Are you cleaning your child's ears properly?

“I only use it on the outside…”

When I ask parents on their initial visit with me if they use cotton swabs, this is frequently the response I get. They insist that they only use cotton swabs on the outside of the ear and that they NEVER go into the ear canal. I have even heard this from a parent, and then ended up pulling several cotton swab heads out of their child’s ear.

The reason people frequently use cotton swabs is to remove earwax, or cerumen. Ear wax is normal in the appropriate amount. It protects the ear canal by providing a physical barrier and an anti-bacterial layer. Normally, ear wax is worked naturally out of the ear canal with normal movements of the jaw and ear canal.

Occasionally, though, ear wax gets stuck in the ear canal. This can cause problems on multiple levels. The biggest concern is for resulting hearing loss. An impaction can result in significant hearing loss, and prolonged ear wax impactions can become severe enough to damage the ear canal. This can also allow water to get trapped in the ear canal. This moist, dark environment is a perfect breeding ground for yeast, mold, and bacteria leading to an infection of the ear canal, known as otitis externa.

Cotton swabs frequently worsen these deeper ear wax impactions. Instead of removing the wax, they actually plunge the wax further down the ear canal.  Furthermore, they can cause damage to the skin of the ear canal resulting in small injuries, which can more easily become infected.

“But how do I clean my child’s ears?”

This is one of the more common questions I hear in the office.  The truth is, we should not have to do much to clean the ears; they are quite good at cleaning themselves. Occasionally the wax may become too thick or dry to work out of the ear canal. In these instances, using a drop or two of mineral oil in the ear canal once per week can soften the earwax and help get it out of the ear canal.  If this is not enough, your ear, nose and throat doctor can use specialized suctions and instruments to get the wax out SAFELY!

“What about over-the-counter remedies?”

There are numerous things sold over-the-counter that can be used to clean the ears. Beyond mineral oil, I would not recommend any of these.  Ear candles, in particular are dangerous, with common injuries including burns and rupture of the eardrum. In fact, the Food and Drug Administration (FDA) has expressed concerns over these as well. Other ear drops and remedies are not recommended unless used under the direct supervision of your doctor.

So remember, nothing smaller than your elbow in your ear! Ear wax impactions can cause significant issues for your child, so be aware of this as a source of hearing loss, ear pain, and infections.