Hearing aids are small devices that fit in or behind your ear and can help you to hear sound louder and more clearly.
Hearing-aid technology has improved considerably in recent years. Most, including all NHS hearing aids, are now digital. This means they can be quite accurately personalised to your hearing loss.
The best type for you will very much depend on your hearing issues and your lifestyle. The audiologist you see should discuss which brand they're recommending for you and why, and explain the pros and cons.
Here, we run through the main types so you have an idea of your options.
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Video: How to buy the best hearing aid
Hearing aid types compared
Behind-the-ear (BTE) with earmould
Who it's for:People with mild to severe hearing loss.
Pros: Fits widest range of hearing loss. Earmould fits snugly while the rest of the aid sits behind the ear. Most versatile and reliable type of hearing aid.
Cons: Most visible type of hearing aid. Ear might feel 'plugged up', but vents in mould can relieve this and are fitted when appropriate.
Behind-the-ear (BTE) open-fit
Who it's for:People with mild to moderate hearing loss.
Pros: Has a small, soft earpiece at the tip of the tubing instead of an earmould, which will make you feel less plugged up.
Comfortable (not too heavy on the ear) and less visible than an earmould. It can give you a very natural sound.
Cons: Needs to be inserted correctly otherwise can become loose.
Receiver-in-the-ear (RITE) digital aids
Who it's for:People with mild to severe hearing loss.
Pros: All the benefits of an open-fit hearing aid, but can be fitted with more amplification. Often smaller than BTE aids because some parts sit inside the ear.
Cons: Vulnerable to wax and sweat, which can affect the sound in the receiver.
In-the-canal (ITC) and in-the-ear (ITE) digital aids
Who it's for:People with mild to some severe hearing loss.
Pros: Both have working parts in the earmould, or a small compartment clipped to it, so the whole aid fits in the ear. ITC aids are less visible than ITEs, but neither has parts behind the ear.
Cons: Tend to need repairing more often than behind-the-ear aids.
Completely-in-the-canal (CIC) or invisible hearing aids
Who it's for:People with mild to moderate hearing loss.
Pros: Smallest type of hearing aid. Almost invisible, as working parts are in the earmould. They fit further into the ear canal than ITE/ITC aids.
Cons: Unlikely to be suitable if you have frequent ear infections. Ear might feel plugged up unless it's vented. Small tube is particularly vulnerable to becoming blocked with sweat and wax, which may cause temporary malfunction. Can be tricky to use if you can’t manage small switches or buttons. How hidden it is will depend on the shape of your ear.
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Are smaller hearing aids better?
Many people believe that small hearing aids that fit in your ear are pricier, more up to date and ‘better’ – but that's not the case, and this type is usually only suited to people with mild to moderate hearing loss.
Some smaller hearing aids can be difficult to handle if you have poor eyesight or dexterity. They can also be a bit harder to keep clean and can be more affected by heat and moisture.
Despite looking more discreet, invisible hearing aids are not necessarily more expensive than other types. What the hearing aid looks like has no bearing on the cost, as it’s the technology that’s important. Our guide to hearing aid prices shows how much you can expect to pay, based on the features you need.
Rechargeable hearing aids
Traditionally, hearing aids were powered by small lithium batteries that needed frequent replacing, but rechargeable ones are increasingly available, though they are easier to get hold of if you go private.
Just over half of private patients in our 2022 survey of the best and worst hearing aid providers had rechargeable hearing aids, compared with just 5% with NHS-issued hearing aids.
You may pay around £100-200 more for a pair of rechargeable hearing aids as a private patient, but you’ll dodge disposable battery costs (presuming they’re not free in your package) averaging £3 a month.
Alternatives to hearing aids for milder hearing loss
'Hearables' are a rapidly growing market. Some are very basic amplification devices, but more sophisticated ones have specialist features such as pre-set hearing assessment – and subsequent adjustment of the frequencies and pitch you hear.
Many are designed to look like stylish wireless headphones, or ear buds, which some people prefer.
More sophisticated hearables can reduce background noise and enhance audio quality or speech – for example, one-to-one conversations – and they plug your ear, which helps suppress background noise, but could also isolate you.
We haven’t tested them, but the top price is around £400 – cheaper than the most basic hearing aids, which come in at around £1,000. Nuheara is one of the few brands on sale in the UK at the moment.
They are a possible ‘starter’ device for people with milder hearing loss, but you’re not getting the audiology assessment and degree of personalisation to improve your specific hearing loss, so they may be a false economy in the long run. They're also less suitable for more significant hearing loss issues.
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Hearing aids vs hearing amplifiers: what to you need to know
You may have seen cheap hearing aid-style devices on sale in pharmacies and online for around £20, including medically approved devices from well-known health companies such as Beurer and Kinetik Wellbeing.
But be warned - these are no substitute for a hearing aid.
They look similar to hearing aids, but these off-the-peg devices cannot legally cannot be marketed as hearing aids, and don’t require a hearing assessment.
They provide very basic sound amplification, but they don’t adjust the sound frequencies for your individual hearing loss.
These products may have some benefit simply by plugging your ear, but RNID argues caution, as you may inadvertently turn them up too loud (as they’re not helping you to hear) and risk further damaging your hearing.
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Less common types of hearing aid
Hearing aid with tinnitus masker
These are designed to mask the presence of tinnitus, a condition where you hear annoying internal noise. They don't always bring long-term relief though.
Bone conduction hearing aids
These are suitable if problems with your outer or middle ear are stopping sound from getting through. They send sound vibrations through the skull directly to the inner ear.
They can be worn with a headband or attached to your glasses, and some are surgically implanted.
CROS and BiCROS hearing aids
CROS hearing aids are suitable if you have hearing in one ear only. They pick up sounds from the side with no hearing and transmit it wirelessly to your better ear. BiCROS aids amplify sound from both sides and feed it into the ear that has better hearing.
Body-worn analogue hearing aids
These may be useful if you have a visual or sight impairment or find it hard to use small switches or buttons. Some can be very powerful. They’re not widely available anymore because they’re so bulky.
Custom-made spectacle hearing aids
It’s possible to have your hearing aids and glasses built into one unit. But this generally isn't ideal: if your hearing aids need repairing or you need a new glasses prescription, you could be left with neither hearing nor visual aids in the interim.
With some spectacle aids, the frame has to be adapted or cut, meaning that the glasses can’t be returned to their original state. Once the hearing aid has been fitted to the frames, some opticians are reluctant to change the lenses in the glasses because they're worried about damaging the hearing aid. Also, the hearing aids can’t be removed and worn separately.
But one instance where spectacle hearing aids can work really well is if you have conductive hearing loss or mild to moderate hearing loss, but are unable to wear any device in or around the ear due to allergy or infection.
Implantable devices
If a standard hearing aid really isn’t suitable for you, either because your loss is too severe or you are unable to wear one, you still have options, including cochlear implants and bone-anchored hearing aids (BAHAs).
Cochlear implants are small electronic devices that give you the sensation of sound. They comprise an external part worn like a hearing aid and an internal part that is surgically implanted into your inner ear. The sound from the implant will take a little while to get used to (voices can sound distorted) and you will need to be trained to understand what you are hearing.
BAHAs are digital bone-conducting devices that are fitted to a press-stud-like screw that has been inserted into the mastoid bone behind your ear. BAHAs are suited to people whose hearing is reduced by problems with their middle ear, such as infections. The sound is sent directly to the cochlear via the bones in the skull.
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