Here’s what can happen if you clean your ears with a cotton bud

Using cotton buds to clean your ears can make certain earwax issues worse or cause injuries. Photo / Getty Images

Ears are self-cleaning organs. But if you want to get rid of earwax, try these expert-recommended tips.

Is it safe to use cotton buds to remove earwax?

Most of us have seen or used the earwax-cleaning products all over social media – high-tech lavage kits, spoons equipped with smartphone cameras, suction devices, ear candles or even classic cotton buds.

But many of these tools are not effective and can make certain earwax issues worse or cause injuries, particularly when not performed correctly and under the care of a professional, experts cautioned.

“While all of those technologies are nifty and cool to see, they’re not the safest,” said Ana H. Kim, a neurotologist and professor of otolaryngology at Columbia University.

Earwax, or cerumen – that yellow or light brown substance – is produced by glands in the outer one-third of the ear canal, where it mixes with sweat, dead skin cells and loose hair, among other substances. And the wax has a purpose. It is intended to moisturise the skin inside the ear canal, trap dirt and debris, and help protect against bacteria and fungi, research shows.

The inner two-thirds of the ear canal is composed of bone and thin skin and does not have earwax-producing capabilities. There should not be wax that far inside, experts said.

Graphic / Aaron Steckelberg, The Washington Post

The ear is a self-cleaning organ. When you chew or talk, your jaw movement helps push the earwax to the opening of the outer ear canal, known as the meatal opening. From there, the wax usually falls out or, when stuck, can be gently encouraged to do so, Kim said.

“After showering, when everything is moist, you can use a towel or a Q-tip, and you can swab around the entry point, not going deeper into the ear canal,” she said.

When people insert earwax removal tools such as cotton buds into the ear canal, it not only disrupts the natural cleaning process but also can reverse that process by pushing earwax deeper inside, potentially causing a wax build-up, or an impaction, Kim said. This can lead to muffled or reduced hearing, she said.

Also, because cotton bud heads have abrasive fibres, they can scratch the delicate ear canal skin, compromising the protective barrier against bacterial and fungal invasion, she added.

Cleaning with cotton buds can lead to more severe injuries as well.

Kim, who specialises in the inner ear and the nerves connecting to the brain, said she has seen cotton bud heads retained inside the ear canal. One study reported that cotton buds were among the most common foreign objects found in the ears of adults visiting emergency rooms.

Graphic / Aaron Steckelberg, The Washington Post

In more serious cases, Kim said, she has seen a cotton bud get inserted too far into the ear canal or inadvertently shoved inside when someone unknowingly swings open a bathroom door or knocks into the arm of the person holding a swab. This can puncture the eardrum and even dislodge the hearing bones, known as the ossicles, which can cause hearing loss, among other issues, she said.

Technologies that use small spoonlike tools to scrape out earwax can cause similar issues; ear candles, which are hollow cones that are placed into the ear canal and then lit at the other end, do not work and can burn the skin inside the canal; and water irrigation, when not used correctly, can be uncomfortable and cause symptoms such as dizziness, experts said.

“If you stick a Q-tip in your ear, you’ll notice that the Q-tip has some wax on it, but it’s getting half of it out and then pushing the other half deeper,” said Tiffany Chao, an assistant professor in the Department of Otorhinolaryngology - Head and Neck Surgery at the University of Pennsylvania. “The safest thing to do is to leave the deeper cleaning to somebody who has specialised training.”

There are certain skin conditions, such as eczema, dermatitis and psoriasis, that may make it more challenging for the earwax to slide out on its own, leading it to potentially build up over time and cause an impaction, Kim said.

Similarly, she said, certain anatomical differences or devices such as hearing aids can impede the natural cleaning process.

In such cases, Kim said, routine cleaning by an otolaryngologist, also known as an ear, nose and throat (ENT) doctor, may be medically necessary.

What else you should know

If you want to self-clean your ears, first see a specialist such as an ENT to make sure you do not have anatomical issues or earwax impactions, experts said.

Then consider some of these home remedies that, when performed with care, come recommended by ear-care professionals:

• Use a damp towel or a cotton bud to carefully remove visible earwax. After showering – when the earwax is soft – dampen a cotton swab with mineral oil or baby oil and gently swab in a circular motion only at the meatal opening, which is the dark shadow at the entrance of the ear canal, Kim said. “But never go inside,” she said. When looking in the mirror, “if you can’t see the tip of your Q-tip head, that means you’ve gone in too far,” she said.
• Try mineral oil or baby oil, or a homemade remedy using hydrogen peroxide, to gently break up earwax impactions. Use an eyedropper to apply one to two drops of mineral oil or baby oil into the ear canal. Or mix small amounts of saline and hydrogen peroxide in a 1:1 ratio and use an eyedropper to apply about five drops into the ear canal. Then, with either method, place a cotton ball into the outer ear and wait about 10 minutes. Remove the cotton ball before showering, letting the warm water wash out the broken-up wax, Kim said. Alternatively, there are over-the-counter earwax removal drops. These methods can be used weekly or monthly depending on how much wax your ear produces, but too often “may result in a clogged sensation if the oil is retained in the canal,” Kim said.
• Take care when using ear lavage kits, which you can buy over the counter. Be gentle and use clean water – such as distilled water, or even sterile saline – that is warmed to body temperature. Water that is too cold can be uncomfortable and cause temporary, but sometimes severe, dizziness, Chao said. Also, when the water is pushed into the ear canal with too much force, it may cause injury to the ear canal or eardrum, she said.

The bottom line

While the ear is self-cleaning and does not typically require earwax removal, experts said it is generally safe to gently wipe the meatal opening of the ear canal with a damp towel or cotton swab but not to enter the ear canal.