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How frequently should I clean my ears? How often should I do the following: place a cotton bud in my ear, push it in as far as possible, rotate it along the canal and extract as much muck as I could? The average person takes pride in the amount of ear wax (image 1) removed, repeating the procedure as long as necessary and getting a “high” out of inserting a foreign object into the ear canal.
Sample of ear wax removed from a patient’s ear.
Don’t deny it! You have felt that kind of satisfaction, as I have! However, the question remains – how frequently should I clean my ears?
The answer, as any otolaryngologist will tell you, is NEVER!
Ear wax is a substance that is found in the outer third of the ear canal. It helps keep the inner part of the canal waterproof. Removing ear wax predisposes the ear to painful infections caused by bacteria or fungi that flourish in damp conditions. In addition to that, ear wax has antibacterial and anti fungal properties, comparable to commercially prepared medications and safer too.
“Digging” the ears with a foreign object like a cotton bud or metal pick can damage the skin lining the ear canal, which is thinner and more sensitive to friction compared to the rest of the body.
If that is not convincing enough, consider the fact that the ear canal has a self-cleansing mechanism. Whatever wax or dirt accumulated will slowly migrate towards the outer part of the ear.
We should be grateful that God has blessed us with an organ that can clean itself. However, there are a few circumstances where cleaning by another person is allowed.
If there is a large piece of ear wax at the ear opening, an assistant can use a cotton bud to gently flick it out. For deep-seated ear wax, leave it to the professionals. “Digging” is not recommended as it may worsen impaction. Self medicating with ear wax softening agents is also not advised. Ear candling can result in hot wax dripping into the canal and damaging the ear drum.
It is better to consult an otolaryngologist if deeply impacted ear wax is suspected. Cleaning is done using operating microscope and suction machine as well as other fine instruments (images 2 & 3). Ear syringing with a jetstream of fluid at body temperature cannot apply to everyone.
Ear toilet procedure done with operating microscope allowing a magnified view & both hands free for better manipulation of instruments.
Few of instruments used for ear cleaning.
A tip to relieving itchiness of the ear, as taught by a senior otolaryngologist, is to repeatedly rub the outer triangular soft cartilage (tragus) of the ear against the ear canal. This will give temporary relief from the urge to “dig” the ears. Continued scratching and “digging” will worsen the itch and continue its vicious cycle.
Final note of caution against the cotton bud: there have been cases where individuals happily using a cotton bud to scratch or “dig” the ears had their ear drums inadvertently ruptured following a bump against their children or friends. Yes, accidents do happen!
Bottom line – do not dig! Avoid cleaning your ears on your own and be sure to tell your friends to do the same. Remember, the cotton bud is meant for cosmetic use, not for “digging” your ears!
Dr Ahmad Nordin is an Ear Nose and Throat surgeon currently working in Sabah. Find out more about him on The Team page.
References:
- Antibacterial and antifungal properties of human cerumen. Lum CL1, Jeyanthi S, Prepageran N, Vadivelu J, Raman R. Department of Otorhinolaryngology, University Malaya, Kuala Lumpur, Malaysia. Journal, J Laryngol Otol. 2009 Apr;123(4):375-8. doi: 10.1017/S0022215108003307. Epub 2008 Aug 11.
- The Good, the Bad and the Eww of Earwax Removal -WSJ http://www.wsj.com/articles/SB10000872396390444354004578058513951005712
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]