Ringing In Ear: What To Do In The First Two Weeks

Most people arrive at “ringing in ear” searches with the same three worries in a different order: is something wrong with my ear, will it stop, and is there anything I can buy.

This page is the plain-language version of the longer <a href="/tinnitus/">tinnitus guide</a>. It stays with the everyday questions: what the sound usually is, what commonly causes it, what to check yourself, what to do in the first fortnight, and what a hearing test actually tells you. It is educational information rather than medical advice, and it does not diagnose anything.

We have an affiliate relationship with a hearing supplement, which is disclosed at the top of every page on this site, and which is the reason the product section further down is short and unflattering.

Most of the time this is a high-pitched tone, a buzz or a hiss that nobody else can hear, and it is clearest when the room goes quiet. That last part surprises people. It is not a sign that the problem is worse at night. In silence there is nothing else for your attention to land on.

What makes tinnitus frightening is the sense that it is a warning signal from the ear. For most people it is not that. The NIDCD describes tinnitus as hearing a sound when no other sound is present, and while it frequently accompanies hearing loss it is not commonly associated with other underlying physical problems. The sound is a report from the auditory system, and the useful response is to find out what produced it rather than to keep monitoring whether it is getting worse.

The most practical thing on this page: the majority of the common causes of ringing are either visible on examination, measurable on a hearing test, or modifiable by you. Wax can be seen. Noise damage and age-related change show up on an audiogram. Medicines can be reviewed in five minutes. Those four things account for most of what is found, and checking them is cheaper than any product.

Loud noise, including headphones

The NIDCD identifies noise exposure as a leading cause and explains the mechanism: loud noise damages sensitive structures in the inner ear, most often the cochlear hair cells, and it states that unlike the hair cells of birds and amphibians, human hair cells do not grow back. It also notes that loud noise can cause tinnitus directly, and that the effect can be immediate or can take a long time to become noticeable.

Two numbers from the NIDCD. Sounds at or below 70 dBA, even over long exposure, are unlikely to damage hearing, while long or repeated exposure at or above 85 dBA can. The NIDCD places music through headphones at maximum volume, concerts and sporting events in the 94 to 110 dBA range. It also notes that a single intense burst, such as a gunshot or an explosion, can cause immediate and permanent damage, so “it was only a moment” is not a safe calculation.

Earwax

Impacted wax produces more symptoms than most people expect: a ringing or humming sensation, pressure, and hearing that feels dull or blocked. The mechanism is straightforward. Wax sitting against the eardrum reduces the sound getting through, and that change in input is often enough to make tinnitus newly audible.

It is also usually the easiest to resolve, because it is visible on examination and often removable. And here the caution matters more than the treatment: nothing should be put into the ear canal to dig wax out. Cotton buds push it deeper, and small tools or heated devices are how people end up with a scratched, inflamed canal or a perforated eardrum. It is a quick appointment, and in many systems it is a nurse appointment.

Medicines, including over-the-counter painkillers

The NIDCD states that more than 200 medicines can cause tinnitus when they are started or when they are stopped, and the over-the-counter painkillers are part of that list. The pattern that matters is timing: a sound that appeared after a new prescription and settles when the prescription changes is a different situation from one with no medication event anywhere near it.

What to do is not to stop anything. Write down everything you take, including the painkillers you take occasionally, and take the list to the appointment. That is a five-minute job for you and a two-minute job for a pharmacist, who can spot a pattern that self-diagnosis will miss.

Jaw, teeth and clenching

Clenching, grinding, chewing gum and a jaw that clicks are routinely part of an ear history. The muscles involved run close to the ear, and the clicking and fullness people notice in their own jaw is exactly the kind of mechanical detail a clinician can use. Stress makes clenching worse, which links this section to the one about sleep and stress.

The same goes for the neck. Mention stiffness, tightness or a change in how you hold your head, particularly if the sound changed at the same time.

Age-related change

Hearing depends on hair cells and a functioning auditory nerve, both of which change with age. Ringing that appears later in life often comes alongside gradual hearing change rather than appearing in isolation, which is why an audiogram is more informative at that point, and why amplification is often the first thing an audiologist discusses.

Inner-ear conditions

Meniere’s disease is the condition people most often describe badly, because the episodes are separated in time and people assume each one is unrelated. StatPearls characterises it by episodic vertigo, fluctuating sensorineural hearing loss, tinnitus and aural fullness, and the combination is more useful than any single part. Otosclerosis, in which abnormal bone remodelling around the inner ear affects sound transmission, most often presents with gradually worsening hearing loss, with tinnitus and vertigo also possible.

The practical point is that if the sound comes with attacks of spinning, or with a blocked feeling that comes and goes across hours, that is a pattern for an ear, nose and throat specialist rather than a self-directed experiment.

Two follow-up questions are worth adding. Is it constant, or does it come and go? And what is it costing you? Not in money, although that matters, but in sleep, concentration, work and mood. Those are the terms the interventions with trial support are measured in, and the NICE guideline recommends tinnitus questionnaires when the psychological effect needs fuller assessment.

1. Get the ear looked at. If the ear feels blocked, if you have had a lot of headphone use, or if you use cotton buds, this is the first call. It is quick, usually inexpensive, and it can end the conversation.

2. Reduce the noise, including in the room. Lower the headphone volume, take listening breaks, and if you work somewhere loud, get proper ear protection rather than foam plugs. The NIDCD describes noise-induced hearing loss as the only type of hearing loss that is completely preventable.

3. Add sound rather than silence at night. A fan, a radio, a shower or any consistent low-level sound gives the brain something to sit on. It is the cheapest version of sound therapy, one of the approaches with consistent support in the 2025 umbrella review of 44 systematic reviews.

4. Write down your medicines and your timeline. Everything you take, and roughly when the sound started relative to each change. This is the input nobody else can supply.

Two things to avoid while you wait. Do not buy loud-noise apps, or wear masking headphones at high volume, because the treatment can become the cause. And do not buy ear candling, home syringing kits, or anything promising to draw wax out at home.

A hearing test plots your threshold across pitches for each ear separately. What it can show you:

- whether hearing is within the normal range or reduced, and by how much; - whether the two ears differ, which often matters more than the average does; - whether the pattern suggests a conductive problem, where sound is being blocked or inefficiently transmitted, rather than the sensorineural pattern associated with inner-ear damage; - a baseline, which is the part people underestimate. Without one, a change in six months is undetectable, because worse is a comparison and comparisons need two measurements.

What it cannot do is measure your tinnitus. There is no objective way to record a sound only you can hear, which is why assessment relies on hearing tests and questionnaires rather than on volume. It also does not tell you whether you would tolerate a hearing aid or benefit from sound therapy, which is a conversation to have with an audiologist after the test rather than before it.

1. Day one. Note the sound: which ear, what it resembles, whether it is constant or intermittent, and when you first noticed it. Write it down, because you will not remember the detail in a month.

2. Days one to three. Book the ear examination. Do not wait until you are sure it is serious.

3. Days one to seven. Turn the volume down, take breaks from headphones, and protect your ears around noise. If noise exposure has not been reduced in the first week, nothing has started.

4. Days one to fourteen. Keep a consistent bedtime, and put some sound in the room at night. Do not deliberately test whether the ringing is there; repeated checking is what makes it more present.

5. Throughout. Take the medicines list to a pharmacist if you take anything regularly, and do not stop a prescribed medicine on your own.

6. Day fourteen. Look back at what you wrote on day one. If it is unchanged and you have never had a hearing test, book an audiogram. If it is unchanged and you already have one, book an appointment to discuss management rather than buying anything.

For zinc, the Cochrane review included three trials with 209 participants, found no evidence that oral zinc improves tinnitus symptoms in adults, and rated the quality of the evidence as very low. For ginkgo biloba, the 2022 review pooled twelve studies and 1,915 participants and concluded that it may have little to no effect on symptom severity compared with placebo, at very low certainty, noting that European and German tinnitus guidelines recommend against it. The earlier 2013 review, from four trials and 1,543 participants all judged to be at low risk of bias, reached the same conclusion.

A page that ends up telling you not to buy a hearing supplement is unusual on a site with an affiliate relationship to one. The 2025 umbrella review across 44 systematic reviews found consistent benefit for cognitive behavioural therapy, hearing aids, tinnitus retraining therapy and sound or music therapy. Those are the interventions with trial support. A product with no trial of the finished product is not competing with them; it belongs to a different, and less evidenced, category of spending.

• The sound started suddenly, over hours or days, especially with a drop in hearing. Sudden sensorineural hearing loss is defined in the clinical guideline as a loss of 30 dB or more across three consecutive frequencies within 72 hours, and the guideline recommends audiometry as soon as possible, with corticosteroids considered within two weeks of onset.

• It is in one ear only and staying there. The NICE guideline lists persistent one-sided tinnitus as a reason to refer for specialist assessment and management.

• It pulses with your heartbeat. See <a href="/pulsatile-tinnitus/">pulsatile tinnitus</a>, which is a separate category with different causes and an imaging pathway.

• It comes with new dizziness, vertigo attacks, or a full ear that comes and goes. Those patterns point towards Meniere’s disease or an inner-ear pressure problem, both of which are worth assessing rather than adapting to.

• There is new weakness, numbness, facial droop or any other neurological symptom. That is a medical assessment rather than an ear one.

• It is getting worse rather than staying level. A changing picture needs a baseline to be measured against.

Published 23 Apr 2026Last updated 25 Sept 2026