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Are Cotton Swabs Really Dangerous? An ENT Specialist Weighs In

The use of cotton swabs is often criticized, but are they truly dangerous? Can we really go without them when cleaning our ears? We consulted Dr. Jérôme Paris, ENT and head and neck surgeon, and member of the DocCity medical committee, to get some answers.

What Are Cotton Swabs Used For?

In 1923, Leo Gerstenzang invented the first cotton swab after seeing his wife attach cotton to a toothpick to clean their baby’s ears (or, according to another version, the baby’s navel). Since then, cotton swabs have not only been used to clean ears but also to fix makeup, remove nail polish from fingers, and clean small crevices. However, their primary use remains the removal of earwax, a function that some ENT doctors, like Dr. Olivier Morineau in his book Le livre noir du coton-tige (The Black Book of Cotton Swabs), have strongly opposed.

What Causes Earwax?

Before evaluating the utility of cotton swabs, let’s look at the physiology of earwax. Earwax, or cerumen, is produced by everyone, from babies to adults. Its purpose is to lubricate the ear canal, the only part of the body where the skin is directly attached to bone, without the protective layers of fat or muscle found elsewhere. Earwax serves as a shield, protecting the ear from foreign objects, dryness, and trauma. It is produced only in the outer half of the ear canal and is made from secretions of sebaceous and ceruminous glands.

Is It Safe to Use a Cotton Swab?

When asked about the safety of cotton swabs, Dr. Jérôme Paris answers: “There’s hardly anything better for cleaning the folds of the outer ear.” However, he emphasizes that cotton swabs should not be inserted deep into the ear canal. “You can use them to clean the entrance of the ear canal where excess earwax can accumulate near the hair, but only insert it a few millimeters. Going deeper is unnecessary and can be dangerous,” he warns.

Going too deep risks touching the eardrum, a delicate and sensitive area that can be perforated by sudden movements. Additionally, using a cotton swab deep in the ear can push earwax further into the canal, leading to blockages. Over time, this can cause hearing loss and potentially lead to bacterial infections like otitis.

In rare cases, the cotton tip can come off and become stuck in the ear, requiring medical intervention.

How to Clean Your Ears Without a Cotton Swab

Dr. Paris suggests cleaning your ears during your daily shower. “Unless you have a medical condition or a perforated eardrum, gently pulling the ear back during your shower helps realign the ear canal, allowing water to enter, circulate, and wash away debris and excess earwax,” he explains.

On hair-washing days, make sure to thoroughly rinse your ears with clear water. Avoid leaving shampoo or soap in your ears as they can irritate the skin. After swimming in the ocean, pool, or lake, it’s also a good idea to rinse your ears with fresh water.

If you frequently experience earwax buildup, cerumenolytic sprays like Audispray or Quies can help. For those with excessive earwax production, visiting an ENT specialist for an ear cleaning once a year may be necessary.

Dealing with Wet Ears

After a shower or swim, if your ears feel wet, a cotton swab can be used at the entrance of the ear canal, but avoid inserting it deeply. Alternatively, you can use a tissue rolled into a small cone to absorb the moisture. If water remains, a hairdryer set to a low, cool setting can help dry your ears.

The Origin of the Cotton Swab

You may have noticed that packaging often refers to “cotton buds” or “cotton sticks” rather than “cotton swabs.” This is because Cotton-Tige is a trademark registered by Unilever since 1952. Over time, the term has become part of everyday language, much like other brand names.

While cotton swabs can be useful for certain tasks, it’s crucial to use them safely and avoid inserting them deep into the ear canal. For thorough ear care, simple water rinsing during a shower is often the safest and most effective method.

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