E

arwax is useful stuff. Some ancient physicians smeared it onto wounds as a soothing salve. Others thought its taste should be used as a diagnostic tool: a hint of sweetness, one doctor wrote, was a sign of impending death. Even today, doctors say it’s the most natural of soaps, carrying dead skin cells and debris out of hearing’s way.

But the near-magical properties of earwax — or cerumen, as scientists call it — don’t stop people from going to extraordinary lengths to get rid of it. No tool seems too pointy for people to want to stick into their ears.

“You name it: bobby pins, pencils, pens,” said Dr. David Jung, an otolaryngologist at Massachusetts Eye and Ear, when asked how his patients attempt earwax removal. “I’ve had some construction workers say, ‘Gently, with nails.’ I’ve seen and heard it all.”

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In case you were thinking of cleaning inside your ears — gently or otherwise — a revised set of guidelines from the American Academy of Otolaryngology has some advice: Don’t. Not even with Q-tips, no matter how innocuous they look.

This recommendation is nothing new. Back in 1901, the monthly Medical Brief advised that “in the removal of impacted cerumen, as little instrumentation as possible should be indulged in. Much harm often follows the use of probes, forceps, and hooks in untrained hands.”

Ear cleaner
A 17th-century 22-karat gold earwax spoon, toothpick, and finger pick. Matthew S. Gunby/AP

Few pieces of medical advice have been so consistent for so long, and by now, people know they’re not supposed to put foreign bodies in their ears — as evidenced by the sheepishness with which Jung’s patients admit to their wax-scraping tricks.

The problem is, they do it anyway. The new guidelines cite one study — titled “What health professionals at the Jos University Teaching Hospital insert in their ears”— in which over 90 percent of the participating staff at a medical center were found to clean their ear canals with objects such as Q-tips or matchsticks.

“When you put it on the inside of your ear and move it around, it feels nice, it becomes a sensual thing. You become like a drug addict, a cigarette smoker,” said Dr. Vito Forte, a professor of otolaryngology at the University of Toronto, who runs the company OtoSim, which makes ear-exam simulators.

Your ear canal is a tube closed off at one end by your eardrum. When you chew and talk, that helps move wax out towards the opening so it doesn’t impede hearing. Inserting a Q-tip or a screwdriver actually reverses that motion, pushing wax back where you don’t want it to be, sometimes creating hardened balls of wax. Then it becomes a job for an otolaryngologist, who might use a tiny suction-tip or beak-like forceps to pull it out.

The tools involved might be minuscule, but the impact isn’t: In 2012, the Medicare program paid nearly $47 million for over a million removals of earwax balls. Not all of those blockages were caused by rogue ear-cleaners — but their picking and scratching is certainly part of the problem.

Sticking things into your ears is not only ineffective — it’s dangerous. “Even though cotton swabs are fairly soft, the skin within the canal is very delicate, and easy to scratch and abrade,” said Dr. Seth Schwartz, an otolaryngologist at Virginia Mason Medical Center in Seattle and the first author of the revised guidelines. “It can be quite painful but can also lead to infection. And you could actually traumatize the eardrum.”

ear cleaning
People have their ears cleaned in Chengdu, China. Feng Zi/Color China Photo/AP

In that case, he said, sometimes the only option is surgery, in which the eardrum is taken out and patched up with bits of the patient’s own tissue.

The new guidelines were written expressly to be more accessible to non-scientists, in the hope of finally getting across medical advice that has been ignored for centuries.

Yet ear canal cleaning is a hard habit to kick. It may be as innate as tool use itself. Forte was once called to the Toronto Zoo to treat an orangutan that seemed to be having ear trouble — and found out that the ape was known to pick up secondhand wads of chewing gum, check them for stickiness, and then use them to extract whatever might have been buried in its ears.

If only the ape had read the latest guidelines.

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  • It’s not that we won’t listen. it’s that we can’t Our ears are full of … wait for it … earwax.
    I can’t believe you used that for a headline.

  • One of my teachers reported for the draft. He didn’t have any hearing in one ear. After they removed ear wax from that ear, he went to boot camp and shipped out to the Korean War.

    Doctors don’t clean your ears out anymore, as insurance won’t pay for it. Mine turns like sheets of paper, and I’ve tried diet additives that my doctors wanted me to try, a few drops of water, peroxide, rubbing alcohol. I use a bobby pin.

  • I have a congenital problem that, without proper intervention, invariably causes ear wax to harden so much in my ears that a physician needs to use a combination of water injection and tools to remove. Ear wax removal is the first medical procedure that I can recall as a child, and it was painful even with a physician doing it.

    In my early 50’s a solution finally arrived, prompted by the advice of an ER doctor who suggested that I see a dermatologist about it. The dermatologist I saw diagnosed seborehic dermatities and recommended daily use of a dab of ketoconazole cream inserted into the outer ear canal of both ears.

    This did not prevent a build-up of earwax that needed removal, but it prevented the wax from becoming compacted and hard. Now, all I need is an injection of warm water two or three times in each ear and the wax just washes out in the form of fluffy white globs. My wife does this for me using a 60ml irrigation syringe with a fine hose-like tip, or a large seasoning injector of about the same size with the same tip, and I only need this done about once a month, when I first notice that one or both ears are filling up and blocking my hearing, usually with no pain because the blockage is still soft. My PCP also volunteered to do it any time during office hours, free of charge, as well.

    Having an irrigation cup to catch the water and wax as it exits the ear is a really good idea, too. I found a really good one on the Internet that wraps around the earlobe as you hold it against your ear to very easily catch the run off.

    In any case, I’m overjoyed that I no longer experience any pain from either the wax or the removal of it. Of course, we leave a little wax behind to function as it is intended, catching foreign material that might otherwise lodge in the ear over time.

  • I’m 72 and have been using Q-Tips my life with no issues. Guess I’d better stop now since medical science has now damned this practice. Oh well…

  • Obviously a paid advertisement by otologists.

    What’s next?

    Don’t take showers or baths. Report to a licensed hygienist for certified cleaning every morning.

    Don’t eat with spoons and forks. Go to a nutrition clinic three times a day for official supervised intravenous feeding.

    Stop this irresponsible breathing and heart-pumping! Pay an expert to suction your lungs and pump your heart.

  • What about the plastic ear curettes doctors use, and a great deal of slow caution? An itching ear canal can be a significant distraction….

  • Having twice had my external canal occlude after swimming in the ocean, I travel with a bulb syringe to irrigate the impacted cerumen out with warm water. Better than a visit to the ER.

    • I mix rubbing (isopropyl) alcohol 1:1 with white vinegar. I keep it in a plastic dropper bottle, formerly for nose spray (I personally cleaned and boiled the water inside in a microwave to clean it). I squeeze that 1:1 mixture into my ear as needed such as after swimming, or when I feel pain in my ear. I have put some in my ear when it hurts and then lay down allowing the mixture to stay inside for a while. Don’t do it frequently or you run the risk lf drying-out the ear canal

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