QUIT THE Q-TIPS

If you make one health resolution this year, it should be to stop cleaning your ears

The best thing you can do to clean your ears is to leave them alone.

No, really. On Jan. 3, the American Academy of Otolaryngology released updated guidelines about the treatment of impacted earwax, a condition characterized by a painful buildup of the substance that naturally coats our outer ear canal. According to the new guidelines, published as a supplement in the journal Otolaryngology-Head and Neck Surgery, impacted earwax affects around 12 million adults per year in the US, and costing $46.8 million (paywall) in 2012. The best way to prevent it, according to an analysis of the latest research? Don’t clean your ears to begin with.

“People to want to clean their ears because they believe earwax is an indication of uncleanliness,” Seth Schwartz, a Washington state-based otolaryngologist who chaired the review, said in a statement.

But earwax, or cerumen as it’s known in the scientific community, helps us stay clean. It’s a mix of oil from glands in the outer ear canal (the part you can touch with your finger), hair, and dead skin cells. Admittedly, all of these sound like substances you wouldn’t want anywhere on your body; however, the wax they form protects the ear from certain bacterial and fungal infections by acting like a sticky trap (not unlike mucus does for our lungs) before flushing them out with our jaw movement. As the BBC explains, way back before humans lived in insulated homes, earwax may have kept insects from crawling into our inner ears while we slept.

And yet, most of us (including yours truly) have cleaned out our ear canals—or at least had them cleaned out by our parents when we were children—with cotton swabs. According to the Washington Post, when sterilized cotton swabs made by Q-Tips first hit the market in 1923 (perplexingly called “Baby Gays” at the time), they were advertised to clean ears, as well as noses, eyes, and gums. Fifty years later, manufactures of cotton swabs started printing warnings on their boxes telling adults to only clean the outside of the ear canal; today there’s an explicit warning on packaging to not use them for ear cleaning at all.

The reason for this change of tune is because people often accidentally go too deep, damaging their ear drums, and sometimes end up clogging their ears with earwax instead of clearing it out. Although it’s oddly satisfying to swirl out a gob of earwax like cotton candy, doctors have found that the process usually ends up pushing earwax further into the ear canal, where it can unnaturally clump together. These clumps can cause ear pain and ringing, loss of hearing, and infection, which leads to odorous discharge.

At this point, doctors intervene by irrigating ears with water or oil, or carefully use tools to scrape, scoop, pick, or suction out the mass. Ear candles, which are foot-long cones of linen or cotton soaked in beeswax, inserted in the ear, and lit on fire on the outer end to create a vacuum to draw out extra wax, are not recommended. They are not proven to work, and can be dangerous because they cause burns and even more wax buildup, this time coming from an external source. In one case study, a woman who attempted to clear her ears using candling had to have candle wax surgically removed from her ear, which damaged her hearing.

Doctors have been saying for years that placing anything smaller than your elbow into your ear is a bad idea. (Though they don’t always take their own advice: One small 2013 survey found that practitioners reported inserting the tips and covers of pens, matches, bobby pins, and even chicken feathers into their ears to clean them.) Schwartz explained in an email that the primary purposes of the American Academy of Otolaryngology updates were to assess any new evidence about ear care found since 2008, when the guidelines were last updated.

The guidelines suggest that doctors shouldn’t remove any earwax unless it’s causing any problems. They should, however, advise patients on how to use non-prescription drops to remove earwax on their own in certain cases. People with hearing aids, for example, tend to have more earwax buildup, which can be safely removed with drops or rinsing if done correctly.

The main takeaways of the report are listed below. If you choose to make any health-related resolutions for 2016 that don’t involve dieting or exercising more, these are some good starting points:

  • DON’T over-clean your ears. Excessive cleaning may irritate the ear canal, cause infection, and increase the chances of clogging.
  • DON’T put anything smaller than your elbow in your ear. Your mother was right! Cotton swabs, hair pins, car keys, toothpicks…these can all injure your ear and, lead to hearing loss, dizziness, and ringing.
  • DON’T use ear candles. There is no evidence that they work, and candling can cause serious damage to the ear canal and eardrum.
  • DO seek medical evaluation if you have symptoms of hearing loss, ear fullness, ear pain, drainage, or bleeding.
  • DO ask your doctor about ways that you can get rid of earwax at home.
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