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Why you shouldn't use cotton swabs to clean your ears

1/15/2017, 6 a.m.
The doctors' advice hasn't changed much, but it's still so unsatisfying: You should not use cotton swabs to clean your ...

— The doctors' advice hasn't changed much, but it's still so unsatisfying: You should not use cotton swabs to clean your ears.

Updated clinical guidelines published Tuesday in the journal Otolaryngology-Head and Neck Surgery say they're not appropriate for earwax removal. In fact, information for patients in the guidelines say no to putting anything "smaller than your elbow in your ear."

Regardless, most of us hoard a stash of the soft-tipped paper sticks; they seem so perfectly suited to that dirty job.

So the authors of the guidelines -- an advisory panel of the American Academy of Otolaryngology-Head and Neck Surgery -- have injected a little bit of freshness into the usual advice, giving more explanation as to "Why not?" They even included a consumer representative on the panel.

"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.

Here's why not: Cotton swabs, hair pins, house keys and toothpicks -- the many smaller-than-our-elbow-objects we love to put in our ears -- can cause cuts in our ear canals, perforate our eardrums and dislocate our hearing bones. And any of these things could lead to hearing loss, dizziness, ringing or other symptoms of ear injury.

Instead, most people can just let nature do its job. Our bodies produce earwax to keep our ears lubricated, clean and protected: Dirt, dust and anything else that might enter our ears gets stuck to the wax, which keeps any such particles from moving farther into the ear canal. Our usual jaw motions from talking and chewing, along with skin growth within the canal, typically helps move old earwax from inside to the outside the ear, where it is washed off during bathing.

The guidelines published in 2008 were overdue for an update. While new randomized trials have been included, "nothing very dramatic" has changed, other than an improvement in the methodology itself, said Schwartz: "The process has become a little more transparent in the way we actually write the guidelines now. We are more clear about why the decisions we made are made and what data there is to support it."

Patient are apparently interested in the nitty-gritty of ear care: More than 50,000 people downloaded the old guideline, Schwartz said.

"It's kind of amazing how many people were interested in reading that," he said.

The do's and don'ts

To be "a little bit more patient-friendly," the guidelines now include lists of "Do's and Don't's" for everyone and a list for people who have had problems with cerumen impaction, the official term for earwax buildup, a condition that is more common among the elderly, according to Dr. James Battey, director of the National Institute on Deafness and Other Communication Disorders.

Impaction can occur when the ear's self-cleaning process doesn't work very well. The resulting waxy buildup blocks the ear canal, causing difficulty hearing.