8 Common Causes of Hearing Loss

Here are several common causes of hearing loss in adults.

1.  Otosclerosis

Otosclerosis is when you have an abnormal bone growth in your inner or middle ear. Your body is constantly replacing — or remodeling — old or damaged bone tissue with new tissue, even in your ears. Otosclerosis occurs during this remodeling process when irregular bone growth blocks sound from traveling from your middle to inner ear.

It usually happens when the tiny triangular bone in your middle ear called the stapes get stuck in place. When the stapes bone can’t vibrate, sound can’t move through your ear effectively.

Hearing loss from otosclerosis is mostly gradual and often starts in one ear and spreads to the other. Some people also get dizzy and have symptoms of tinnitus. Hearing aids can help, but to restore hearing loss from otosclerosis, you may need surgery.

2. Ménière’s disease

Ménière’s disease is a rare condition that usually affects people between the ages of 40 and 60. The most common symptom is severe dizziness — vertigo — which can make you feel like you’re spinning. Vertigo episodes can last as briefly as 20 minutes or as long as 12 hours. Ménière’s disease also causes tinnitus and hearing loss, usually in just one ear, though sometimes it can be in both. They can come and go with vertigo episodes, but hearing loss can eventually become permanent.

The symptoms of Ménière’s disease are caused by too much fluid in your inner ear. You can usually treat vertigo with a low-salt diet, diuretic pills or anti-vertigo medications, but sometimes surgery is required to prevent permanent damage to your inner ear.

3. Acoustic neuroma

Acoustic neuroma (also known as vestibular schwannoma) is a benign tumor that grows slowly on the vestibulocochlear nerve, which is the main nerve between your inner ear and brain. The nerve sends messages to your brain so you can hear and keep your balance.

A tumor develops when you have overproduction of Schwann cells, which are cells that normally wrap and protect your nerve fibers. When the tumor grows large enough to press against the vestibulocochlear nerve, it can cause issues with your hearing, including tinnitus, as well as balance problems and dizziness.

Because acoustic neuroma has symptoms that are like many other middle ear conditions, it’s difficult for doctors to diagnose. If you have any of these symptoms, talk to your doctor. They may want to schedule you for an ear exam, hearing and balance test, and possible scans to look for a tumor.

4. Ototoxic medications

Ototoxic drugs are those that can damage your inner ear, either to the tiny hair cells or the vestibulocochlear nerve, when you take them. More than 200 drugs are ototoxic.

Signs of ototoxicity include tinnitus, balance issues, and dizziness or vertigo. How severe your hearing loss is from ototoxicity and how long it lasts depends on the drugs you’re taking, the dosages and how long you’ve been taking them. Sometimes the damage is reversible if you stop taking the medication, but don’t stop taking your medicine unless your doctor tells you to.

• Ototoxic medications that can cause hearing damage: 
• Aminoglycoside antibiotics (streptomycin, neomycin, gentamicin)
• Chemotherapy drugs (cisplatin and carboplatin)
• Salicylate pain relievers like aspirin
• Quinine (Qualaquin)
• Loop diuretics like bumetanide (Bumex), ethacrynic acid (Edecrin), furosemide (Lasix) and torsemide (Demadex)
• Benzodiazepines like alprazolam (Xanax), diazepam (Valium) and lorazepam (Ativan)
• SSRIs like sertraline (Zoloft), escitalopram (Lexapro) and fluoxetine (Prozac)·      
• NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen and naproxen

If you take any of these drugs, make sure to get a “baseline hearing test prior to beginning use of the medication,” Creed says, “and let your doctor know immediately if you begin to experience any symptoms.”

5. Earwax buildup

Earwax, also known as cerumen, helps keeps your ears healthy by protecting them dirt, dust and other contaminants that could cause infections. But if you have too much earwax buildup, it can create a blockage. If you don’t have impacted earwax removed, you can end up with ear pain, itching, ringing in the ears and hearing loss.

Removing earwax is relatively easy. Just don’t use cotton swabs. “These can push earwax further into the ear canal, worsening its buildup over time, and can potentially cause damage to the ear drum — both of which can result in hearing loss,” Pompinio says. “Never put anything smaller than your elbow in your ear.” Instead, try over-the-counter solutions that are designed to soften and loosen the dried earwax. You also can try a few drops of mineral oil, hydrogen peroxide or saline. If these don’t work, call your doctor to remove the blockage safely.

6. Traumatic brain injury

A traumatic brain injury affects how your brain works. According to the CDC, more than 214,000 people were hospitalized for TBI-related injuries in 2020 — and people older than 75 made up a third of those hospitalized.

The most common traumatic brain injuries in the U.S. occur from falls, fire-arm-related injuries, car accidents and assaults.

Symptoms of TBI, including damage to your hearing, can vary drastically and will depend on where and how severe the brain is injured. A 2025 study published in the Journal of Head Trauma Rehabilitation that included more than 3,100 participants with an average age of 79 found those with prior TBI injuries were more likely to have hearing loss and tinnitus and use hearing aids compared to those who had never had a TBI.

Still, the CDC says diagnosing TBI in older adults is often missed because the symptoms are similar to other conditions, like dementia, which can contribute to more severe injury or even death.

7. Loud noises

Noise-induced hearing loss is a leading cause of hearing loss, second only to age-related hearing problems. NIHL can be permanent or temporary and affect one or both ears. The symptoms of NIHL can include pressure in your ears, muffled sounds (like when other people talk) and trouble hearing high pitches.

The intensity of sound is measured in units of decibels. The National Council on Aging says any sound louder than 70 decibels puts you at risk of hearing loss. Normal conversations are usually about 60 decibels, but common sounds from kitchen appliances, a barking dog and even city traffic register higher than 85 decibels, according to the Hearing Health Foundation. Gunshots, jackhammers and jet engines can register as high as 140 decibels. “It’s important to remember that a single exposure to a dangerously loud sound can cause irreversible hearing damage,” Creed says. “All it takes is one exposure.”

Protect your hearing by wearing earplugs at concerts and loud events, when using noisy equipment or even when flying. And when you’re wearing headphones, which can have volumes higher than 100 decibels, the Journal of the Acoustical Society of America suggests you don’t set the volume higher than 50 percent.

8. Smoking

Here’s yet another reason to stop smoking: It often comes with hearing difficulties, too. A study in Japan followed more than 50,000 workers ages 20 to 64 for eight years, none of which had hearing loss. When researchers tested their hearing annually, they found that of the 10 percent (5,107 people) who developed hearing issues, many were smokers. In fact, smokers were up to 60 percent more likely to have high-frequency hearing loss. 

The number of cigarettes mattered too: Smoking up to 10 cigarettes a day made high-frequency hearing loss 40 percent more likely, 11 to 20 cigarettes a day raised the risk to 60 percent, and more than 20 cigarettes raised the risk to 70 percent.

The Japanese findings are similar to other research establishing an association between smoking and hearing loss, including a large cross-sectional study published in JAMA OtolaryngologyHead Neck Surgery. Of more than 3,400 participants ages 72 to 94 that were followed for more than 30 years, those who were persistent smokers had worse hearing and speech-in-noise perception than those who didn’t smoke.

Editor’s note: This story, originally published on Feb. 22, 2022, has been updated to include new information.