Tinnitus
When you hear sounds in the ear, such as ringing or buzzing, without an external source
Medically reviewed by a board-certified ENT specialist
- Author:
- Dr. Poj Pinyopornpanish — Otolaryngologist · Thai Board of Otolaryngology
- Medical reviewer:
- Dr. Poj Pinyopornpanish — Otolaryngologist · Thai Board of Otolaryngology
- Reviewed on:
- Last updated:
- Estimated reading time: 5 min
Overview
What is tinnitus?
Tinnitus is the perception of sound in the ear or head when no external sound is present. Common descriptions include ringing, buzzing, humming, whistling, or clicking. It is a frequent symptom that may be temporary or persistent. Tinnitus is not a single disease but often a sign of ear, hearing, or general health issues. A clinical assessment helps identify possible causes and appropriate management.
Symptoms
Common symptoms
The type and intensity of tinnitus vary between individuals and may change over time.
Ringing, buzzing, humming, whistling, or clicking in the ear or head
Sound may be constant or come and go
May affect one ear or both ears
Often more noticeable in quiet settings or at night
Some people feel annoyed, anxious, or have sleep difficulty because of the sound
Hearing loss, dizziness, or ear pain may occur depending on the cause
Pulsatile tinnitus (rhythmic sound matching the heartbeat) in some cases
Possible causes
What can cause tinnitus?
Tinnitus has many possible causes, and in some cases no clear cause is found.
Hearing loss
Age-related or noise-related changes in the inner ear are among the most common associations.
Noise exposure
Prolonged loud noise from work, concerts, or headphones may cause temporary or lasting tinnitus.
Ear canal or middle ear problems
Impacted earwax, ear infection, or other ear conditions may contribute to tinnitus.
Medications
Certain antibiotics, pain relievers, or other drugs may trigger or worsen tinnitus in some people.
Blood pressure and circulation
High blood pressure or altered blood flow near the ear may be linked to pulsatile tinnitus in some cases.
Stress and sleep
Stress, anxiety, or poor sleep may make tinnitus feel louder or more bothersome.
Other related conditions
Ménière's disease, jaw joint (TMJ) problems, or certain neurological conditions may be associated.
When to seek care
When should I see an ENT specialist?
Many cases of tinnitus are not serious, but certain features warrant prompt assessment.
Sudden onset or severe tinnitus
One-sided tinnitus or a clear change in character
Pulsatile tinnitus (rhythmic, heartbeat-like sound)
Sudden or significant hearing loss
Dizziness, balance problems, or ear pain
Tinnitus that significantly affects sleep, work, or quality of life
Other neurological symptoms such as numbness, weakness, or severe headache
Tinnitus starting after a new medication or head injury
Diagnosis
How is it diagnosed?
The doctor will ask about the sound, duration, triggers, medical history, medications, and noise exposure. The ears are examined with an otoscope, and hearing tests (audiometry) may be performed. Further tests such as imaging may be arranged when needed. Assessment helps determine whether tinnitus is related to ear disease or another condition requiring treatment.
Treatment
Treatment options
There is no single treatment that works for everyone. Care focuses on treatable causes, symptom relief, and helping you adapt to the sound. Outcomes vary between individuals.
Treating identifiable causes
Examples include wax removal, treating ear infection, adjusting a contributing medication, or managing an underlying condition as assessed by your doctor.
Hearing aids
When hearing loss is present, hearing aids may improve awareness of external sounds and reduce focus on tinnitus in some people.
Sound therapy
Background noise, white noise devices, or clinician-guided tools may help make tinnitus less prominent.
Psychological and behavioural support
Cognitive behavioural therapy (CBT) or counselling may help when tinnitus significantly affects daily life.
Medication
Medication does not cure tinnitus in all cases but may help related issues such as anxiety, sleep disturbance, or an underlying condition when clinically appropriate.
Self-care
What you can do at home
Self-care focuses on reducing bother and avoiding factors that may worsen symptoms.
Avoid or limit loud noise and use hearing protection when needed
Use gentle background sound in quiet environments to reduce awareness of tinnitus
Maintain good sleep habits and limit caffeine before bed if it affects sleep
Manage stress through appropriate relaxation or activity
Do not insert objects into the ear canal
Seek assessment if symptoms change, worsen, or new symptoms appear
Prevention
Reducing the risk of tinnitus
Tinnitus cannot always be prevented, but certain steps may reduce risk from modifiable factors.
Protect hearing by lowering volume and using earplugs in loud environments
Limit duration and volume when using headphones
Treat ear infections or ear problems as advised
Tell your doctor if a new medication seems to cause ear noise
Have hearing checked as recommended, especially if you have risk factors
FAQ
Frequently asked questions
Common questions about tinnitus, possible causes, and practical self-care steps.
Is tinnitus dangerous?
Most tinnitus is not dangerous, but you should be assessed if it starts suddenly, affects one ear only, is pulsatile, or occurs with hearing loss, to rule out conditions that need treatment.
Can tinnitus go away?
It depends on the cause. Tinnitus linked to wax or temporary infection may improve when the cause is treated. Persistent tinnitus may not disappear completely, but many people adapt and symptoms become less bothersome with appropriate care.
Why does tinnitus seem louder at night?
In quiet settings, the brain often pays more attention to internal ear sounds, making tinnitus feel louder. Gentle background noise may help reduce this effect for some people.
Can hearing aids help tinnitus?
When hearing loss is present, hearing aids may improve external sound awareness and reduce focus on tinnitus. Results vary between individuals.
When should I see a doctor?
See a doctor for new, severe, or changed tinnitus, one-sided or pulsatile tinnitus, associated hearing loss, or symptoms that significantly affect daily life.
References
Related guidelines and patient resources
The sources below are recognized international guidelines and patient-education resources for general learning. They are not individualized medical advice.
Patient information on ear and hearing conditions
AAO-HNS / ENThealth
View source (AAO-HNS / ENThealth)Patient education and clinical guidance in otolaryngology
American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS)
View source (American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS))Public ENT health information
ENThealth (AAO-HNS Foundation)
View source (ENThealth (AAO-HNS Foundation))
Educational information
Medical Disclaimer
This information is intended for educational purposes only and does not replace diagnosis or treatment by a qualified physician. If you have concerning symptoms, please consult an ENT specialist.
Related links
Learn more
Related clinic pages to help you explore conditions, services, and procedures.
Hearing sounds in the ear or finding it hard to cope?
An assessment can help identify possible causes and what care may be appropriate for your symptoms.