Mom always told you not to put anything in your ear that’s smaller than your elbow. Well, she was right. Not only is that good advice; it’s now an official guideline for the diagnosis and treatment of earwax, published Tuesday by the American Academy of Otolaryngology—Head and Neck Surgery Foundation.
This update to the Foundation’s existing earwax guidelines, originally published in 2008, takes a new, consumer-focused approach, says Seth R. Schwartz, M.D., chair of the guideline update group and medical director at The Listen for Life Center at Virginia Mason Hospital in Seattle. That includes a list of do’s and don’ts for doctors to pass on to their patients.
“We tried to include information that was directly applicable to what people are experiencing at home,” Dr. Schwartz told RealSimple.com. “And the most important thing we want to get across to patients is that earwax is not unhealthy.”
In fact, earwax is normally quite good for our ears: Dirt and dust particles stick to the gunky deposits, which keep them from traveling farther down into the ear canal. And when our bodies work the way they should, old earwax moves outward naturally over time, and flakes off—or is washed off during bathing—as new earwax is formed.
But there are times this self-cleaning mechanism gets stuck, and earwax can build up and block the ear canal—a condition called cerumen impaction. It’s estimated that about 1 in 10 children and 1 in 20 adults has impacted or excessive cerumen (a.k.a. earwax), which can cause symptoms like hearing loss, ringing in the ears, a foul odor, or ears that feel clogged, painful, or itchy. In geriatric and developmentally delayed groups, the percentage may be as high as one third.
And that’s where the guidelines come in. In addition to the commonly cited elbow advice, the new list of “don’ts” warns against over-cleaning the ears (which may irritate the ear canal, cause infection, or even increase earwax levels) and using ear candles (which have no established benefit, but can cause serious and permanent damage).
What they do recommend, on the other hand, is seeking medical attention if you have symptoms of hearing loss, ear pain, or ear fullness. You should also see a doctor if you experience drainage or bleeding from your ears, they add, which are likely not caused by earwax and need further evaluation.
Patients should also ask their doctors about ways they can treat their earwax at home, the guidelines state. That may include using wax-softening eardrops or even rinsing your ears with water, says Dr. Schwartz. Your doctor might also recommend a home irrigator designed for ear cleaning, or may refer you to a specialist (like an otolaryngologist or an audiologist) for in-office cleanings or wax removal.
What you shouldn’t do is use a Q-tip—or any other tiny tool—to try to clean out your ear canal. “Even something as soft as a cotton swab can traumatize that delicate skin, which can cause pain and infection,” says Dr. Schwartz. “And a lot of people end up pushing the wax deeper into the eardrum. That makes it harder for it to make its way out naturally, and can cause even more symptoms.”
And finally, if you’re not experiencing any earwax-related symptoms, simply leave your ears alone. “For most people, wiping the outer edges of your ears with a washcloth or a tissue is all you need to do,” says Dr. Schwartz. “Don’t go any deeper than that.”
The updated guidelines were published in the journal Otolaryngology-Head and Neck Surgery, and are endorsed by several large medical groups, including the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Geriatric Society.
The guidelines should serve as a “strong reminder to patients that ear health starts with them,” says Dr. Schwartz, and should help doctors better communicate the importance of healthy habits—and, in this case, a healthy respect for earwax.