In the United States, an estimated 28.8 million adults could benefit from hearing aids. But few of these people have ever used them. Less than 30% of adults over the age of 70 and less than 20% of younger adults who could benefit decide to wear hearing aids. There are various reasons for this. Some see hearing aids as a stigma and others find them unaffordable. If you’re struggling to hear, you have options to improve your hearing. Here is a look at two types of hearing enhancers—hearing aids and personal sound amplifiers. Both hearing aids and amplifiers enhance sound. Hearing aids and personal sound amplifier products (PSAPs) are electronic devices that enhance sound. They both help people hear sound better. They are also both wearable in or around the ear. They even share some of the same technology. However, there are some key differences in how they enhance sound. Hearing aids can analyze and adjust sounds based on your hearing loss needs. They can adjust for hearing distortions and other hearing problems in addition to hearing loss. They are available with features such as noise reduction, noise cancellation, and environmental noise control to reduce wind noise. You can also get hearing aids with variable programming. This allows you to preprogram several settings for different listening environments. You can switch programs when you change environments. PSAPs provide modest amplification of environmental sounds. This is all the most basic ones will do. Some of them come with an app that lets you adjust for different hearing environments, such as restaurants or the outdoors. However, PSAPs can’t adjust for other components of hearing loss, such as sound distortions. Many hearing aids and advanced PSAPs offer several useful options beyond boosting sound. This includes: Bluetooth connectivity to devices for phone conversations, music, and audiobooks Direct audio input to plug into a TV, computer, or other device Directional microphones to enhance sounds coming from one direction Rechargeable batteries Hearing aids are medical devices, but amplifiers are an unregulated consumer product. One of the main differences between hearing aids and PSAPs is their regulation status. The U.S. Food and Drug Administration (FDA) has not approved PSAPs as medical devices. As such, they can’t claim use for people with impaired hearing. Officially, they are for people with normal hearing to use in specific situations. Examples include hunting, listening to distant conversations, and other times when soft sounds need amplification. Since they are basically consumer products, you can buy them at retail outlets and online. They typically cost a few hundred dollars. Hearing aids, on the other hand, are regulated medical devices. The FDA requires them to meet performance and safety standards. You can only get hearing aids from licensed providers, such as audiologists. They require fitting and customization to meet the specific needs of a hearing-impaired person. This tends to make hearing aids expensive. Depending on the options you choose, hearing aids can cost thousands of dollars. Hearing aids may also need periodic service or repair, which can add to the cost. Some personal sound amplifiers may soon fit into a new market. In 2017, the FDA Reauthorization Act included a section on over-the-counter hearing aids (OTC HAs). It created a new class of hearing enhancement products that will be available in 2020. OTC HAs will be for people with mild to moderate hearing loss. They will require self-fitting and self-maintenance. This regulatory change may allow some PSAPs to fit into the new OTC HA market. However, specific regulations and requirements for these devices are not yet available. See a healthcare provider before trying a personal sound amplifier. If you want to try a PSAP, it is best to see an audiologist or your doctor first. Failing to get a hearing test before using a PSAP can make your condition worse. Many causes of mild hearing impairment are treatable. You could delay a simple diagnosis, such as impacted earwax, by skipping this step. Once OTC HAs are available, it will be even more important to work with a healthcare provider. Using these devices incorrectly can cause further hearing loss. Hearing loss also tends to be progressive. Periodic hearing checks will let you know when OTC HAs may no longer be the best choice.