Ear-Nose and Throat Doctor (ENT) Questions Ear Cleaning

Is it safe to clean my ears with hydrogen peroxide?

I read in an article that using Q-tips to clean your ears can do more harm than good. Is using hydrogen peroxide liquid for ear cleaning a better option?

8 Answers

PATIENT INFORMATION

Dos and Don’ts of
Earwax (Cerumen)
ABOUT THE AA0-HNS/F

The American Academy of Otolaryngology–Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents about 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The AAO-HNS Foundation works to advance the art, science, and ethical practice of otolaryngology–head and neck surgery through education, researach, and lifelong learning. The organization’s vision: “Empowering otolaryngology–head and neck surgeons to deliver the best patient care.”
www.entnet.org

SOURCE: Adapted from Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical Practice Guideline (Update): Earwax (Cerumen Impaction). Otolaryngol Head Neck Surg. 2017;156(1_suppl):S1-S29.

Know that earwax (cerumen) is normal.

Earwax that does not cause symptoms or block the ear canal should be left alone.

Don't over-clean your ears. Too much cleaning may bother your ear canal, cause infection, and may even increase the chances of earwax impaction.

Understand symptoms of earwax impaction (wax blocking the ear): decreased hearing, fullness, ringing in the ear (tinnitus), and distortion/changes to hearing aid function.

Don't put cotton swabs, hair pins, car keys, toothpicks, or other things in your ear. These can all injure your ear and may cause a cut in your ear canal, poke a hole in your ear drum, or hurt the hearing bones, leading to hearing loss, dizziness, ringing, and other symptoms of ear injury.

Ask your provider about ways you can treat your earwax impaction at home. You may have certain medical or ear conditions which may make some options unsafe.

Don't ignore your symptoms if home remedies are not helping. Seek medical attention if your symptoms do not go away.

Don't forget to clean your hearing aids as the manufacturer and your hearing health professional recommend.

Seek medical attention if you have ear pain, drainage, or bleeding. These are not symptoms of earwax impaction, and need to be checked out by your health care provider.

Don't irrigate or try earwax-removing/softening drops if you’ve had previous ear surgery or a hole in your ear drum unless cleared to do so by your ear, nose, and throat surgeon (otolaryngologist).

See your health care provider if you have symptoms of hearing loss, ear fullness or ear pain if you are not certain they are from earwax. Otitis media (fluid behind the ear drum), otitis externa (ear canal infection) and sudden inner ear hearing loss can seem like an earwax impaction.

Don't use ear candles. Ear candles do not remove earwax and can cause serious damage to the ear canal and drum.

PATIENT INFORMATION
Ways to Help Reduce
Earwax Buildup
ABOUT THE AA0-HNS/F

The American Academy of Otolaryngology–Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents about 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The AAO-HNS Foundation works to advance the art, science, and ethical practice of otolaryngology–head and neck surgery through education, researach, and lifelong learning. The organization’s vision: “Empowering otolaryngology–head and neck surgeons to deliver the best patient care.”
www.entnet.org

SOURCE: Adapted from Schwartz SR, Magit AE, Rosenfeld RM, et al. Clinical Practice Guideline (Update): Earwax (Cerumen Impaction). Otolaryngol Head Neck Surg. 2017;156(1_suppl):S1-S29.
HELPFUL PREVENTION CHOICES:
1. Physically removing earwax by health care provider
2. Rubbing alcohol or hydrogen peroxide drops or irrigation
3. Irrigation with bulb syringe or irrigation kits
4. Earwax softening drops/agents

Don't do/use:
1. Ear Candling
2. Putting any objects in the ears (i.e. cotton-tipped swaps; pens/pen tops; paper clips)
3. Daily olive oil drops or sprays
Our grandmothers told us to never use anything smaller than the elbow to clean the ears for fear of impacting wax in the ear canal. Hydrogen peroxide is a common product that is generally safe to use for ear cleansing. Several drops to loosen any wax then can be gently removed with a small bulb syringe with warm water.
It is safe to clean as long as certain only have wax and not an infection or an eardrum perforation or hole.

Devang P. Desai, MD
Do not put water/peroxide in the ear. If you want, you can make a 1/2 and 1/2 vinegar and alcohol mixture and put a few drops in the ear a few times a week. This keeps the ear canal acidified and prevents ear canal infection.
Q-tips are risky. Hydrogen peroxide can also be risky if moisture is retained in the ear canal.
This is a big mistake – the skin of the external ear canal is the thinnest, most delicate skin on the body and is actually thinner than the cornea of the eye. It is firmly and directly attached to the bone to help increase the resonance of sounds and thus improve hearing, much like a room with a marble floor and glass ceiling. As such, it cannot take a joke and peroxide will convert a waxy ear into an infected one by breaking down the protective skin barrier. Despite this objective anatomical feature, your local drugstore is loaded with peroxide-like rinses that will harm your ear and increase the possibility of needing a doctor's help. Save yourself the expense and hassle by instead cleaning your ears regularly with the lather from your shampoo every time you wash your hair. This is a fairly gentle and simple technique that will pay dividends (literally!).
As a general rule, hydrogen peroxide is an irritant. After all, we are using it to kill bacterial cells. Some people have dry or sensitive skin in their ear canals. For that reason alone I would advise someone to avoid putting peroxide in their ears. Beyond that is the case where someone might have a ruptured eardrum. If peroxide were to enter the middle ear, it could cause at best a middle ear infection, and at worse may lead to inner ear damage. This would result in hearing loss and / or dizziness.

The good news is that ear wax is natural and for the most part does not need to be removed. Most people’s ears are self cleaning. People with hairy ear canals, narrow canals or with certain skin types are special cases, and I would not use peroxide in those ears either. Those people need a professional to remove their wax to prevent infections or damage.

Dr. LeBlanc
Put the peroxide in your ear just prior to showering, then irrigate ear in shower. No Q-tips. Do this once a month.