If you ask an ENT (ear-nose-throat) specialist about Q-tips, she’ll likely cringe. Cotton swabs are enemy #1 for ears. Yet so many people use them to get rid of earwax. The fact is, cotton swabs cause more problems than they help, sometimes big problems, like poor hearing.

Wax blockage is one of the most common causes of hearing loss, and it’s usually caused by people trying to clean their ears with cotton swabs (or other pointy things like, believe or not, bobby pins). When you attempt to remove wax with a swab, push wax deeper into the ear canal. Since the canal narrows like a funnel, the wax plugs it up. That’s the main reason why approximately 12 million Americans visit their doctors each year for impacted ear wax. Using cotton swabs can also ups your risk of rupturing an ear drum.

What is earwax?

Before you use that cotton swab, you should know that earwax is a good thing. Earwax is not actually a wax, but a mixture of secretions and dead skin that helps protect the function of the ear. “Wax has four main functions,” says Dale Tylor, MD, MPH, pediatric and general otolaryngologist at Washington Township Medical Foundation in Fremont, CA. “It’s a natural antibiotic, natural antifungal, it helps to waterproof the ear so water or moisture doesn’t irritate it, and it’s an anti-itch,” she says. Yes, anti-itch. “People often clean out their ears because they itch, but the reason they’re feeling the itch is because the natural wax has been overly removed,” says Tylor. “If your ears are itchy and you clean them more than twice a week, the problem is probably a lack of wax, not too much wax,” she says.

Your ears are supposed to do the job of wax cleaning themselves. Earwax migrates outward from the ear canal, assisted by chewing, to the outer ear, where it dries, flakes and falls out.

Here are 6 ear hygiene pointers.

  • Use a washcloth. When you shower, use a washcloth to clean the outer ear (don’t try to jab the cloth inside your ear). 
  • Ditch the cotton swabs, and never insert anything else into the ear. 
  • Get help with breaking your Q-tip habit. If you’re an avid cotton-swab user, while you wean yourself off, you may need an over-the-counter eardrop meant for soothing itchy ears. (Until normal earwax builds back up.) You can also use a few drops of mineral oil or olive oil to soothe them.
  • Stay clear of ear candling. Ear candles are hollow 10-inch long cones of fabric soaked in wax. While one end is inserted into the ear, the other end is lit, and the heat supposedly creates suction that draws earwax out. The Food and Drug Administration has warned consumers not to use ear candles because of the risks of burns, clogging the ear further and ruptures to the eardrums.
  • Use an at-home treatment for heavy wax build-up. There are some people who do produce a lot of wax, which can make the ears feel plugged or create pressure if not cleared more regularly. “But these people are few and far between,” says Tylor. If you’re prone to major build-up, you can safely clean the ears at home. All you need is hydrogen peroxide and an eye dropper, both available at the drugstore. “I generally recommend once a week, putting a squirt of hydrogen peroxide into each ear while in the shower. Do it as you wash your hair. It’s water soluble, it bubbles a bit, and loosens up the wax,” says Tylor. Over-the-counter drops marketed for wax removal generally consist of hydrogen peroxide and oils, but are more costly than buying hydrogen peroxide alone, says Tylor.
  • See a doctor if your ears are hurting or you can’t unclog them. A primary care physician will likely try a rinse or try to pull out the wax. ENT doctors usually have more tools at their disposal, and can use vacuums or other tools to pull the wax out.      

Laurie Tarkan is an award-winning health journalist for the New York Times, national consumer magazines and websites.