Cotton swabs send dozens of children to ERs each day, study says

The advice from doctors is clear: Don't use cotton swabs to clean your ears.

But people continue to use a soft-tipped plastic or paper stick to dig out the wax from their ear canals -- and it's a problem.

Authors of a new study in the Journal of Pediatrics, conducted by researchers at Nationwide Children's Hospital, warn that using cotton-tip applicators to clean the ear can be dangerous, especially in the hands of little ones.

Each year, about 12,500 children under the age of 18 are treated in US emergency departments for ear injuries related to cotton swabs, the study says. That breaks down to about 34 visits per day.

"This is not like brushing your teeth every day. Children and adults do not need to clean out the ear canal of wax as part of a routine hygiene practice," said Dr. Kris Jatana, assistant professor of otolaryngology-head and neck surgery at the Ohio State University and the lead author of the study.

The researchers looked at hospital visits between 1990 and 2010 and discovered that an estimated 260,000 children ended up in the emergency room with ear injuries. Of those visits, tears in the tissue that separates the ear canal from the middle ear, called the tympanic membrane or simply the eardrum, were the most common.

The largest portion of those injuries occurred when children were using the applicators themselves to clean their ears, a practice that doctors have unanimously denounced.

Cotton swabs can cause cuts in our ear canals, perforate our eardrums and dislocate our hearing bones. And any of these things could lead to hearing loss, dizziness, ringing or other symptoms of ear injury.

Instead of potentially pushing the wax farther into the ear, Jatana says, we should let nature do the job.

"The ear canal is self-cleaning, and the cotton-tip applicator actually works against your ear's natural cleaning mechanism by pushing the earwax deeper toward the eardrum, where it essentially gets trapped and can't get out on its own," he said.

Dr. Seth Schwartz of the American Academy of Otolaryngology-Head and Neck Surgery said "it's cultural" to want clear ears, but "wiping away any excess wax when it comes to the outside of the ear is enough to keep it clean."

"It's not a bad thing to have wax in your ears. Everybody does and should. It's more of an issue when it becomes too much," he said.

If someone is concerned about their earwax or other problems, Jatana recommends seeing a pediatrician, a primary care physician or a specialist. "People do not generally need to clean out their ear canal in the home setting, and certainly, a cotton-tip applicator should not be the product used to do so," he said.

As for irrigators, candles and other home remedies, Jatana sticks to the medical community's basic advice: Stay out of the ear.

In the study, 99% of the ER patients were treated and did not suffer permanent damage. In some severe cases, however, damage sustained from injuries resulted in a permanent loss of hearing.

The ear is sensitive, Jatana said, and the risk of harm is too high. "We need to dispel the idea of cleaning ears in the home setting and the use of any products to do so," he said.