Blog

NO COTTON SWABS ALLOWED

February 11, 2011
By: Diane E. Williams, Au.D., CCC-A
Doctor of Audiology

Not long ago a gentleman came into the office complaining of decreased hearing in his left ear. He stated he had been seen by several physicians who prescribed wax softeners and recommended he flush his ear. After several attempts to clear his ear he came in expecting to be diagnosed with a hearing loss. However, much to his surprise, a wad of cotton approximately one inch in length was removed from his ear. His hearing was dramatically improved.

Another incident occurred involving a young boy whose mother was ambitious about keeping the ears clean. Following her lead, he went into the bathroom, grabbed a cotton swab and proceeded to clean his ears as his mother had indirectly taught him. Unfortunately, he punctured his eardrum.

COTTON SWABS AND EARS DO NOT MIX!

The outer ear is comprised of the auricle, the convoluted flap of skin on the outside of the head, and the ear canal which inserts medially. Within the ear canal are sebaceous and ceruminous glands which produce oil and earwax (cerumen) to coat the ear canal preventing dryness or external ear infections, trapping dirt and dust particles, and deterring bugs from entering the ear. The ear canal is a self-cleaning orifice. It will produce the earwax, trap dirt and other objects, and left alone, will move the debris laterally out of the canal. When cotton swabs are used instead to clean the ear canal several damaging events can occur. One event would be the removal of earwax causing dryness which can lead to dermatitis and other skin disorders. What earwax is not removed can be pushed down into the canal causing it to become lodged, hardened, and potentially create hearing loss and/or outer ear infections. The earwax will have to be removed then by medical means.

Other damaging events may also occur. For example, one young mother, diligently cleaning her daughter’s ear canals, was not prepared for her daughter becoming startled by the child’s sibling. As a result the cotton swab, which was being used to swab out the offending earwax, was jabbed into the canal wall creating abrasions and a large hematoma. Thankfully the eardrum remained intact. However, the potential for puncturing it was very high.

So how does one care for the ear? The outer ear, auricle, is to be cleansed with a wash cloth, soap, and water. The ear canal will clean itself. The old adage: “Nothing smaller than your elbow in your ear,” is as true today as when first uttered. For those individuals who are wearing hearing aids, it is recommended that approximately every 6 months have the ears examined by a physician or audiologist. If there is an accumulation of debris in the canal preventing sound from reaching the eardrum, it can be removed in the office or flushed out at home with an ear syringe and lukewarm water/white vinegar (50/50) mixture. There are over-the-counter solutions designed for softening earwax. These contain 6.5% carbamide peroxide which gently and safely softens the earwax facilitating removal either by a professional or by flushing at home. Avoid hydrogen peroxide as it is potentially damaging to the tissue of the ear canal. Again, never use cotton swabs for earwax removal.

Complaints of moisture in the canals have been lodged by many. This is one excuse given for using cotton swabs. If moisture is truly an issue, such as with swimmers, there is a device on the market called an Ear Dryer. Prices can range anywhere from $50.00 to $99.00. It is a personal dryer for the ear canal which comes with four color coded tips for each member of the family. The device produces warm air for approximately one minute and automatically shuts off. It is small enough for travel as well. If purchasing an additional device is not desired, using the personal hair dryer on cool or warm air gently waving it across the ear (not pointing the hair dryer directly into the ear) will also assist in drying the ear canal.

Cotton swabs are not our friends and are best suited for other activities such as arts and crafts instead of ear canal cleaning. Do yourself and your family a favor and just get rid of them. Your ears will feel a lot safer.