“But if I don’t clean my ears, won’t water get in them?”  “What will happen to all that wax if I don’t remove it?”  “If I don’t clean my ears they itch like crazy.”  In 24 years of primary care, believe me I’ve heard it all.  And attempting to alter the relationship between a patient and their Q Tips can be a very volatile discussion.

The truth is, the ear, like other parts of your body, is a balanced system that is the result of millions of years of evolution.  And, in general, this system works perfectly well, until we mess with it.  In this week’s Weekly Wellness Report, we’ll approach the topic of ears and how to care for them including the effects of ear cleaning, but first, let’s take a moment to review the anatomy of the ear with particular attention to the part of the ear we all seem so tempted to disturb, the external ear.

The ear is composed of three main sections: the inner ear, the middle ear, and the outer (or external) ear.  Starting from the inside, the inner ear lies deep behind the eardrum (aka the tympanic membrane) and is the region responsible for balance. It accomplishes this via a very special arrangement of nerves and receptors submerged in fluid.  The middle ear lies just behind the eardrum and contains three small bones responsible for transmitting and amplifying sounds from the eardrum.  The eardrum separates the middle ear from the external ear and acts much like the surface of a musical instrument drum, it transmits sound from the outside of the ear (air) to the inside of the ear (liquid) by vibration.  Moving further outward, the external ear is composed of the tube (the external auditory canal) that leads from the eardrum to the outside.

But importantly, the external auditory canal is more than just a tube. It is a canal lined with hair and wax (cerumen), the two components working together in a flawless never-ending waltz to protect downstream structures from outside invaders. Its opening at one end allows ears to funnel sounds from the outside, but also presents a vulnerable opening to all the harms of the outdoors.  Hairs coated with wax catch invaders (bacteria, viruses, foreign bodies, etc.) while the hairs move the encapsulated material back out of the ear to the outside. Thus, the external auditory canal balances the critical responsibilities of transmitting sounds for hearing while preventing passage of invaders.

Enter the Q Tip. (cue Darth Vader’s theme music)

When we put a Q Tip (or bobby pin, plastic ear loop, hair removal device, twisted paper towel, toothpick, random Star Wars figurine, etc.) into the external auditory canal, we break off the tiny protective hairs and move and/or remove the waxy material, thus disrupting the invaluable balance of the system.  When the hair and wax are removed, what is left behind is a naked, exposed external auditory canal, unprotected and susceptible to infection.  It is no exaggeration when I tell my patients that “Nearly every adult with an ear problem is an adult that cleans their ears”.  Adults that do not clean their external auditory canals are protected by their ear’s natural defense mechanism and typically do not have ear problems.

So, let’s all take a big step toward better health and stop cleaning the inside of our ears.  Remember what your grade schoolteacher told you about what can go inside your ears,
“Nothing smaller than your elbow.”  Want to learn more? Check out some of the links below for some additional reading from trusted resources.

Additional Reading

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/the-scoop-on-earwax

https://www.washingtonpost.com/news/wonk/wp/2016/01/20/we-have-a-q-tips-problem/

The Wellness Report is a periodic newsletter composed by Dr. Michael Duffy, offering up to date, evidence-based guidance on common medical concerns exclusively for members of reMDdirect.  Have questions, feedback, or an idea for a future topic for a Wellness Report? Email me directly at doc@remddirect.com

At reMDdirect, my hope is not just to provide top notch medical care, but to educate and empower members to take an active role in their wellness.  As always, thank you for being a member of reMDdirect, where we are changing healthcare for the better, by reuniting patient and provider.          -Michael Duffy MD

Share This Story, Choose Your Platform!

About the Author

Dr. Michael Duffy

As a Board Certified Family Physician who has practiced medicine for over 20 years, I have held a variety of leadership roles in hospitals and healthcare technology while always maintaining an active clinical practice. Using those many lessons learned, and in an effort to uphold what is best in primary care, I launched reMDdirect, a new Direct Primary Care practice in Twin Falls, Idaho in October of 2023. My focus is to provide a top notch primary care experience that ensures easy access, transparent pricing, and a great patient experience. I am committed to working with patients and employers to empower the individual to understand and manage their health conditions. In this blog section, I will offer current, evidence-based advice on health issues relevant to you so that you may be better involved in your own care. If there is an issue you would like to see addressed, or if you have any questions on a post, please reach out via the “Contact Us” tab at the top of this website, and please feel free to share this info with others and invite them to connect via this website.  At reMDdirect, we are excited to welcome new patients to the practice. Thank you for being part of the reMDdirect family!