Should you clean out your ears with cotton swabs? Is ear candling safe? The American Academy of Otolaryngology – Head and Neck Surgery provide answers to these questions in their updated guidelines for the best ways to prevent and treat the buildup of earwax.

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Updated ear care guidelines have been issued for the prevention and treatment of earwax buildup.

Earwax – also called cerumen – is a substance naturally produced by the body to clean, protect, and lubricate the ears. Without earwax, the ears would be dry, itchy, and prone to infection.

Although cerumen is essential for ear health, too much of the waxy substance can cause a number of problems, such as earache, partial hearing loss, tinnitus, itching, and coughing.

The American Academy of Otolaryngology – Head and Neck Surgery note that around 1 in 10 children and 1 in 20 adults experience a buildup of earwax.

Many individuals think that they are halting the buildup of earwax – otherwise known as cerumen impaction – by regularly cleaning their ears. However, certain cleaning practices are actually contributing to the problem.

“Patients often think that they are preventing earwax from building up by cleaning out their ears with cotton swabs, paper clips, ear candles, or any number of unimaginable things that people put in their ears,” says Dr. Seth R. Schwartz, chair of the guideline update group.

“The problem is that this effort to eliminate earwax is only creating further issues because the earwax is just getting pushed down and impacted further into the ear canal,” he adds. “Anything that fits in the ear could cause serious harm to the eardrum and canal with the potential for temporary or even permanent damage.”

The updated guidelines from the American Academy of Otolaryngology – Head and Neck Surgery, which replace their 2008 recommendations, offer advice on ear care and the best treatments for earwax buildup.

According to Dr. Schwartz and colleagues, the updated guidelines are based on an in-depth review of research relating to ear care, which involved an analysis of observational studies and randomized controlled trials using an algorithm.

Additionally, the Academy appointed a consumer representative when drawing up their new recommendations.

“Having the consumer perspective on the guideline update group provided us a value-added opportunity to incorporate more extensive patient counseling within our treatment protocols,” notes Dr. Schwartz.

The main purpose of the new guidelines is to help clinicians pinpoint which individuals require treatment for earwax buildup, say the authors, as well as help them inform patients of the best ways to look after their ears.

Some of the recommendations in the new guidelines include:

  • Avoid overcleaning your ears, as this can lead to irritation in the ear canal, ear infection, and earwax buildup
  • Do not put cotton swabs, hair pins, toothpicks, and other small items in your ears; doing so can damage the eardrum, ear canal, or even dislocate the hearing bones
  • Avoid using ear candles; they can damage the eardrum and ear canal, and there is insufficient evidence to suggest they are effective for removing excess earwax
  • Seek medical attention if you are experiencing ear pain, ear fullness, or hearing loss and you are unsure whether these symptoms are caused by earwax buildup. Ear drainage or bleeding may signal other problems
  • Ask your clinician about how you can safely treat earwax buildup at home.

The American Academy of Otolaryngology – Head and Neck Surgery hope that their updated guidelines will encourage better ear care among the general public.

This update is significant because it not only provides best practices for clinicians in managing cerumen impaction, it is a strong reminder to patients that ear health starts with them, and there are many things they should do as well as many things that they should stop doing immediately to prevent damage to their ears.”

Dr. Seth R. Schwartz

Read about a study that suggests earwax contains ethnicity-specific data.