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What are OTC ear drops?

OTC stands for “Over The Counter” medications that are available without a prescription. There are plenty of OTC ear drops that you can buy from your local pharmacy. Others are scheduled and restricted drugs, easily available nevertheless due to lax attitude of individual pharmacies about dispensing them. Read more about Indian Pharmacy laws here.

Self medication is a common problem encountered in day to day practice. It is far more common for drops, creams and ointments to be misused and considered harmless as compared with oral and injectable medications.

Listed below are a few common ear drops that a person may buy from their local pharmacy without any fear of regulations along with the reasons why you shouldn’t use them.

1. Ear wax solvents (Example: Soliwax ®, Dewax ®, Clear Wax etc.):

These are OTC medications that have been used for softening the ear wax prior to removal. They commonly consist of turpentine oil, carbamide peroxide, benzocaine, paradichlorobenzene or a mixture of such. In the majority of patients that use them without medical advice, nothing untoward may happen, but, in a few patients they can lead to complications. These drops act by softening or loosening of hard wax. When dry hard wax comes in contact with a softening agent, it expands. If the wax is sufficient in amount it will block the canal by expanding, making it an unpleasant and painful experience. Softened wax also molds and sticks against the curvature and crevices of the ear canal and tympanic membrane, making it difficult to remove sometimes. Some components of these drops may cause skin reactions and allergies in certain individuals.

2. Antibiotic ear drops (Example: gentamicin, tobramycin, ciprofloxacin ear drops):

There are many antibiotic ear drops that are easily available in pharmacies even though their sale should be regulated as per the law. Their indiscriminate use has led to development of drug resistance. Some of these ear drops contain a aminoglycoside group of antibiotics, that are ototoxic (injurious to inner ear and nerves) and can cause deafness with prolonged use. Unjustified use of antibiotic ear drops kills the local “good” bacterial microbiome and encourages the growth of the “bad” disease causing bacteria and fungi, which can get difficult to treat.

3. Anti-fungal drops (Example: Clotrimazole ear drops):

Fungal infections are difficult to treat because fungus can sporulate. These spores are meant to carry the next fungal generation forward. Inadequate use of fungal ear drops sets into motion a cycle of fungal infection – anti-fungal ear drops back and forth. This cycle can become difficult to break. Certain anti-fungal medications are known to cause local skin irritation and reactions that can further complicate the situation.

4. Steroid ear drops (Example: hydrocortisone, dexamethasone drops):

Judicious use of steroids can shorten the inflammation in any disease, however, excessive and unnecessary leads to complications. Steroids tend to mask acute symptoms of underlying conditions and provide instant relief that’s why they are the most abused group of medications suggested by unqualified or under-qualified “health” practitioners. Once these medications are stopped the disease and its symptoms return with increased severity. 

5. Vegetable oil drops:

These are commonly used home remedies. However, it is easy to explain – Oil + Moisture = Mould growth. It may reduce that itching or pain for now, but beware of the fungal growth that comes later.

6. Local anaesthetic ear drops for ear pain:

Pain relief provided by these formulations is usually temporary and incomplete. These drops mask the symptoms and delay the diagnosis. Often they are of no use as the cause of ear pain may not even lie in the ear.

It is understandable that ear pain and ear itching are terrible symptoms and one wants instant relief from them. However, haphazard and ill advised use of these drops leads to worsening of the problem, which can be avoided. You should consult an ENT Doctor at the earliest with the onset of these symptoms and ask yourself if you really need to self prescribe ear drops.

This article was written by Dr Akanksha Saxena, Consultant ENT, Head & Neck Surgeon, ENT360. She is a practising ENT Specialist in Gurgaon with over 10 years of experience. Read more of her blogs here.

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