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Dangers Of Using Cotton Swabs For Cleaning Ears

Medical Daily logo Medical Daily 24/4/2018 Sadhana Bharanidharan
Swabs © Swabs Swabs

Whenever you come across cotton swabs, your mind is bound to associate it with the image of someone cleaning their ears with a Q-tip. Despite being the most obvious connection most people would make, this is not a safe method recommended for removing earwax.

Wait, what? But I've seen many people use them.

Swabs were invented in the 1920s for the purpose of ear-cleaning. Due to relatively low public awareness, the practice has persisted even after doctors and manufacturers alike have pointed out how dangerous they are. The warning label on Q-Tip boxes reads "CAUTION: Do not enter ear canal. … Entering the ear canal could cause injury."

Curious children often try to use them, which is particularly dangerous as their ears are delicate. According to a 2017 study, more than 260,000 children (under the age of 18) were treated for cotton swab-related ear injuries from 1990 to 2010.

What can potentially go wrong when using swabs for cleaning ears?

Swabs are inserted into the ears in order to "clean" the cavity. But this can actually have the opposite effect and end up pushing ear wax deeper into the ear canal. As a response, people are more likely to insert the swab deeper as well. 

"Anything that fits in the ear could cause serious harm to the eardrum and canal with the potential for temporary or even permanent damage," said Dr. Seth Schwartz, one of the otolaryngologists who drafted guidelines for diagnosing and treating earwax for the American Academy of Otolaryngology in 2017.

Swabs can also tear or rupture the eardrum, leading to pain or bleeding at the least. The worst case scenario is considered to be a permanent hearing loss. This rupture, known as a perforated eardrum, may heal on its own or require surgery depending on the severity.

But what should people do to maintain ear hygiene?

While considered to be "dirty," cerumen (the medical term for earwax) is actually a natural moisturizer and self-cleaning agent. Usually, excess wax is cleaned out in the shower after it has dried. Dr. Robert Shmerling, an associate professor of medicine at Harvard Medical School, states that no routine maintenance is required as earwax helps in preventing bacteria and dirt from reaching the inner ear.

In the rare case that a build-up of ear wax starts causing pain and hearing difficulties, seeking medical advice is recommended over trying to clean it with foreign objects. A doctor may remove it in a safe manner or prescribe ear drops. The American Academy of Otolaryngology has provided guidelines on what to do (and what not to do) with regards to cerumen.

What can cotton swabs be used for?

Swabs can be used to apply and remove makeup, proving quite handy when removing excess nail polish. They are often used in labs to study DNA samples by collecting cells from the inner cheek. They can also be used to clean hard-to-reach areas and objects in the house.

It should be noted that plastic cotton swabs can contribute to marine pollution if they are flushed down the toilet. Some countries have even prepared to ban them.

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