The truth about cleaning your ears with cotton swabs

Woman cleaning ear using cotton stick (Copyright: Phasin Sudjai)

We all know that you’re not supposed to clean your ears with a Q-tip. And yet, people still do it all the time. Surely you’ve heard the horror stories about a friend of a friend of a friend piercing their eardrum (or maybe you watch Girls and have yet to scrub the memory of Hannah’s Q-tip scene out of your head). But do you really know what’s at stake? And how bad is it that no matter how many times you’re told to stop you know that you’re never going to drop the habit?

Here are the ear-cleaning do’s, don’ts, and please-don’t-but-if-you-do’s you need to know.

OK, so first of all, you don’t actually need to clean your ears.

“Generally speaking, the ear canal is self-cleaning,” Dr. Christopher Chang, an otolaryngologist in Warrenton, Virginia, told SELF. “You really don’t have to do a whole lot. In certain individuals, earwax can build up in the ear canal—and you don’t want it to build up to the point where you can’t hear. But the majority of folks don’t have to do anything.”

That said, we know you’re cleaning your ears with Q-tips, even though everyone says you shouldn’t.

“Everyone knows you’re not suppose to use them, and yet everyone does it,” Chang said. “I’m not going to get all bent out of shape if someone admits to using Q-tips. You just want to make sure that your ear is safe.”

The dangers of sticking a cotton swab into your ear are real. And there’s a range of damage you can do.

The most basic issue is that using a Q-tip is probably doing the opposite of what it’s supposed to do. Your intention is to get earwax out, but you’re probably just packing it deeper in there, which can plug up your ear canal and make you feel stuffy or itchy, or can interfere with your hearing. If the ear canal is totally blocked with wax you can get tinnitus, a ringing or buzzing in the ear.

And don’t think your doctor isn’t going to notice, either. “You can actually see the impression of the Q-tip on the earwax,” when you look at it with a scope, Chang said. Busted.

The skin inside your ear canal is also really, really sensitive, so scraping around in there with a stick wrapped in cotton can scratch it, which leaves you open to ear infections. If an infection gets really bad you can get swimmer’s ear, which is when the skin swells up so much that it completely closes the ear canal. It’s also really painful.

The worst thing you can do is to pierce the eardrum with the end of the Q-tip, which hurts like hell and can take weeks or months to heal (and that’s assuming you don’t also get some massive infection).

If you go too far down the ear canal with the swab, you can literally put a Q-tip-sized hole in your eardrum. Chang said that usually when he sees this it’s because the patient was cleaning her ear, and her boyfriend came into the bathroom, startling her and causing her to jerk her arm. Or she was multitasking and accidentally bumped her elbow into the wall.

The result: very sharp pain and bleeding. Hearing loss is not uncommon. “The good news,” according to Chang, “is that the vast majority of the time the body will heal the hole closed on its own. Depending on how big the hole is, it may close up completely in a week.” More severe cases can take a couple months to heal, and in the worst-case scenario, surgery is required. If it happens to you, call a doctor right away and definitely don’t put any water in your ear because it could trigger an infection.

So what’s the right way to clean your ears?

If there’s wax buildup that’s bugging you, Chang recommends buying an ear syringe at the drugstore and flushing the ear gently with body-temperature water. (Water is a good enough solvent, and though getting water stuck in your ear is annoying, it’s really not dangerous, Chang said.) You can also use an ear bulb to suction stuff out, but they’re harder to clean. Hydrogen peroxide and other OTC solutions (like Debrox and Murine) are OK, but they can irritate and dry out your skin. Make sure you follow the directions carefully, and you should probably consult your doctor first.

(Don’t even bother with ear candling. Chang is adamant that it doesn’t do anything.)

Since no matter what we say, you’re going to keep cleaning your ears with cotton swabs, here’s how to do it without massacring yourself:

For one thing, be gentle. That soft cotton tip can leave grooves and scratches in the fragile skin. (And your doc will totally notice them and call you out.)

As a rule of thumb, Chang said not to put the swab in so far that you can’t see the cotton anymore. The eardrum is only about 2 to 3 cm in from the opening of the ear canal. The first centimeter in is cartilage, which has a little give when you press against it, and the skin is slightly tougher there. After that, the canal is surrounded by bone. There’s no give there, and that’s where the eardrum connects, so consider it the danger zone. Conveniently, the cotton head on a Q-tip is about 1 cm long, so stopping there ought to keep you relatively safe.

Of course, this doesn’t mean that we’re condoning cleaning your ears this way. You should probably just leave them be, and go to an ENT if the wax situation is getting out of hand. But if you are going to practice aural penetration, we want you to be safe.

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