A sampling of U.S. emergency department records confirms that sticking anything smaller than your elbow in your ear is a good way to puncture an eardrum. About 66% of patients treated for traumatic tympanic membrane perforations had hurt themselves by sticking “instruments,” in their ears, and nearly half of these cases involved cotton-tipped swabs. This published in JAMA Otolaryngology Head & Neck Surgery.

The current study focused on the traumatic causes of eardrum perforations. Many patients do not realize they can often injure the ear canal, push earwax further in (impaction), or even burst their eardrum. Dr. Eric Carnoil said, “In our experience, cotton tip applicators (Q-tips and similar products) are frequently the instrument that patients will use to clean their ears. The researchers looked at five years of records from 100 nationally representative emergency departments in the U.S. and found over 900 visits for ear-related injuries.

These represent almost 5,000 emergency department visits for tympanic membrane perforations nationally during the same period, the researchers write. About 60% of patients were male, and most were 18 years old or younger. “Ear canal instrumentation” was the cause of injury in 61% of cases, and 45% of these specifically involved cotton-tipped applicators, the study found. For children from infants to 5 years old, foreign instruments were the cause of 86% of injuries and for 6-to-12-year olds, it was 66%.

Among adults 37 to 54 years old, sticking foreign objects in the ears caused 53% of perforations and among those 55 or older, it was 67%. Carnoil said, “If you’ve taken away nothing else from this interview and the article, it is please, do not use Q-tips to clean your ears.” “Earwax is made in the outer 1/3 of the ear canal, and it is water-soluble. Therefore, after a shower, most people can get away with just using a washcloth to wipe the wax away from the ear.”

The ears have a self-cleaning mechanism, said Djalilian. “This means that the dead skin of the ear canal along with the earwax gradually move outward and come out of the ear on their own.” Therefore, using a Q-tip (or anything else) is almost never necessary and nearly always will just push in the wax deeper into the canal rather than remove wax.

Djalilian said, “A little bit of wax will stick to the Q-tip and make the user feel great about themselves that they accomplish something, but chances are approximately 5-10 times more wax was pushed in."Using Q-tips (or other things) in the ear canal is also the leading cause of ear canal infections as it scratches the ear canal skin and allows bacteria to enter the skin causing otitis externa, he noted.