For the right patients, over-the-counter hearing aids can help with hearing and communication and may decrease some of the negative outcomes associated with age-related hearing loss, says Carrie Nieman, associate professor of otolaryngology–head and neck surgery at the Johns Hopkins University School of Medicine. 

That’s why she and other otolaryngologists recommend that primary care doctors take hearing health into consideration when treating patients, particularly older ones.

Many over-the-counter hearing aid options are now available, from inexpensive hand-held amplifiers to self-fit devices that use a smartphone app to calibrate amplification to a patient’s specific needs.

“This is a new and evolving space,” Nieman says. She notes that a law enacted in 2022 expanded options by allowing OTC sales of air conduction hearing aids — which amplify sounds before they reach the middle ear — without prescriptions or professional fittings, provided they meet certain requirements such as having volume controls and clear labeling. Hearing aids for children and for those with more severe hearing loss still require prescriptions. 

With this boost in hearing aid accessibility, clinicians have more opportunities to promote hearing health in patients. “It’s not just otolaryngologists,” says Nieman. “Primary care doctors can and should be talking about hearing with their patients.”

OTC hearing aids are intended for adults who have experienced gradual changes in hearing, who perceive themselves to have a mild to moderate amount of hearing loss, and who have hearing loss that is about the same in both ears, she says. 

Referral to an otolaryngologist is recommended for patients with severe or sudden hearing loss, fluid draining from the ear, dizziness, or a big difference in hearing between one ear and the other.

Patients who want more information about OTC hearing aids, or who have tried them and are not satisfied, may also benefit from a referral to an otolaryngologist and/or audiologist, Nieman says.

“Hearing loss has been associated with increased falls, depression, loneliness, social isolation, accelerated cognitive decline and dementia,” she says. “We know that hearing aids, whether prescription or otherwise, can improve communication and help with quality of life.”