When Should I Worry About...

What to Consider Before Trying Over-the-Counter Hearing Aids

May 31, 2023 - Katie McCallum

If you struggle with your hearing, you might be wondering whether it's finally time to do something about it.

Should you try over-the-counter hearing aids? A fairly new option — the FDA only last year began allowing hearing aids to be sold without a medical exam or a prescription — they are now readily available. Purchasing a pair is as easy as visiting your local pharmacy or shopping online.

But with something as complex and essential as hearing, you likely have some questions about these products, including whether they're the best first step.

You're right to wonder. Over-the-counter hearing aids aren't for everyone.

"These devices may be a temporary solution for people with mild hearing loss, acting as a stepping stone to help transition them into traditional hearing aids — which we're now calling prescription hearing aids," says Dr. Rebecca Martin, an audiologist at Houston Methodist. "They may also be a more realistic solution for those with a mild level of hearing loss who aren't able to afford traditional hearing aids."

How do you know if your hearing loss is only mild? Dr. Martin shares her perspective on what to consider before trying over-the-counter hearing aids:

How do you know if you need hearing aids?

If you're considering over-the-counter options, how do you know if you should give them a try?

Dr. Martin notes that hearing loss can be subjective for the average person. Though some people understand and recognize they're not hearing well anymore, others don't notice a decline until a friend or loved one brings it to their attention. In either case, it's hard to know when to actually do something about your hearing.

The true best first step if there's a concern about your hearing is to see an audiologist. (Related: 5 Signs It's Time for a Hearing Test)

"It's best to seek medical expertise prior to purchasing any type of hearing amplification, whether it is an over-the-counter device or prescription hearing aids," says Dr. Martin. "An audiologist will be able to give their professional advice in regard to your specific level of hearing loss and whether an over-the-counter device is an option."

How do over-the-counter hearing aids work?

The new over-the-counter options share similarities with traditional, prescription-based hearing aids, but there are key differences.

How they're similar: Both are small electronic devices worn in the ear to help improve the wearer's hearing. They also both work by making certain sounds louder — picking up sound, amplifying it and delivering that amplified sound into the ear.

Which sounds are amplified is where the two options begin to differ.

"Over-the-counter hearing aids are set for a mild hearing loss across a general range of sound frequencies," says Dr. Martin. "Whereas prescription hearing aids are fit to the hearing deficits of each individual person, specifically programmed based on the results of their hearing test and their own ear canal resonance. For the other frequencies where hearing is normal, we just leave them be — we don't make any changes to those."

The physical fit — wire length, dome shape and size — is also customized with prescription options to contribute to a more comfortable, personalized fit.

Over-the-counter hearing aids vs. prescription: Which is right for you?

Another reason Dr. Martin recommends first consulting an audiologist: It's almost impossible for the average person to know what exactly they need.

"Over-the-counter hearing aids may be helpful for people with mild hearing loss, and there's a select group of people for which these products are going to be totally fine," says Dr. Martin. "But everyone's hearing loss looks different, and the general fit that the over-the-counter options provide across the board isn't going to help everyone."

That's because hearing loss varies from person-to-person. Configurations, types and degrees of hearing loss are unique to each individual.

You won't know any of this unless you see an audiologist, who has the expertise and technology to determine whether your level of hearing loss requires a prescription or if it's mild enough to start with an over-the-counter product and go from there.

Are there any risks to using over-the-counter hearing aids?

One big concern Dr. Martin has with a person using an over-the-counter hearing aid without first consulting an audiologist is the potential for harming hearing instead of helping it.

"If your hearing loss isn't as significant as you think, there is certainly a risk of over-amplification of sound," warns Dr. Martin. "This could cause permanent damage."

It's also important to be sure you're cleaning the device properly since there's always a risk of infection, however small, when you're putting something into your ear every day.

"Be sure to read the instruction manual so you know how to clean and care for your hearing aids, but your audiologist can definitely help with this instruction as well," adds Dr. Martin.

Who shouldn't use over-the-counter hearing aids

These products aren't always the answer, so it's best to get an audiologist's input before making a decision.

But certain people should never use over-the-counter hearing aids without first consulting a specialist, including:

  • Children
  • People with severe hearing loss
  • People experiencing pain or pressure in the ears
  • People experiencing drainage or leakage from their ears

"In these cases, you definitely need to first consult an ENT doctor and an audiologist," adds Dr. Martin.

When should you see an audiologist about your over-the-counter hearing aids?

If you're already using over-the-counter hearing aids and haven't yet consulted an audiologist, Dr. Martin recommends doing so.

"Since these devices are automatically programmed and set to be somewhat universal, we're limited in what we can do with over-the-counter products," says Dr. Martin. "But we can do an audiologic assessment and determine whether what you've chosen is actually right for you, and make alternative suggestions if it's not."

It's also important to see an audiologist if an over-the-counter hearing aid isn't working for you, or is no longer working for you.

"If what you're putting in your ear isn't giving you the amplification you need, it essentially becomes an ear plug, right?" says Dr. Martin. "We would want to take a look at your specific hearing deficits, determining where it's lacking and whether customized programming via prescription hearing aids is needed."

Dr. Martin says that over-the-counter hearing aids are rarely a long-term solution, acting more as a transition to prescription hearing aids.

"I think, in time, most people realize that they actually want more of that customized fit that comes with prescription hearing aids," adds Dr. Martin. "Rather than the general amplification across all frequencies you get with over-the-counter hearing aids, we can target a person's specific needs and provide a fit more tailored to your specific hearing loss."

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