The Q-Tip Paradox: Why do we Put These Things into our Ears?

We all know we’re not supposed to put Q-tips in our ears, but we do it anyway. Why?

Firstly, why aren’t we supposed to clean our ears with Q-tips? I’ve been doing it for as long as I can remember. What’s the damage?

Secondly, if Q-tips aren’t meant to clean your ears, then why do we all do it? If Q-tips weren’t designed for their most popular purpose, how did this unintended use become so popular??

Well, here’s the short version: Q-tips were designed to clean your ears, but later, the company learned that doing so can cause harm. The Q-tip company did promote diverse use cases, but ear care stuck as the main reason people buy them. So there is a conflict of interest putting the company in a precarious position. To the company’s credit, Q-tip packaging now includes the famous “Do not insert inside the ear canal” warning. However, Q-tip’s marketing walked an interesting balancing act to eventually get there.?

Q-tips are the most popular brand of cotton swabs (or cotton buds for those across the pond), but they’re just pieces of cotton attached to toothpicks.

Or at least, that’s how it started. According to Unilever’s Q-tip history page, Leo Gerstenzang, the inventor of Q-tips, saw his wife fasten wads of cotton around toothpicks to clean their baby’s ears. Leo Gerstenzang mass-produced this invention, creating the Q-Tip Company in the early 1920s.?

Fun fact: the “Q” in Q-tips stands for “quality.” Quality Tip Cotton Swabs.?

As you can see in Figure 1, Q-tips were explicitly advertised for cleaning babies' ears. However, they were also marketed to women as a tool for applying and removing makeup.

Ear cleaning was a key element of the Q-tips company’s original marketing strategy. However, in the 1950s, the company broadened its product’s usage.?

“Imagine… stealing Q-TIPS from a baby,” reads the magazine advertisement shown in Figure 2.?

The advertisement depicts family members using said Q-tips. Mom cleans her daughter’s boo-boos with Q-tips. The brother cleans the hard-to-reach mechanisms of his cash register. Oh! And Dad uses Q-tips to get water out from his ears after a swim!

The mid-century version of Q-tip boxes listed “adult ear care” as one of the main uses. Today, that message is replaced with the warning, “Do not insert inside the ear canal.”

The transition away from adult ear care happened so gradually you couldn’t be blamed for not noticing. I couldn’t even find the exact year when the Q-Tip Company added the warning to its packaging.?

The Q-tip gradually shifted away from ear care around the 1970s and 80s. The company never cited a reason why. You might think it was a lawsuit, but I couldn’t find any records citing ear damage from Q-tips.?

My guess is that warnings from otolaryngologists (medical doctors who specialize in the ear, nose, and throat) prompted the Q-tip Company’s caution.?

What’s the big deal? How much damage could tiny little cotton swabs cause?

The vast majority of the medical community agrees that you shouldn’t use Q-tips to clean your ears because they are ineffective and can worsen underlying issues.?

The American Academy of Otolaryngology-Head and Neck Surgery routinely warns against Q-tips. The sentiment is also echoed by the American Academy of Family Physicians and the American Academy of Pediatrics. I mention these prestigious groups so you know it's not just a few overprotective doctors.?

So what’s the damage?

Just think about it from a design perspective. Wouldn’t a blunt object just push the earwax deeper inside your ear??

“But I see the wax on the Q-tip!”

That is true, but as Dr. David Stuz, clinical assistant professor at Michigan Medicine, explains in an interview with the school’s newspaper:

“People don't realize the wax they see on a Q-tip would have come out anyway because the ear cleans itself.”

~ David Stutz, M.D.

Our ears evolved to clean themselves. And that makes sense because wouldn’t chimpanzees (humanity’s closest living relatives), cavemen, and ancient people go deaf from earwax buildup and lack of Q-tips?

In fact, cerumen (the fancy, scientific term for earwax) plays several important roles, such as hydrating the ear canal and protecting your inner ear from infections. The sticky goo captures many foreign bodies, protecting you from bacteria. It gradually migrates toward your outer ear. Along the way, it waterproofs the ear canal, preventing the inner ear from soaking up too much water. But it also hydrates the skin of the ear canal, keeping it healthy.?

Once the nasty ear wax reaches the outer ear, it can be cleaned up with a damp cloth or washed away in the shower.?

Consistently using Q-tips disrupts the ear's natural self-cleaning mechanism, leading to dryness, which leads to itching, which leads to using Q-tips to satisfy said itch.?

It is a self-perpetuating cycle. Q-tips provide a satisfying sensation, like scratching an itch, but doing so will continue the underlying issue.?

Adult ear care with Q-tips does not pose a single considerable health risk but several smaller risks.?

1. Q-tips can introduce bacteria or fungi into the ear canal. Since they also remove protective wax, they increase the risk of an ear infection.?
2. Remember when I said Q-tips often push earwax deeper into the ear canal? Well, earwax buildup can cause cerumen impaction, a painful blockage requiring professional medical attention to remove.?
3. Inserting Q-tips too far into the ear canal can cause internal damage, bleeding, or even hearing loss. Most of you already know that because doing so will hurt. But most kids don’t know their limits and have little self-control. I would say children are probably at the highest risk for internal injuries from Q-tips.?

Question: why aren’t we supposed to clean our ears with Q-tips??

Answer: because they don’t actually clean your ears and can disrupt your ear’s natural cleaning mechanisms.?

But if Q-tips don’t clean your ears, then why do we all do it?

As mentioned, we partly do it because it provides a satisfying sensation.?

We mainly do it because decades of Q-tip advertisements have trained generations of customers that Q-tips are the quintessential ear-cleaning method. The damage from doing so is so far removed that we don’t realize the cause.?

“My mom taught me to clean my ears with Q-tips because that’s how she was taught.”?

This is the part where I legally need to say that the Q-tip Company and its current owner, Unilever, have never explicitly said, “Insert our product into your ear canal.” Technically, it’s perfectly safe to use Q-tips to clean the outer ear, that bowl-like structure of cartilage. So, any advertisements that promote Q-tips for ear care are technically fine.?

Check out this commercial from 1982 (Figure 3) featuring the late Betty White.?

“Just because nobody ever slips on a cotton swab in the bathtub doesn’t mean you shouldn’t be concerned about its safety. This is a Q-tip cotton swab, they call it the safe swab. That’s because Q-tip has a nice, safe, soft cushion of cotton right here at the tip. So they feel nice and soft and safe when you use them on your eyes or on your nose or on your ea— [drops Q-tip] or even when you drop them on your foot.”

I find this balancing act very interesting.

Notice how she stops herself from saying ear? At the time, the Q-tip company was trying to thread a delicate needle: insinuate ear care without explicitly saying so.?

To Unilever’s credit, they now promote the versatile usages of Q-tips and give a warning on the box.

So how are you supposed to clean your ears!??

I always want to leave you better off, so let’s hear from the experts. Full disclosure: I am not an otolaryngologist, so I am just echoing their recommendations.?

As a preventive measure, you can minimize the amount of time you spend wearing earbuds or earplugs. I’m guilty of this habit. Sometimes, I’ll put my earbuds in and forget to even play music. Having a physical object blocking your outer ear prevents earwax from naturally migrating. Over-the-ear protection is recommended for tasks requiring noise protection.?

Dr. Sina Joorabchi from the Broward Center for Ear, Nose, Throat, and Allergy suggests tilting your head in the shower. Tilt it so the shower water flows in, and then tilt your head down so it rinses your ears out.?

You can use Q-tips to clean the outer ear— the bowl of the ear. The Q-tip’s design is well-suited to all those nooks and crannies.?

Most professionals recommend using a damp cloth. Use a warm, damp cloth and your finger to run around the curves of your ear. Your fingers are too big to fit inside your inner ear, but you’ll still wipe up the excess earwax.?

If you’re experiencing an uncomfortable buildup, you should probably make an appointment with a specialist. A few home remedies are recognized as functional and safe by professionals, but try them at your own risk.?

You can use a syringe to drip a few drops of solution into your ears to soften the earwax. You can use:

• Medical-grade olive oil
• A 1 part baking soda and 1 part sterile water solution
• Diluted hydrogen peroxide (you only need 3% hydrogen peroxide)?
• Or warm water.

Once you drop your solution of choice into your ear, lie down with that ear facing up for 5 to 30 minutes. That gives the solution time to soak in. Then you can try irrigating.?

Irrigating in this context simply means removing the earwax. You can use a bulb syringe to suction the loose wax out. You can lie on the other side for a while and let gravity work.

In conclusion…

When I set out to write this article, I thought I’d only need 750 words. But this article doubled that word count! Who knew there was so much to Q-tips??

If you’re curious about something and would like me to write on it, drop a suggestion below. I’d love to hear your thoughts.?