How to Stop the Ringing in the Ears Called Tinnitus

Common causes of tinnitus include:

• Age-related hearing loss
• Noise-induced hearing loss
• Injury or trauma to ears
• Earwax impaction
• Ear infections
• Certain medications

Less-common causes include:

• Ménière’s disease
• Temporomandibular disorders like TMJ
• Chronic blood vessel issues like high blood pressure

When should you see a doctor for tinnitus?

If your tinnitus doesn’t bother you, it’s probably OK not to see your doctor. If the ringing in your ear is annoying or disrupting your life, talk to your primary care physician. They can determine if you have an underlying medical cause or if you need to see an otolaryngologist for more tests.

Call your doctor right away if your symptoms of tinnitus show up after an upper respiratory infection, or you feel dizzy, anxious, depressed or have hearing loss.

Tinnitus treatments 

Treating tinnitus depends on whether it’s caused by another health problem that can be managed. If so, your doctor may recommend some of the following ways to treat common underlying causes of tinnitus.

• Change medications. Some everyday medications can cause tinnitus, including analgesics like aspirin, NSAIDs, diuretics, cancer drugs and certain antibiotics. The Center for Hearing Loss Help has a list of medications that may be connected to tinnitus. Talk to your doctor about all medicines you’re taking, including over-the-counter medicines. They may want to consider alternatives.
• Get earwax removed. If impacted earwax is the cause of your tinnitus, your doctor can remove it safely and that may solve the problem.
• Try a hearing aid. Tinnitus and hearing loss are associated, particularly in older adults. “I don’t prescribe hearing aids for tinnitus, but I prescribe hearing aids for hearing loss,” Backous says. “Oftentimes that reduces their tinnitus because they are hearing what they want to hear.”

Noise suppression therapies 

If your tinnitus can’t be helped with a hearing aid, earwax removal or change in your medication, you need to focus on managing your symptoms. One way to do that is by using techniques to silence or quiet the noise.

• Sound therapy. Sometimes called acoustic therapy, sound therapy simply adds background noise to help your brain disengage and quiet your tinnitus, especially at night. “It can be any sound you find pleasant and calming,” Onozuka says. You can use a white noise machine, fan, music or air conditioner. Even smartphone apps can be used to make soothing sounds.
• Mask the sound. ​Masking devices are like hearing aids but they provide a continuous white noise sound that can help alleviate the noise from your tinnitus. Some hearing aids also offer masking options.
• Levo. Levo is an FDA-cleared sound therapy that uses your own sensitivity to tinnitus and hearing loss to generate a custom set of tones you listen to while you sleep. The sounds and frequencies help train your brain to ignore the symptoms of your tinnitus.

Mind-body techniques

If your tinnitus is causing extreme anxiety, there are other options for reducing its severity. Research has shown that therapy, like cognitive behavioral therapy (CBT) and retraining therapy, is one of the most successful ways to manage your symptoms.

• Cognitive behavioral therapy. One of the most common treatments for tinnitus, CBT helps you reduce your emotional response to tinnitus. You work with a therapist to focus on positive changes to lessen the impact of tinnitus. A 2022 review of studies on tinnitus treatments published in the journal Clinical Psychology & Psychotherapy  found that “CBT is nonetheless widely regarded as a gold standard for the treatment of subjective tinnitus.” 
• Tinnitus retraining therapy. This form of therapy combines counseling and sound therapy to “retrain” your brain. The goal is so you won’t hear your tinnitus symptoms. TRT can take months to be effective, but studies have shown it can work, if you stick to it.
• Bimodal stimulationBimodal auditory-somatosensory stimulation combines acoustic therapy with electric stimulation, usually on the tongue, neck or vagus nerve. The therapy helps stimulate your brain so it changes your tinnitus symptoms.
• Lenire. The FDA approved Lenire, the first bimodal stimulation treatment, in 2023 and it became available to patients in April 2024. It’s a prescription therapy you in 30-minute sessions at home that sends mild electrical shocks to your tongue while you listen to music or sounds through headphones. The journal Communications Medicine published the first study on its real-world clinical effectiveness. Researchers determined that Lenire was safe and effective at reducing tinnitus in the 220 patients who participated.

Medications

There currently are no FDA-approved drugs for tinnitus. But your doctor has several options to help you with stress, anxiety and even depression caused by tinnitus. These medications won’t cure your tinnitus, but may help you deal with some of the symptoms it causes.

Common antidepressants prescribed for tinnitus:

• Clomipramine (Anafranil)
• Desipramine (Norpramin)
• Imipramine (Tofranil)
• Nortriptyline (Pamelor)
• Protriptyline (Vivactil)

Common antianxiety prescribed for tinnitus:

• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Diazepam (Valium)
• Lorazepam (Ativan)

New tinnitus treatments and research 

Because so much evidence suggests tinnitus is caused by changes in the brain, much of the research is focused on ways to reprogram the brain.

• Repetitive transcranial magnetic stimulation (rTMS). This is a painless procedure that uses an electromagnetic coil to send short magnetic pulses to your brain. Numerous published studies show that rTMS can be effective at treating chronic tinnitus, but others found it to be no more successful than placebo. More large-scale trials are needed to determine if rTMS will be a possible treatment for tinnitus.
• Deep brain stimulation. This invasive treatment involves surgery to implant electrodes deep in your brain to regulate activity, similar to DBS for Parkinson’s. It’s begun showing promise as a treatment for severe refractory tinnitus, though most studies have been small. A systematic review published in the journal Brain Sciences found DBS to be safe and effective, but the authors cautioned about the small size of the study and the need for more research.  
• New biomarkers for diagnosing tinnitus. Researchers at Mass General Brigham found that the pupils of people with severe tinnitus were almost always dilated extra wide when they heard any sounds. They hope to expand on this and develop new therapies to quiet or eliminate the sounds of the tinnitus.
• Genetic risk factors. A large genome wide association meta-analysis published in the journal Nature Communications found several genetic links between tinnitus and hearing loss. The study determined tinnitus was genetically linked to several psychiatric disorders, as well, which could help open new opportunities for treatments.

Editor’s note: This story, originally published January 9, 2023, has been updated to reflect new information.