"You may've heard the expression, 'Don't put anything smaller than your elbow in your ear!' That expression comes recommended by the American Academy of Otolaryngology. Yet, I routinely see patients use cotton swabs, or other tools – such as bobby pins, in their ears," Nurse Practitioner Elena Tansy, said.

To scratch an itch, remove wax or just dry the ear canals after showering, people often shove objects into their ears. However, what many may overlook is a warning clearly printed on the cotton swab box. 'Do not insert swab into ear canal. Entering the ear canal could cause injury. If used to clean ears, stroke swab gently around the outer surface of the ear only.' 

"Turns out, that warning label is not just to prevent customers from suing the company for damages – it happens to be valuable medical advice," Tansy said.

Inserting cotton swabs, or anything else, into the ear canal is one of the leading causes of ear wax (cerumen) impactions, external ear infections and perforated ear drums. It can also dislocate the ear bones (ossicles), causing a conductive hearing loss.

"Moreover, ear wax is actually quite beneficial to the body and protective of the external ear canal," Tansy said. "Wax kills bacteria. It hydrates the skin of the external ear to prevent it from becoming dry, itchy and flaky. It's sticky, which allows it to capture any debris or foreign objects entering the ear canal and then carry it naturally out of the ear. Left to its own devices, ear wax can migrate naturally out of the ear canal and into the bowl of the outer ear, where you can use a washcloth to clean the external portion of the ear."

As an Ear, Nose and Throat clinician, my recommendations are as follows:

• Avoid inserting any objects into the ear canal.

• If you feel you have excessive ear wax that seems stuck in the ear, use DeBrox wax softening drops, available over-the-counter; without a prescription. Follow the manufacturer's instructions for use.

• If you have itchiness, drainage or other concerns, call to schedule a consultation with an Ear, Nose and Throat provider for professional removal of wax, treatment of infection or eczema of the external ear canals.

Elena Tansy, NP, with Union Medical Group treats a wide range of ENT and allergy disorders in adults and children with advanced medical training in conditions affecting the ears, nose and throat. You can schedule an appointment with her by calling 812.242.3170.