New Earwax Guidelines: Put Down the Cotton Swabs

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Doctors have long warned people against cleaning out the inside of their ears with cotton swabs. But updated clinical guidelines recently published in the journal Otolaryngology-Head and Neck Surgery emphasized even more that cotton swabs are not suitable for earwax removal. According to the new guidelines, you should not put anything “smaller than your elbow in your ear.”

The authors of the guideline — an advisory panel of the American Academy of Otolaryngology-Head and Neck Surgery — have given a little bit more insight into this common, yet dangerous practice, which can lead to cerumen impaction or severe earwax buildup.

“We really have come to appreciate that clinicians are not the only users of (the guidelines), that patients are really interested in their own care and people are really taking ownership of their own care,” said Dr. Seth Schwartz, chairman of the guideline update group for the academy.

Cotton swabs or any other object smaller than your elbow, such as hairpins and house keys, can cause cuts in the ear canals, perforated eardrums and dislocated hearing bones. These things can lead to hearing loss, dizziness and ringing.

Related: Fewer Americans Under 70 Are Losing Their Hearing

The solution to all this is simple — put down the cotton swabs and let your body do what it was meant to do. Our bodies naturally produce earwax to keep our ears lubricated, clean and protected. In fact, earwax actually traps dirt, dust and anything else that might enter ears, preventing it from moving deeper into the ear canal.

Our bodies also naturally get rid of excess earwax. Our normal jaw movements from talking and chewing, in addition to the skin growth within the canal, help move old earwax to the outside of the ear, which gets washed off when we take a shower or bath.

The original guidelines were published in 2008 but were long overdue for an update. Not much has changed during the new randomized trials from the 2008 findings; however, there was an improvement in the methodology.

“The process has become a little more transparent in the way we actually write the guidelines now,” Schwartz told CNN. “We are more clear about why the decisions we made are made and what data there is to support it.”

Related: Children’s Teething, Ear Products Recalled Due to Possibly Toxic Ingredient

Patients, researchers discovered, are interested in the gritty details of ear care — over 50,000 people downloaded the old, less accessible guideline.

“It’s kind of amazing how many people were interested in reading that,” Schwartz explained.

In an effort to become a bit more accessible to patients, the new guidelines published a list of ear care “Do’s and Don’ts.” Some “don’ts” include not over-cleaning your ears; not using ear candles; not ignoring any symptoms; and most definitely not sticking cotton swabs, toothpicks, hair pins or even car keys into your ear canal.

On the “do” list, the guideline suggests understanding symptoms of cerumen impaction and leaving your normal earwax alone. It also urged people to seek medical attention if they experience ear pain, drainage or bleeding.

Danielle Tarasiuk

Danielle Tarasiuk is a multimedia journalist based in Los Angeles. Her work has been published on, Yahoo! Sports, KCET, and NPR-affiliate stations KPCC and KCRW. She’s a proud Sarah Lawrence College and USC Annenberg alumn.