Ear cleaning: how can you prevent infections?

The ear’s natural mechanism

This process, known as epithelial migration, is continuous and silent. It allows the ear to naturally rid itself of cellular debris, dust, and microorganisms, provided this process is not disrupted. Chewing, yawning, or simply moving your jaw helps push these foreign particles outward.

This is why, in the vast majority of cases, the ear does not need to be thoroughly cleaned. Only the outer ear and the visible part of the ear canal require regular attention.

However, symptomatic earwax plugs remain a common reason for visits to general practitioners and ENT specialists. They affect about 6% of the population and up to one-third of people who wear hearing aids.

In the vast majority of cases, they are the direct result of clumsy self-cleaning attempts, not excessive earwax production.

The importance of good daily ear hygiene

Proper ear cleaning helps prevent most uncomfortable situations: excessive earwax buildup on one hand, and outer ear infections on the other. These two problems are often the direct result of cleaning too frequently or improperly. In fact, by trying too hard to clean your ears, you end up creating a local imbalance and disrupting the ear's natural equilibrium.

Earwax, that yellowish substance we instinctively try to remove, isn’t dirt. It’s a secretion produced by the ceruminous glands located in the outer third of the ear canal. It plays several essential roles:

• Mechanical protection: it traps dust, debris, and small insects before they penetrate deeper

• Antimicrobial action: its slightly acidic pH (between 6 and 6.5) and its lipid components naturally limit the growth of bacteria and fungi in the canal

• A lubricating role: it prevents the skin of the ear canal from drying out, thereby avoiding itching and micro-cracks.

There are two types of earwax, determined by genetics: wet earwax (orange-brown in colour, more common in people of European or African descent) and dry earwax (grey or beige, more common in people of Asian descent). This difference is due to a polymorphism in the ABCC11 gene and has no impact on hearing health. It is simply a genetic trait.

Excessive or insufficient earwax production may indicate a local imbalance. But in most cases, earwax production is physiological and beneficial. By systematically disrupting it with a cotton swab, we deprive the ear canal of its first line of natural defence.

Inserting a cotton swab into the ear canal is one of the most counterproductive things you can do. Here are the main consequences:

• The formation of an earwax plug: the cotton swab pushes the earwax deeper into the canal instead of removing it, gradually compacting it until it forms a plug. This will require a doctor’s visit if the plug is too large

• Irritation of the ear canal: The walls of the ear canal are very thin and sensitive. Repeated rubbing can cause micro-lesions, creating an ideal entry point for bacteria

• Risk of eardrum perforation: In the most severe cases (sudden movement, unexpected impact), inserting an object into the ear can cause a painful eardrum perforation. This is a reason for emergency medical attention

• Otitis externa: disruption of the natural flora and the protective layer of earwax can promote the development of otitis externa, a bacterial or fungal infection of the ear canal. You should then consult your doctor to receive appropriate treatment

• Chronic itching: By systematically removing the protective earwax, the ear canal dries out, causing itching. To relieve this itching, our instinct is to scratch. This mechanically removes fragments of skin that protect our ear canal. This perpetuates the itching, requiring more scratching and leading us into a vicious cycle... Don’t hesitate to consult a doctor if needed

The golden rule: do not insert anything into the ear canal. The recommendations from otolaryngology specialists are clear on this point. But here are a few appropriate steps to safely clean your ears according to current guidelines.

• For the outer ear: A simple damp washcloth is sufficient to clean the outer ear and the area around it. Dry thoroughly after showering to avoid any residual moisture

• For occasional visible excess earwax: if earwax is visible at the entrance to the ear canal (without having to go deeper), you can gently remove it with a cotton swab placed on the outside, without ever pushing it inward

• If you experience hearing discomfort: a seawater-based ear spray or saline solution can help soften the earwax and facilitate its natural expulsion. These products, available at pharmacies, are well-tolerated.

What you must absolutely avoid:

• Inserting cotton swabs into the ear canal. They can be used to clean the outer ear, but should not be inserted further

• Ear candles. The medical community strongly advises against this practice. For one thing, its effectiveness is not backed by scientific evidence, and there is a real risk of burns

• The use of unsuitable or improvised objects. Do not use sharp objects or other improvised items, even to remove earwax

• Using a showerhead is also a bad idea, as it puts pressure on the eardrum, risking perforation

Special cases:

• For hearing aid users: Prolonged use of a hearing aid reduces ventilation in the ear canal and can promote the buildup of earwax. More regular checkups with a professional are recommended

• For regular swimmers: water remaining in the ear canal after swimming causes maceration and weakens the skin. Earplugs designed for swimming help limit this issue. In cases of recurrent otitis externa, custom-moulded earplugs may be prescribed

• For children: A child’s ear canal is more horizontal and narrower than an adult’s. Any ear hygiene practices must be performed with particular care and limited to the outer ear. Be mindful of the child’s movements while cleaning their ears to minimise the risk of pushing the cotton swab deep into the ear canal.

Certain symptoms should raise a red flag and require a medical consultation:

• Pain inside the ear or when pressing on the tragus (the small piece of cartilage in front of the ear)

• Sudden hearing loss or a persistent feeling of a blocked ear

• Discharge of fluid (clear, yellowish, or pus-like) from the ear canal

• Intense and persistent itching in the ear canal

• Ringing (tinnitus) or a sensation of fullness or persistent blockage

• Fever associated with ear pain in children.

These symptoms may indicate otitis externa (an infection of the ear canal), otitis media (an infection of the middle ear, behind the eardrum), or a wax plug. Only a healthcare professional can make a diagnosis and assess the urgency of the situation.

Prevention relies on a few simple steps to incorporate into your daily routine:

1. Do not insert objects into the ear canal: regardless of the object’s size or shape

2. Dry your ears thoroughly after swimming or showering: tilt your head to each side to help water drain out, and dry the outer ear with a soft towel. Excess moisture is the main factor contributing to otitis externa

3. Wear appropriate earplugs when swimming: if you are prone to infections, and opt for models designed for this purpose (silicone, swimming earplugs)

4. Consult a healthcare professional: if you wear hearing aids: prolonged use of these devices reduces ventilation in the ear canal and can promote infections

5. Do not use ear sprays without medical advice: if you have a perforated eardrum or are unsure of its integrity: a perforation may be present without any apparent signs

6. Report any earwax blockage to your doctor: for proper medical removal (irrigation, suction, or manual removal with instruments).

Beyond preventing infections, a few habits can help maintain good ear hygiene over the long term:

1. Clean only the outside: Clean the outer ear with a washcloth or your fingers every time you shower. No intervention is necessary inside the ear canal unless you experience discomfort

2. Follow a gentle routine after swimming: After each swim, tilt your head to the side and gently pull the earlobe downward to help water drain out. Dry the outer ear without rubbing

3. Have your ears checked regularly: If you wear hearing aids or are regularly exposed to noisy environments (construction sites, concerts), an annual checkup with an ENT specialist or general practitioner can help detect any problematic earwax buildup early on

4. Protect your ears from noise: wearing hearing protection in loud environments (amplified music, power tools) not only preserves your hearing but also protects the integrity of the ear canal

5. Avoid using excessive force when drying: Rubbing vigorously with a towel or your finger can irritate the ear canal. Gently patting the outer ear dry is sufficient

6. If you wear earbuds: clean them regularly with a slightly damp cloth. Dirty earbuds can introduce bacteria into the ear canal and contribute to ear infections.

Any product intended for the ear (ear spray, cerumen-dissolving solution, oil) should be used only if the eardrum is intact. If in doubt, consult a doctor before use. People with a perforated eardrum, who have undergone ear surgery, or who have an active ear infection should refrain from any self-treatment of the ear and consult their doctor.

In children, never attempt to remove a foreign object or earwax plug yourself: always consult a healthcare professional.

The ear is one of the few organs in the body that takes care of itself, provided we let it. The habit of using cotton swabs is deeply ingrained in our routines, but it does more harm than good in almost all situations. If you experience no hearing discomfort, pain, or discharge, your ears likely need nothing more than to be dried thoroughly after a shower.

Camille specialises in writing content on the topics of beauty, health, and natural well-being. Passionate about these subjects, she writes articles for major media outlets to help everyone look after themselves in a natural and holistic way.