 ALEXANDRIA, VA— An updated clinical practice guideline from the American Academy of Otolaryngology–Head and Neck Surgery Foundation published today in Otolaryngology–Head and Neck Surgery provides evidence-based recommendations on diagnosis and treatment of earwax (cerumen impaction) as well as important patient information on the dos and don’ts of earwax and healthy ear care. “People to want to clean their ears because they believe earwax is an indication of uncleanliness,” Seth Schwartz, a Washington state-based otolaryngologist who chaired the review, said in a statement. Our usual jaw motions from talking and chewing, along with skin growth within the canal, typically helps move old earwax from inside to the outside the ear, where it is washed off during bathing. Cotton-tipped applicators can compact the wax and push it deeper into the ear, making it harder to remove. Although it’s oddly satisfying to swirl out a gob of earwax like cotton candy, doctors have found that the process usually ends up pushing earwax further into the ear canal, where it can unnaturally clump together. “Anything that fits in the ear could cause serious harm to the ear drum and canal with the potential for temporary or even permanent damage.” 
 
 Impacted earwax can cause symptoms like ear pain, itching, feeling of fullness in the ear, ringing in the ear (tinnitus), hearing loss, discharge coming from the ear, odor coming from the ear, cough, and/or change in hearing aid function. Excessive cleaning can irritate the ear canal, cause infection, and even increase the chances of excessive buildup, or what’s known as cerumen impaction, the guidelines note. “The mantra from previous generations of ‘don’t stick anything in your ear that is smaller than your elbow’ still applies,” said Dr. Duane Taylor, chief executive officer and medical director of Le Visage ENT and Facial Plastic Surgery in Bethesda, Maryland. Cotton swabs, hair pins, care keys, toothpicks…these can all injure your ear and may cause a laceration (cut) in the ear canal, a perforation (hole) in the eardrum, and/or dislocation of the hearing bones, leading to hearing loss, dizziness, ringing, and other symptoms of ear injury. If you choose to make any health-related resolutions for 2016 that don’t involve dieting or exercising more, these are some good starting points: There’s no evidence that using ear candles, a process that relies on heat to remove buildup, actually works at clearing impaction, and this can cause serious damage to the ear canal and eardrum, the guidelines also emphasize. Patients should see a doctor if they experience hearing loss, pain or feel fullness in their ears or aren’t certain whether the amount of wax is normal. The guideline definition of "too much" is an operational one: If you have symptoms -- such as pain, drainage, bleeding or hearing loss -- then you have a problem. While new randomized trials have been included, "nothing very dramatic" has changed, other than an improvement in the methodology itself, said Schwartz: "The process has become a little more transparent in the way we actually write the guidelines now. "We really have come to appreciate that clinicians are not the only users of (the guidelines), that patients are really interested in their own care and people are really taking ownership of their own care," said Dr. Seth Schwartz, chairman of the guideline update group for the academy.
– There's a reason Q-tips come with a warning to never use them in your ears—and it's about time we heeded the advice, says the American Academy of Otolaryngology. The academy's new guidelines for dealing with earwax, the first in almost a decade, stress that the wax is as beneficial as nose mucus or eyelashes and should be left alone as much as possible. While it might seem icky, earwax traps dirt, dust, and other stuff that might get into our ears; the wax is slowly pushed outward by new skin growth and jaw movement and washed away with normal bathing, reports Reuters and CNN. That means there's no reason to get rid of earwax with cotton swabs, your finger, or any other tool. Doing so is actually a really bad idea. You might "push the wax in further, and there also is the potential for damage to the ear drum," says Dr. Seth Schwartz, who helped draft the new guidelines. You might also scratch the ear canal, which "can lead to pain and infection," he says. "Wiping away any excess wax when it comes to the outside of the ear is enough to keep it clean." Doctors say you should seek medical help if your ear feels full, painful, itchy, or if you're experiencing hearing loss, drainage, ringing in the ears, or bleeding, rather than using a cotton swab to poke around. In fact, they say you shouldn't put anything smaller than your elbow in your ear—including ear candles, which are supposed to remove wax with heat, though there's no evidence they really work, per Quartz. (It turns out your earwax says a lot about you.)