Posted by Dr Kim on January 13, 2020 · Leave a Comment
A friend once told me with great disdain, while watching me wiggle a cotton swab deep in my ear canal with great satisfaction, “I never use Q-tips to clean out my ears.” Apparently a 
doctor once told him never to put anything smaller than his elbow into his ear, and he took these words as gospel.
Do you ever have the feeling when someone tells you some great truth, a law of the universe that you’ve been breaking for years in ignorance, that it’s remarkable that you have survived this long, having missed out on some basic manual on life along the way? I often wonder if the parents in my practice feel this way as I spout my wisdom on general health issues, and they look chagrined at having broken the rules with their child. The good news is, it’s hard to break your child. ..especially with things like the management of ear wax.
So what are the rules of proper ear hygiene? Though I think that my friend’s doctor was a bit dramatic, I do agree that for the most part, cotton swabs do more harm than good for children’s ears.
Here’s the lowdown.
Ear wax (otherwise known as cerumen) is icky, and sometimes smells quite foul, but it actually serves several important functions. It is created in the outer half of the ear canal, where it serves to lubricate the skin of the ear canal, and prevents flaking and itching. It also has antibacterial properties and protects the skin of the ear from infections like otitis externa, commonly known as swimmer’s ear.
Ear wax almost always comes out of the ear on its own accord. There are small hairs, called cilia, lining the outer half of the ear canal which act as a conveyor belt, pushing the old wax out as the new wax is formed. And so under most circumstances, ears clean themselves.
What is the harm of a little friendly assistance? There are several potential problems caused by good intentions. Often, especially in children’s small ear canals, using a cotton swab actually pushes the wax deeper into the canal, to the far recesses where there are no hairs to help remove it. In children who make a thick, moist wax, their ears often become so clogged with wax that their hearing becomes dulled, which can impact speech development in younger kids and learning and behavior in older kids.
And then there are those over-eager toddlers who wiggle a little too hard and deep and puncture their eardrum. This common injury usually heals very well, but sometimes the tiny bones that are essential for proper hearing are damaged or the membrane fails to heal and an innocent cleaning exercise can have profound impact on the life of a child.
In the end, though I was chagrined myself when I first heard this advice, I too now recommend avoiding q-tips or cotton-tipped swabs for ear hygiene.
Tips for Parents:
- The secret to clean ears is to use a wash cloth only on the outer, visible part of the ear to clean the wax as it naturally comes out. Internal cleaning is not necessary, and may be harmful.
- If you are concerned about your child’s hearing, visit your doctor to see if they have ears plugged with wax.
- Never allow your children to play with cotton swabs or place anything else (carrots included) in their ears.
- Itchy ears are often caused by over-zealous cleaning habits. A few drops of mineral oil can help soothe them while you wait for the ear’s natural lubricant to return.
