Cleaning your ears – What works and what doesn’t

Healthy ears clean themselves by secreting a “cleanser” that traps dirt and dead skin cells as the liquid moves through the ear. This antibacterial “cleanser” is called earwax. The lack of earwax can cause ears to be dry, itchy and prone to infections.

However when too much wax gets stuck in our ears, it causes a blockage and has to be removed. Here are 5 common ear cleaning methods and our recommendations towards them:

1) Q-tips (Cotton buds)

Contrary to popular belief, Q-tips were never invented to clean ears. They were created in the 1920s as a tool for applying lotions to babies. However, people started misusing them by sticking them inside their ears. This has led to many ear problems as:

a. Ear blockage
Q-tips push wax deeper into the ears. Over time, wax becomes more tightly packed and won’t be able to drop out on its own.

b. Damage to eardrum.
Q-tips (7.6 cm) are longer than the average ear canal (2.5 cm). Hence there is a risk of accidentally puncturing the ear drum.

c. Ear infections
Frequent use of Q-tips can cause damage to the skin in the ears. This makes the ears vulnerable to bacterial infections.

Our recommendation: Don’t use Q-tips to clean your ears.

If you frequently clean your ears out of habit, the lack of ear wax could be cause of dry and itchy ears. Try using ear drops to moisturize and soothe your ears instead.

2) Ear candles

In ear candling, a hollow candle is placed in a person’s ear with the other end lit up. The heat from the candle is said to create a suction strong enough to pull all the wax out of the ear.

Ear candle unrolled to reveal at there is no difference between ear candle after burning on its own (left) or over a person's ear (right). Image by Dr. Brett L. Kinsler.

Unfortunately, ear candles are proven to be ineffective.

Burning a ear candle on its own and burning it over a person’s ear will produce the same “ear wax” looking substance.

Hence the removed “ear wax” shown at the end of a ear candling session is more likely to be burnt candle wax.

Our recommendation: Ear candling is dangerous and should be avoided at all costs.

3) Ear drops (Cerumenolytics)

Ear drops or cerumenolytics are over-the-counter remedies that are proven to be safe and effective at softening ear wax. The ear drops are usually applied for a short period and the ear wax is usually able to drop out on its own. Ear drops are available in a variety of solutions (oil- or water-based) and can be administered via sprays or droplets.

When choosing the right ear drop formula, there is little evidence to prove that one formula works better than the other. Regular saline water can be used to replace commercial ear drops.

Our recommendation: This is probably the safest home remedy for ear wax removal. However, we recommend you use ear drops only when necessary or when directed by a medical professional.

4) Ear irrigation

Ear irrigation utilizes a syringe or spray bottle to emit a pressurized stream of fluid into the ear canal to flush out earwax. It is a routine procedure commonly used in general practitioner clinics and polyclinics all over Singapore.

Recently, there has been an increase in ear irrigators purchased for self-use at home. While it is convenient and a much safer option than Q-tips, it can lead to ear drum perforation, vertigo and deafness if not done properly. Unsterilized equipment or fluid can lead to painful ear infections.

Our recommendation: It is a good method to clean the ear but let the professionals do it! If you have a hole in your eardrum or are prone to dizziness, you can consider using a micro-suction (see point 5).

5) Micro-suction

Ear wax extractions

Micro-suction or ear toilet is commonly performed by Ear, Nose and Throat (ENT) surgeons to remove ear wax. They use high-powered magnification tools to look into the ear canal and they insert a small cannula to gently pull out the ear wax. Sometimes it is accompanied by manual removal using sterilized metal loupes. This is accepted as the safest and most comfortable method of ear wax removal by medical professionals.

Our recommendation: This is a safe and effective ear cleaning method but should only be done by medical professionals. Micro-suction done by an untrained person can cause damage to the ears.

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