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Q-tip Quandary: Are Cotton Tip Applicators Dangerous?

Everyone’s hygiene habits are different: Are you a manual or electric toothbrush user? Do you wash your face with soap or follow an oil cleansing routine? Do you wash your hair every day or once per week? While there are many different ways to keep your body clean, there are some hygiene habits that can be potentially dangerous to your health—like cleaning the inside of your ears with cotton tip applicators, more commonly known as Q-tips.

To understand why it’s dangerous to clean your ears with Q-tips and how we can keep up with our ear-related hygiene, we spoke with Kenneth H. Einhorn, MD, chief of otolaryngology, Jefferson Health - Abington.

Q: Why is it dangerous to use Q-tips, or other cotton tip applicators, to clean your ears?

Dr. Einhorn: There are several complications that can happen as a result of using cotton tip applicators in your ears. For example, your earwax can become impacted and temporarily affect your ability to hear. Using Q-tips can also lead to a punctured eardrum, skin injuries or dislodged cotton in the ear canal.

Q: Do these complications pose serious health risks?

Dr. Einhorn: It depends on the individual person and type of injury. An eardrum puncture typically causes pain, bleeding and hearing loss that will usually resolve on their own but, in some cases, this type of injury could need surgical repair or, in very serious cases, could lead to permanent hearing loss, vertigo or partial facial paralysis. Skin injuries and dislodged cotton can cause serious complications, like bacterial infections, if not treated in a timely manner. In rare cases, an infection can even spread to the brain.

Q: Is it necessary to clean our ears on a regular basis?

Dr. Einhorn: Our ears actually have a self-cleaning mechanism: Earwax contains enzymes that prevent fungal and bacterial growth and the hair in the outer one-third of the ear canal pushes excess earwax out. Sometimes water from showering can also help remove small bits of wax from the outer parts of the ear. For most people, cleaning the ear canal is not necessary—and can result in the opposite of the desired outcome because you can risk pushing earwax to the part of your ear that’s hairless, causing the earwax to get stuck and harden.

Some people have a larger accumulation of earwax, mostly due to genetics. In these instances, it’s best to clean your ears with an over-the-counter medicine that can dissolve or break up the wax. I recommend using cerumenolytic—earwax-dissolving—drops when you have impacted earwax or an excess amount of earwax. If you have a history of repeated earwax impaction or buildup, you can put an application of cerumenolytic drops in each ear every other week throughout the year as a preventive measure.

Q: What else should people know about using Q-tips to clean their ears?

Dr. Einhorn: Many parents believe they need to clean their children’s ears with a cotton tip applicator; however, children are especially vulnerable to ear canal injuries. The use of these cotton swabs to clean children’s ears has accounted for about 73% of all Q-tip-related ear injuries over the past decade. While it’s important that we all take care of our personal hygiene, this is one instance in which it’s better to let the body use its natural mechanisms to take care of us instead.

Q: When should someone visit their healthcare provider with concerns about their ear health or potential injuries?

Dr. Einhorn: If you’re experiencing pain, bleeding, hearing loss, a feeling of blockage or a foreign body in your ear, make an appointment with your healthcare provider. Your primary care physician or an otolaryngologist can physically remove impacted wax or a foreign body, help manage your pain or prescribe antibiotics if there’s an infection. Severe dizziness, a change in facial movement or a significant amount of bleeding are all symptoms that warrant a visit to the emergency room for immediate care.

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