests work?
Phone and web hearing checks can be a useful nudge: they screen roughly for whether your hearing is worse than expected. They are not diagnostic, they cannot tell wax from nerve damage, and no online service, including this one, can replace a formal hearing test by an audiologist, which is what the consultation arranges when hearing loss is gradual.
Will a hearing aid help, and can you prescribe one?
For most gradual, age- or noise-related hearing loss, yes, hearing aids genuinely help, and using them earlier preserves listening skills and may protect memory and mood. They are not prescribed like medicines: they are fitted by audiologists after a formal hearing test. What the consultation does is confirm the pattern, exclude reversible causes and refer you for the test.
Is hearing loss linked to dementia?
Untreated hearing loss in mid and later life is one of the largest modifiable risk factors for dementia, partly because the brain works harder to decode sound and partly through social isolation. Treating hearing loss with hearing aids is associated with slower cognitive decline, which is one more reason to have gradual hearing loss tested rather than tolerated.
How can I protect my hearing and prevent hearing loss?
Prevent hearing loss by keeping headphone volume under about 60% and listening time limited, wearing ear protection around loud machinery and at concerts, treating ear infections and colds promptly, never using cotton buds, keeping blood pressure and diabetes controlled, and asking a doctor about hearing-safe alternatives if you take medicines known to affect hearing. Have your hearing tested if you notice any change.
What can I do at home while waiting for a hearing test?
While a hearing test is arranged, use softening drops if wax is likely, face people and reduce background noise when talking, turn on subtitles, and tell family that you are not ignoring them. Keep a note of when the hearing loss started, which ear, and any ringing or dizziness, because that history steers the test and the referral.
- Hearing loss in adults: assessment and management (NG98), NICE, National Institute for Health and Care Excellence, 2018.
- Hearing loss in adults: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Deafness and hearing loss: fact sheet, WHO, World Health Organization, 2025.
- Earwax: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Earwax build-up, HSE, Health Service Executive (Ireland), accessed August 2026.
- Hearing loss, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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