Editor's note: This article is a reprint. It was originally published on May 24, 2017.
If you clean your ears with cotton swabs, you are not alone. However, contrary to popular belief, cleaning your ears is not only unnecessary, but can damage your ear canal. This can be especially dangerous for children. There are tiny hairs inside your ears that help keep the ear canal clean of debris and earwax. In fact, earwax in your ears naturally moves away if left alone, making it easy to clean.
However, there is a potential risk to hearing if you put a foreign object, such as a cotton swab, in your ear. It can damage the thin skin and/or small bones (ossicles) in the middle ear that conduct sound. Studies show that about 30 children are treated in emergency rooms (ERs) across the United States every day after a foreign object (usually a cotton swab) has damaged their ear canal or eardrum.
What's behind the drums?
This short video shows the structures of the outer ear that are essential for the early stages of hearing, and the areas where cotton swabs cause the most damage. The ear is a complex structure designed to collect sound waves, transmit them through delicate bone structures, and send signals to the brain to interpret them as sounds and speech. Each part of the ear has a specific function that allows hearing.
The outer ear is shaped to help transmit sound waves from the environment through small tubes to the eardrum. Tiny hairs called cilia line the walls of the ear canal, which help to carry earwax and debris from the tube to the external structures.
The eardrum is also called the tympanic membrane. When sound hits this membrane, it begins to vibrate, sending sound waves to the middle ear.1 These waves vibrate three tiny bones in the middle ear, transmitting the sound into the fluid-filled cochlea.
Tiny hairs in the cochlea collect sound waves and transmit this information to the auditory nerve, which then transmits the data to the brain. Once this process is complete, the brain interprets the information. All of this happens in milliseconds.
Thirty children a day visit emergency rooms with ear injuries related to cotton swabs.
This delicate system can easily be damaged by a simple cotton swab. In one study, researchers found that nearly 30 children were seen by emergency room doctors each day after injuring the ear canal with a foreign object inserted into it.2 And in many cases, that object is a cotton swab.
In most cases, the child cleaned the ear canal himself using a cotton swab.3 The remaining injuries occurred when children played with cotton swabs or fell down with the swabs in their ears. The researchers concluded:4
“Despite warnings about the use of cotton swabs (CTA) in the ear canal and the use of CTA by children, these injuries have continued to occur. Additional injury prevention strategies, including additional education of parents/guardians and children, are needed.”
The highest injury rate is among children under 3 years of age.5 It seems like they're following what their parents are doing. The injuries the researchers found ranged from minor to serious, but nearly all of the children were discharged home from the emergency room without hospitalization.
The number of visits for this injury has changed over the past 20 years. In 1990, there were nearly 10,000 ER visits. That number rose to more than 17,000 in 2001, but fell to 12,000 in 2010.6 About 40% of children complained of feeling like something was stuck in their ear.
Do not use if smaller than elbow
When foreign objects enter the ear canal, the cilia in the canal can become damaged, making it more difficult for the earwax and foreign objects to be removed naturally. Foreign objects in the ear canal can push the earwax further toward the eardrum, muffling sound and causing hearing problems.
Removing earwax that has accumulated near the eardrum must be done in a doctor's office. This is a difficult and sometimes painful procedure. Also, without removing the earwax, it is difficult or impossible to diagnose an ear infection.7 If earwax is pushed too far into the ear canal, it can reach the eardrum, causing discomfort or pain similar to an ear infection and possibly hearing loss.
There are some ear cleaning methods that you may have heard of that are equally not recommended. For example, ear candling involves gently inserting a lit ear candle (an empty linen or cotton tube soaked in paraffin or wax) into the ear. Some people believe that this will draw out wax and debris from the ear.
However, experts generally warn against this procedure, and I wholeheartedly agree. The risks include perforation of the eardrum, burns, earwax blockage, and earwax damage to the ear canal.8 If you delay seeking medical help when using these treatments, you may increase your risk of long-term damage.
Irrigation with a syringe can be safe, but if the tube is not properly and completely dried, there is a risk of causing swimmer's ear, a painful episode of ear infection. There is usually no need to rinse the ear. My advice is to keep it away from the ear if it is smaller than your elbow.
Damage can cause hearing loss
Another potential risk of using cotton swabs or other mechanical devices to remove wax from the ear is puncture of the eardrum. This membrane exists to protect the three small bones of the middle ear from bacteria and foreign matter. The membrane naturally heals after puncture, but damage during an accident or when foreign matter enters the middle ear after an accident and damages the small bones can result in significant hearing loss.
Most of the children in the study did not require hospitalization and were discharged home, but follow-up hearing tests were not part of the study protocol. According to the researchers, while nearly all of the patients were treated and discharged, that doesn’t mean some injuries weren’t serious.9
Potential risks of delayed treatment of a serious injury include perforation of the tympanic membrane, hearing loss, dislocation of small bones of the middle ear, and paralysis of the fascial nerves. If residual foreign bodies are removed promptly, there are usually no complications.
However, if left untreated, these types of injuries are associated with intracranial complications, including brain abscesses and life-threatening meningitis. The ear is a sensitive area and is at high risk for injury. It is time to dispel the myth that cleaning your ears at home is necessary.10
Using a cotton swab outside the ear
If you don’t use cotton swabs to clean your ears, what else can you use them for? Women can use them to remove makeup mistakes like mascara, eye shadow, and cover-ups, or to repair nail polish mistakes. Cotton swabs also help you apply blemish creams more accurately, preventing excessive dryness and peeling.
Cotton swabs can also be used to clean things around the house. For example, they are handy for cleaning computer keyboards, removing dust and dirt from small spaces inside a car, or even from the inside of a hair dryer.11
If the zipper is stuck, you can easily free it by applying some lip balm to the end of a cotton swab and rubbing it against the zipper teeth. You don't have to take out your paint brush to touch up a small part of the wall. A cotton swab will do, and you can just throw it away when you're done.
The same goes for arts and crafts. Cotton swabs can be used to apply fabric glue precisely, draw polka dots, or even be used as paintbrushes for your youngest child. Cotton swabs can even be part of a work of art. Check out Pinterest for some really creative ways to use cotton swabs that are gentle on your ears.12
If you enjoy aromatherapy, try making your own by putting essential oils on a cotton swab and putting it in a zip-lock plastic bag to carry around.13 Lavender can help you relax before boarding a plane, while peppermint can help energize you during an afternoon break at work.
Safe Ways to Clean and Dry Your Ears
As you consider options for keeping your ears clean and dry at home, remember not to put anything in your ears. This can cause significant damage and increase your risk of hearing loss. Earwax buildup near the eardrum can cause pain or a feeling of fullness.
Some liquids can help soften the earwax and help it move out of the ear canal naturally. These liquids include saline solution, coconut oil, hydrogen peroxide, or olive oil. Do not use solutions or irrigate your ears if you have a tube in your eardrum, diabetes, or a weakened immune system.
In this situation, it is best to see an ENT doctor. As the wax comes out of the tube, a moist cotton swab will be used to clean the outer ear.
When you get out of the shower, you may be tempted to dry your ears with a cotton swab, but there is a better way to do this without risking damage. Use a hair dryer on a warm, low setting and point it at your ears for a minute or two. This may help reduce the risk of developing swimmer's ear.
