Hearing Aid Comfort
One rule holds for every style, and it is worth learning before anything else: nothing goes into an ear canal further than the wearer can comfortably take it out again. Everyday hearing aids are built to be inserted and removed by the person wearing them, several times a day. If you have to fish for a device, or dig, or ask someone else to retrieve it, it went in too far. The only exception is the extended-wear device, which a trained provider places and which is not patient-inserted at all.
What follows is style by style: a receiver-in-canal with a soft dome, a custom in-the-ear, a completely-in-canal, and extended wear. Then the three problems that send most people looking for this answer in the first place. It hurts, it whistles, or it will not stay put. Any of those is something to correct at a hearing aid fitting appointment, not something to get used to.
At a glance
- Never insert a hearing aid deeper than you can comfortably remove it yourself.
- Correct depth is set by the device style and your canal shape, not by how firmly you push.
- A hearing aid that hurts is a fitting problem. There is an adjustment period for how hearing aids sound, and none for how they feel.
- Whistling and devices that work loose usually mean the wrong dome size or a device that is not seated, and both are fixed in the office in minutes.
The rule that applies to every style
Whatever you wear, the depth is limited by one thing: your own ability to get it back out. Hearing aids are made to be handled daily by fingers that may not be as steady as they once were. If a device disappears from view into the canal, or you find yourself pinching at it and catching skin, it is sitting deeper than it should. There is an anatomical reason to care. The inner third of the ear canal runs over bone, with skin lying almost directly on it and very little padding in between, and that stretch is exquisitely sensitive to pressure. It is the part you are trying to stay out of. Nothing you put in yourself belongs there.
Receiver-in-canal with a dome
This is the common style now: a small case behind the ear, a thin wire over the top of it, and a speaker at the end of that wire sitting in the canal under a soft silicone dome. Reach across with your opposite hand and pull gently down and back on the earlobe, which straightens the canal, then push the dome along the line the canal actually runs. That line points forward and slightly up, toward the tip of your nose, not straight back into your head. It is seated when the dome is out of sight from the front and the wire lies flat in the crease behind your ear. A wire that bows out in a loop means the dome is not all the way in. The depth itself is governed by the length of that wire, which is sized to your ear in the office. Too long, and the speaker presses deeper than it should and rubs.
Custom in-the-ear devices
A custom in-the-ear aid cannot easily go too deep, because the shell is a cast of your ear and it stops where your ear stops. The failure runs the other way: it does not go in far enough. Rotate it in following the curve of the canal rather than pressing it flat against the opening, then seat it until the faceplate sits level with the bowl of your ear with no gap around the rim. A faceplate standing proud of the surrounding skin is the most common reason a custom device squeals. If it will not seat without real force, the shell needs modifying. That is a few minutes of work in the office, not a problem to solve by pushing harder.
Completely-in-canal and extended wear
A completely-in-canal device sits wholly inside the canal, with the faceplate recessed a short way in from the opening so nothing shows from the side. It comes with a removal cord or a small handle, and that cord is your depth gauge. If you can pinch it easily with dry fingertips, the device is deep enough and no deeper. If you have to hunt for it, stop and have the fit checked. Extended-wear devices belong in a different category altogether. They are placed close to the eardrum by a trained provider and stay in for months at a time, which is only reasonable because you are not the one placing them. You do not insert one, and you never push one further in for any reason. If an extended-wear device becomes uncomfortable, contact the provider who placed it rather than trying to adjust it yourself.
What correct seating feels like
For the first few days you will be aware of the device the way you are aware of a new watch. Awareness is fine. Soreness is not. A hearing aid that fits produces no single point of pressure, no throbbing, and no tenderness that outlasts the wearing. Take it out at the end of the day and the canal should look and feel much as it did that morning. A red ring still visible an hour after removal, an ache at one specific spot, or a canal that feels bruised all say the same thing: something is too large, too long, or too deep.
If it hurts
Pain is a fitting problem, and it is worth saying flatly, because people are told to give it time and they do. They give it weeks, while a dome one size too large wears a sore spot into the canal wall. There is a real adjustment period for how hearing aids sound, and it does run into weeks. There is no adjustment period for how they feel. If a device hurts, take it out and call the office. The usual remedies are quick: a smaller or softer dome, a different dome style, a shorter receiver wire, or a little shell modification on a custom aid. None of them ask you to endure anything in the meantime.
If it whistles, or will not stay in
Whistling is feedback, and feedback means amplified sound is escaping around the device and being picked up again by its own microphone. The usual causes are a dome that is too small, a device that is not fully seated, a custom shell that is not flush, and earwax sitting against the eardrum and reflecting sound back out. Reseat it first. If it still whistles, resist the temptation to turn the volume down and live with it, because a device quietened to stop a squeal is no longer doing the job you bought it for. There is more on the causes in our piece on why hearing aids whistle. A device that works loose has the mirror-image cause, and the answer is a different dome size, a different dome style, or a custom mold.
When to come in
Do not sit on a comfort problem until your next scheduled visit. Fit problems get worse rather than better, and an irritated canal takes time to settle once it is inflamed. Come in if a device hurts at any point, if redness or soreness lingers after removal, if you cannot get something out, or if you notice discharge, bleeding, or a change in hearing on that side. If a device is genuinely stuck, do not go after it with tweezers or a hairpin, which is how canals get cut and eardrums get injured. Call us, or urgent care if you cannot reach us. Patients at our San Mateo and San Carlos offices can get in touch for a comfort check, and it is a short appointment.
Frequently asked questions
Your questions, answered
How do I know my hearing aid is all the way in?
For a dome, the test is visual: nothing should be visible when someone looks at you straight on, and the wire should lie flat in the crease behind your ear rather than bowing away from your head. For a custom device, run a fingertip around the faceplate. It should sit level with the surrounding skin with no lip or gap. If either one squeals when you cup your hand over your ear, it is not seated.
Can a hearing aid touch my eardrum?
A properly sized everyday hearing aid should not reach the eardrum, and if yours feels as though it does, the receiver wire or the shell is too long for your canal. That is measurable and correctable in the office. Extended-wear devices are the exception and are placed deep by a provider who can see the eardrum while doing it.
My ear is sore after a few hours. Should I push through it?
No. Soreness after a few hours means something is rubbing, and continuing to wear it turns a pressure point into a raw spot that then needs time to heal before you can wear anything at all. Take the device out, note where it hurts, and call us. Most of these are solved by changing a dome or trimming a shell.
Why does my own voice sound boomy since I started wearing these?
That is the occlusion effect, and it comes from blocking the canal rather than from inserting the device too deep. It usually eases within a week or two, and when it does not, the fix is a vent, a more open dome, or a settings change. We cover it in more detail in why your own voice sounds boomy.
What if the dome comes off in my ear?
It happens, usually when a dome has been on the receiver a long time and the silicone has stretched. Do not go looking for it with anything rigid. Call the office and we will remove it under magnification, which takes a couple of minutes. Checking that the dome is firmly on the receiver each morning is the simplest way to avoid it.