Cotton-tip swabs (or Q-tips) are useful for many things. Cleaning ear canals isn’t one of them. Fortunately most ears don’t need them because earwax is actually an important protector of the ear canal. Dirt, dust, and even bacteria that enter the ear canal get stuck in the sticky wax which works it’s way out, slowly but surely, to the opening of the ear canal, where a washcloth (or fingernail) will take care of it. As we learned on The PediaBlog back in 2012, the best advice is to leave the wax alone:
Cotton swabs especially tend to be problematic for two reasons. First, while a little wax will be seen on the tip of the swab after cleaning, more unseen wax is actually pushed further into the canal, potentially leading to an impaction of wax. Second, older children and teens tend to use cotton swabs more aggressively than their parents and can cause considerable trauma to their ears. A frequent cause of ear pain at this age is simply from frequent or vigorous swabbing, which, by friction, produces inflammation of the ear canal. Usually no treatment is needed for that, but the pain results in a lot of visits to the doctor.
A lot of visits to the doctor, as we discovered in January:
Earwax (cerumen) isn’t a trivial issue. The American Academy of Otolaryngology – Head and Neck Surgery estimates that about 12 million Americans suffer from cerumen impaction (defined as “an accumulation of cerumen that causes symptoms or prevents a needed assessment of the ear canal, tympanic membrane, or audiovestibular system or both”). In 2012, $46.9 million was spent on 1.3 million office encounters to remove impacted wax by doctors and other health care providers.
Children are especially fond of jamming things into their little ear canals (and nostrils, too!) and every pediatrician can catalogue the treasures they’ve pulled out of one of these tiny orifices. A new study, published last week in Journal of Pediatrics, assesses the damage done to children’s ears. A. Pawlowski provides the details that reinforces the idea of just leaving earwax alone:
Despite years of warnings to avoid putting the product into the ear canal, more than 263,000 children in the U.S. had to be treated in emergency rooms for ear injuries related to cotton-tip applicators between 1990 and 2010(…) That amounts to about 34 injuries a day.
Here’s the scoop (pun intended):
> A quarter (25%) of the children who were seen in emergency departments during the 20-year study period had perforated ear drums. This painful condition can be very serious and lead to hearing loss. Another 23% damaged the skin and soft tissue of the ear canal.
> 67% of the injured children were under the age of 8, with most (40%) under the age of 3.
> The majority (77%) of children with injured ears hurt themselves while handling the cotton swabs; the rest were injured by others including parents (16%) and siblings (6%).
Pawlowski has three important reminders about earwax:
• Realize ear wax is normal. Ear wax that’s not causing symptoms or blocking the ear canal should be left alone.
• (Don’t) overclean your ears: it may irritate the ear canal and cause infection.
• Go to the doctor if you have hearing loss, a feeling of fullness in the ear or ear pain. An ear, nose and throat doctor can remove more stubborn excess wax.