For children with earwax, avoid cotton buds

Earwax is healthy and protective when present in normal amounts. In this article by Sade Oguntola, experts say that cleaning the ears with cotton swabs may do more harm than good especially in children, who have very narrow ear canals.

It is common to see many people use Cotton buds to clean out their ears. But, contrary to popular belief, scrubbing inside the ear to clean it is not only unnecessary, it is potentially damaging to the ear canal. It can be particularly dangerous for children, who have very narrow ear canals.

Earwax is sticky, gooey and has a terrible shade of yellow and certainly not something mothers want to see on their children. And so many try to clean it by what seems to be a very logical course of action, cotton swab.

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But doctors do not recommend Cotton buds because earwax is said to be healthy and protective when present in normal amounts. It is actually protecting, lubricating and offering an antibacterial activity to the ear.

They also discouraged using a cotton swab to clean a child’s ears as part of the act of caring for a child such as brushing the teeth or washing the hair. They warned that by cleaning a child’s ear, it is possible for an injury to the eardrum, hearing bones or inner ear to occur.

Unfortunately, the medical advice not to clean the ears is not widely known, whether in children or adults. In 2014, researchers’ assessment of the knowledge, attitude, and awareness of hazards associated with the use of Cotton buds in Bida community, indicated that 74.1 per cent of the respondents lacked information on the danger of using Cotton buds in cleaning their ears.

Bida is an urban settlement/town in North-Central Nigeria, the capital city of the Nupe Kingdom and headquarters of Bida Local Government Area of Niger State.

Even though most of the participants in the study were literate, 61.2 per cent of them believed that there was benefit in using cotton buds to clean the ears, reported the study published in 2015 edition of the International Journal of Otolaryngology and Head & Neck Surgery.

In addition, 92.8 per cent of the respondents had indulged in the use of cotton buds to clean their ears and most (57.8 per cent) of those that had used cotton buds did so because of itching in the ears.

Some of the respondents also claimed that apart from the aesthetic appearance of cotton buds, the tip is softer and safer to use than matches.

Globally, cotton-bud-related injuries are a common reason for attendance at ear, nose and throat (ENT) referral clinics.  At the Ear, Nose, and Throat Clinic of the University Teaching Hospital, Ado Ekiti, Ekiti State, between April 2008 and March 2009, self-ear cleaning with indiscriminate objects such as cotton tip swab was the most common predisposing factors to earwax impaction.

At the hospital, 437 patients were diagnosed with earwax impaction, with the age range of six months to 96 years. Earwax impaction was predominant at the extreme of ages of life, in zero to 10 years and 61 years and above age groups and these were 27.2 per cent and 17.6 per cent, respectively.

The researcher, according to the 2014 edition of the Journal of Family Medicine and Primary Care, said that ear picking and or its resultant ear infection, abnormalities of external auditory canal, foreign body impaction, excessive earwax production due to anxiety, fear and stress, and ageing are among important factors for earwax to become jammed or stuck in the ear.

Impacted earwax causes discomfort such as irritation, blockage, hard of hearing, earache, noise in the ear or head, and dizziness.

Moreover, recent research in the journal, Paediatrics, has discovered that younger children are at higher risk for such injuries. The study had analysed more than two decades of data from U.S. emergency department and doctor visits that involved children’s ear injuries related to cotton swab use.

Nearly 70 percent of the injuries were to children younger than eight years old, and 40 percent were eight years old or younger. In most cases, the kids were trying to clean their own ears, but instead caused damage. The damage included bleeding, pain, hearing loss and dizziness.

Dr James Tobih, a consultant otolaryngologist, LAUTECH Teaching Hospital, Osogbo, Osun State, who stated that wax blockage was the commonest cause of temporary hearing loss, declared that eight out of every 10 persons, would have imparted wax, when examined under the light.

He stated, “an imparted wax usually reduces the ability to hear and many individuals might not realise a reduction in their ability to hear if it is only one ear that is affected. However, if the two ears are affected, such a person might only realise that people need to shout before they can hear what is said.”

He, however,  stated that earwax is also self-cleaning, adding that it undergoes a slow and steady movement from the eardrum toward the outside of the ear prompted by the motion of chewing and movement of the mouth.

However, sticking a foreign object in the ear, like a cotton swab, poses a potential risk to hearing, including trauma, impacted ear wax, infection and retention of the Cotton buds.

Professor Titus Ibekwe, an Ear, Nose and Throat Surgeon, University of Abuja Teaching Hospital, stated that wax belongs to the ear and when there is too much of wax in the ear, or none of it at all, the problem arises.

He stated that cotton buds are specially meant for cleaning of fluids in the nose and not for the ear, urging the general public to desist from using cotton buds, pen cover, car keys, among others to clean their ear.

The consultant ENT surgeon declared: “It is tempting to use a Cotton buds or other objects when you feel your ears are blocked, but this can interrupt the natural cycle of wax production, which actually acts as a self-cleaning agent.

“Earwax is the normal substance that the body produces to clean and protect the ears. Using any object to remove such wax will further push it into the canal, thereby causing a blockage, which, in the long run, causes hearing loss, among other complications.

“You are not supposed to clean the ear with anything, because the ear canal has the kind of configuration that will hinder you from removing the intended dirt or wax.

“The problem is that efforts to eliminate earwax only create further issues because the earwax is just getting pushed down and impacted further into the ear canal.

“Anything that fits in the ear can cause serious harm to the eardrum and canal ,with the potential for temporary or even permanent damage,’’ he added.

The most important thing to know about cleaning a child’s ears is this: nothing goes into the ear canal. If an earwax buildup is seen, a cloth or wet wipe can be used to clean the outside of the ear, the portion of the ear that is easily visible to all.