Cleaning your ears with a cotton swab can feel pretty good. But you may be causing more harm than you ever imagined.

In fact, recent guidelines published in the Otolaryngology – Head and Neck Surgery journal are warning against it. When it comes to ears, otolaryngologists – doctors who diagnose and treat conditions of the ears, nose, throat, sinuses, larynx and mouth – have seen patients who have cleaned their ears with hair pins, car keys, toothpicks, paper clips and so much more.

Unsurprisingly, these same patients can end up with holes in their ear canals and ear drums, dislocation of hearing bones and cuts in their ear canals which can lead to hearing loss, dizziness, ringing and other injuries to the ears.

“The recommendation that we should not be using cotton swabs has been around for many years,” said Dr. Robert Whitaker, an otolaryngologist at Novant Health Pinnacle Ear, Nose, Throat & Allergy in Salisbury. “It has just not been well-publicized. I have been in the ear nose and throat specialty for 26 years and the recommendation has been around at least that long.”

In the course of a typical day, Whitaker said, he frequently warns patients about the use of cotton swabs. “Cleaning your ears with cotton swabs is actually not good hygiene. Cotton swabs generally pack the wax further into the ear canal, rather than removing it. Repeated use packs the cerumen, or wax, tightly into the ear canal. Cotton swabs can also strike the eardrum which can result in serious injury.”

If wax gets packed tightly into the ear canal, it can even result in ear infections or erosion of the ear canal bone. “I’ve brought patients to the operating room to remove cerumen that has been packed repeatedly into the ear canal,” Whitaker said. “Many of the more serious injuries seen come from adults multitasking in the bathroom where they forget the cotton swab is in their ear or in children who are using cotton swabs because they saw their parent use them.”

In fact, removing all the wax in your ears can cause itching, burning or a clear drainage from the ear canals, Whitaker warned. “Wax acts as a lubricant and protects the ears against fungus and bacteria, so it’s actually beneficial to have ear wax,” he said. “Complications that we see from cotton swab usage are perforated ear drums and the disruption of the ear bones, which results in permanent hearing loss.”

Whitaker said he sees these serious complications in his clinic several times a year which requires major corrective surgery in order to gain back hearing.

If you’re wondering whether you have impacted earwax, Whitaker said that eventually symptoms such as decreased hearing and ringing in the ear without an upper respiratory infection may be a good sign that it’s time to see a health care specialist. “Also, an impending obstruction may be anticipated when the hearing goes in and out after showering because the water mixes with the cerumen and creates a temporary seal that diminishes hearing.”

Whitaker said impacted earwax can be treated with half strength hydrogen peroxide. Earwax can also be suctioned or scraped out, which is often what otolaryngologists will do at their practice “Also, never flush your ears if you have ever had ear surgery, including ear tubes, or have an ear drum perforation.”

Whitaker said he advises his patients to clean their ears weekly in the shower with a wash cloth by wiping away the wax at the opening of our ear canal. “When the hearing begins to weaken or remains diminished, then an evaluation with your primary care or otolaryngologist should be sought, but do not instrument the ear on your own.”

Finally, Whitaker discouraged the use of ear candling – a practice that involves inserting a burning hollow candle into an ear, ostensibly to draw out wax. “Ear candling is not a recommended, safe method to removing ear wax. There have been cases of burns to the skin and hair from using this method.”