We're cleaning our ears wrong: Why the daily cotton buds habit is doing more harm than good

It’s become a daily habit for most Filipinos to clean their ears inside and out, with some going the extra mile and dipping the bud in alcohol to make it extra clean.

But do you know that you could end up with an ear infection by having ears that are too clean?

According to Dr. Shiella Lim, Ear, Nose, and Throat—Head and Neck Surgery (ENT-HNS) at Makati Medical Center and De Los Santos Medical center, this cleaning routine of Filipinos is wrong.

“The diameter of the ear canal is very small, sometimes smaller than the cotton bud. When you insert a cotton bud into the ear canal, the wax that is produced is merely being pushed further into the canal. Over time, it will just accumulate and form a big chunk of ear wax, which can cause discomfort and decrease hearing.”

Dr. Julius Perry Velasco, an Ear, Nose, & Throat – Head & Neck Surgery doctor at UST Hospital and MyHealth Clinics, repeats the saying, “You can’t use anything smaller than your elbow to clean the ear canal. It means you can’t put anything inside your ears to clean it, let alone do it yourself.”

Dr. Francis V. Roasa, an Ear, Nose, & Throat – Head & Neck Surgery at UST Hospital and at St. Luke’s Medical Center at Global City, agrees. “The use of cotton buds to clean the outer ears is acceptable, but not inside the ear canal, because it may cause more problems.

"Using cotton buds to clean the ear canal is the most common cause of having a perforated or ruptured eardrum. Daily cleaning of the ears can result in excessive removal of the earwax, and stripping of the canal skin that can predispose to injury, leading to infection.”

Illustration by Jannielyn Ann Bigtas

According to WebMD, "a ruptured eardrum is a tear in the thin membrane that separates your outer ear from your inner ear." It can lead to complications but the consolation, is that it can heal on its own.  

Dr. Roasa believes that the misconception that you need to clean your ears on a daily basis comes with the basic thinking that earwax is bad and dirty. “Patients use cotton buds because it feels good whenever they use it inside the ears, not knowing it causes more problems.”

But cotton buds aren’t the only culprit when it comes to daily ear cleaning. Dr. Lim is against using a small ear spoon, while Dr. Roasa suggests you say no to using wooden or metallic objects to clean your ears, like ear curettes, and to not do candling.

Dr. Velasco adds, “Inserting your pinkie finger to clean one's ears is also as bad as inserting a cotton bud. Flushing water in your ears  on your own using the shower head is also not advised.”

Without the earwax to protect your ears, or due to improper ear cleaning, Dr. Lim says that the telltale signs of an ear infection are the following, “Swelling, redness, pain, ear discharge, sometimes even fever.”

Dr. Roasa says that it can even bleed. “The sensitive skin of the ear canal can be traumatized and get infected. Once injured, it can bleed considerably as a result of tear or laceration in the ear canal.”

Dr. Velasco states that there are two types of earwax — dry and wet — with dry earwax being more common to Asians.  “Earwax has mild antibacterial and fungistatic properties. It lubricates the ear, maintains its pH or the acidity of the canal. It also acts as a filter for foreign objects.”

So what's the right way of cleaning our ears?

Dr. Lim has a simple answer: Grab a washcloth and use your fingers. “Every time you take a shower, use a washcloth to clean whatever your finger can reach in your ear.” Dr. Roasa seconds the motion. “The external ears can be washed with clean water, and dried with cotton or cloth, without inserting anything inside the ear canal.”

If there’s more earwax buildup that your daily cleaning doesn’t cut it and you’re having a hard time hearing due to the blockage, Dr. Roasa suggests softening the wax “by putting several drops of clean mineral oil, baby oil, glycerin, or any commercially available earwax softeners, like Docusate sodium.

"Keep the solution inside the ears for 15-30 minutes, after which it can be flushed out with warm water. You can have this done by an ENT, or by yourself using commercially available ear cleaning kits.”

If it’s graver, Dr. Roasa and Dr. Lim suggest seeing a specialist. Dr. Velasco says that there is no standard time for heading down to the clinic for ear cleaning. “It depends on the frequency of earwax formation, cotton bud habits and if these results to blockage of the ear canal or other symptoms.

"Personally, once a patient has been diagnosed with impacted cerumen and after removing it, I would advise the patient to follow up three to six months. I would also advise the patient for symptoms to watch out for so he or she can follow up whenever ear symptoms appear. After proper ear cleaning, some patients come back 4 to 6 weeks because there is re-accumulation of earwax. These patients are frequent cerumen formers who need more frequent follow-ups with ENTs. Whenever you have ear pain, hearing loss, tinnitus, dizziness, ear fullness, or ear discharge do not hesitate to visit an Ear Nose Throat (ENT) Doctor.”

Dr. Roasa says, “Irrigation to remove the earwax is not to be done in cases where an infection is suspected, perforated eardrum, eczema of the ear canal and patients with diabetes and weakened immune system since they may develop the infection after irrigation. In such situations, your Ear, Nose & Throat doctor may elect to manually remove the earwax by suctioning or removing it using specialized instruments under microscopic visualization. For patients who are having excessive earwax, it is advisable to visit your Ear, Nose & Throat doctor every 6-12 months for check up. But, ears of patients with dry type earwax are usually clean already. Remember our ears can clean itself, even without intervention.” — LA, GMA News