Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

Q-Tips – Weapons of Ear Destruction?

A week does not pass where I have the opportunity to chastise yet another injured Q-tip user on the Ear Disorders Board or in my own clinic. I had two today, including one admitted bobby-pin user. I have a well-deserved reputation of being a venomous and unsympathetic opponent of using Q-tips in the ear, so I thought this topic deserved another blog post.

Now, I use the term Q-tip, a brand name and registered trademark of the Chesebrough-Pond/Unilever Company, and makers of Vaseline and other slick products, in the generic sense. Since Q-tips are a lot easier to say than “cotton-tipped applicators”, I will use this term. There are certainly other manufacturers of cotton-tipped applicators out there, but none with eighty years of manufacturing experience.

I always thought that the Q of Q-tip meant “quick” since others have chosen to bastardize this fine brand name in this fashion. I was surprised to discover that the Q actually means “quality”. Strangely enough, I also discovered that Q-tips used to be called Baby Gays; a name given to this product by its Polish inventor (I’m not going there) that would not be considered politically-correct marketing today.

Let me say up front to ward off the lawyers of this fine company, that it is not the Q-tips that are the problem. It is the USERS of the Q-tips that I wish to address. Q-tips do not harm people; people harm people.

I wish that I had a box of Q-tips to check my facts, but I have been told that the company has a warning on the box not to use them INSIDE the ear. That is a very good and responsible statement. Unfortunately, few people read the box or heed this warning.

I found the following statement on their Web site:

“Q-Tips cotton swabs have more cotton at the tip* than any other swab, making them the safest, softest and gentlest tool you can use for family care. They also provide the ultimate precision, making them the perfect tool for uses outside your ear.” (I added the italics to the word, “outside”).

Human beings have been digging around in their ears since the Dawn of Time. I bet even selective-hearing Adam was cleaning out his ears during God’s “Don’t eat the apples” lecture. Museums have examples of ivory and gold ear spoons that date back thousands of years. When I was visiting Japan a few decades ago, a cute little Japanese girl handed me a sample of a modern, disposable ear spoon. That’s what the world needs: another product that can cause potential harm.

We can blame some of this stuff on our parents and our parent’s parents and so on. They were the ones that started the rumor that earwax was bad stuff that had to be removed, like toe jam or a booger hanging out of your nose. They could not have been more wrong.

While excess, hard, or obstructive earwax can be problematic, most earwax (cerumen) is infinitely more beneficial. It is a normal, protective coating for the sensitive skin of the ear canal. A canal coated with ear wax will repel water and help prevent external ear infections. When you dig it out like some demented gold miner, you leave your ear very vulnerable.

Since we do not have the ability to look inside our own ears at the present time (you can buy a video otoscope for under a thousand dollars if you want), most Q-tip users blindly probe around looking for yellow, often getting red instead. Many will look at their wax-stained swab with pride and admiration of a job well done. Eventually, they will go too far and injure or rupture their eardrums. If it wasn’t for pain and blood, I suspect that some people would excavate around until they pulled out little bones or brain tissue. Perhaps, many have already done that.

Q-tips are not unlike the plungers used to load cannon. They can pack softer wax deeply in the ear canal against the eardrum. By creating a formidable plug and preventing the eardrum from moving normally, it is quite easy to cause some significant hearing loss. Water can also be trapped behind these self-created wax dams and entertain you by constant sloshing around. When this happens, the ear will need to be lavaged — washed out by a gentle stream of warm water. Or, you will need to see your medical provider, someone that CAN look inside your ear and remove the impaction professionally.

Chronic Q-tip use creates dryness in the sensitive ear canal. Dry skin itches. People with itchy ears use Q-tips (and other found objects) to scratch them. The scratching causes itching. Do you see the cycle here? Eventually, the damaged skin will break down and crack, allowing opportunistic bacteria or yucky fungus to invade. Congratulations. You have caused otitis externa, also known as Swimmer’s Ear.

Speaking of swimmers, chronic water exposure can wash out all of the protective wax, too, causing the water to remain in the ear canal. In order to remove the water, people will use Q-tips, or put drops of drying alcohol in the ear canal, often making the matters worse. I recently tested a new product called DryEar, a portable/rechargeable ear dryer. I loved it. It blows a gentle stream of warm air into the ear canal to dry out that trapped water.

There is absolutely nothing wrong with Q-tips; a fine, well-made product. They have hundreds of clever uses. As long as you don’t put them INSIDE your ears, they are a safe product. In the hands of idiots, they are true Weapons of Ear Destruction.