When purchasing a box of cotton swabs (Q-Tips), we usually have one use in mind—cleaning our ears—even though the box provides no instructions on how to do so. Instructions for the use of cotton swabs range from cleaning the grout between your tiles to make up-removal and the cleaning of electronics. In today’s litigious society, ear trauma with a cotton swab is considered the “fault of the user, not the supplier.”

Earwax Protects the Ear Canals

The ears have a great ability to take care of themselves and usually do not need our help. Wax is produced as a lubricant and a protection for the ear canals. But while small amounts are a natural lubricant, large amounts can be uncomfortable and itchy and can affect hearing. People may be genetically prone to excessive wax production or they have dry skin or “eczema” in the ear canals where the ear may produce more wax in an attempt to stay moist. This condition can best be diagnosed by your local ENT (ear, nose, throat doctor).

To Use or Not to Use?

Not!

If you tend to produce a lot of earwax—and you know who you are—then cotton swabs are a bad idea. They will push the wax in further, block your hearing and make it harder to eventually remove the wax. We also do not recommend ear candling—a technique that involves placing a lit (on the outer end), hollow, cone-shaped candle into the ear canal—as it may cause serious injury. Over-the-counter ear cleaning kits are effective for many people, but read the directions carefully before you use them. Many patients have wax successfully removed by their primary care physician. If these methods don’t work for you, then a visit with your ENT will do the trick.

At Your Own Risk

Those of us who are not wax builders and have used cotton swabs successfully and safely for much of our lives may use them at our own risk. But, be careful—I have had not one, but two patients accidentally answer a telephone with a Q-tip in the ear. This is very traumatic to the eardrum and the small bones in the middle ear, and can potentially damage your hearing permanently—thus the old adage, “Nothing in the ear smaller than your elbow.”

It is hard, however, to get water out of your ears with your elbow! If you are uncertain and concerned about using cotton swabs, you can instead take the corner of a towel or a tissue with your finger and just clean or dry the ear where you can reach.