I'm a doctor, but I'm not here to take sides on the Q-tip issue.
I'm here to clarify how many (but not all) of us use medical research: the "pyramid of evidence."
The idea is that I rely upon the best available evidence, which (roughly in order) is: meta-analysis, randomized controlled trials and other prospective data, retrospective analyses, expert consensus, and (finally) clinical experience.
This is rough because there are good critiques of meta-analyses as a tool, the available data may be a bad fit for that patient, research biases, etc. A big one is that many questions don't have a big commercial upside, so nobody will ever fund a good prospective blinded trial. Which takes us to the last point: absence of evidence is not evidence of absence. Just because all the of the studies about Q-Tips are low quality doesn't mean a better study would find something different. We don't know the answer to that, and that would be a big assumption to make.
So, sometimes the best available evidence is not statistically ironclad. It falls on us to use a reasonable approach about how hard a line to take. Some do a better job than others.
That was long and rambling, but hopefully it helps to clarify some misconceptions. As an applied science, we have to go with the data we've got, which is almost always not an ideal fit for the patient in front of us.
Regarding the commercial upside: Wouldn't q-tip manufactures have an incentive to prove using q-tips is, in some way, beneficial? In the case there is no benefit, but it's unclear if they are harmful, for what purpose do they serve? At least with respect to human anatomy. Q-tips have other applications, like cleaning electronics, but I am considering those uses not germane here.
I'm someone who naturally produces a lot of ear wax. I don't think people really appreciate just how unpleasant it is. After it builds up past a certain point, sounds become distorted and it's hard to decode individual words. It can often be extremely itching and irritating.
When i was young my doctor would repeatedly sternly talk to my mother that she must clean my ears out, as the doctor thought she was ignoring me and/or my ears.
She cleaned them regularly. I was a ear wax machine, to an absurd degree.
Luckily as an adult they're pretty normal...i assume. But i still clean them after i get out of the shower since i dislike the feeling of water in my ears.
Exactly this. Use a syringe and inject hot (but not too hot) water into your ear with your head tilted. Do this a couple of times. Then you should use a paper tissue and your finger to get it out what you can. Repeat.
I dunno if this is a good advice, but it worked every time I got excessive build-up.
Some people just tilt their head to the right side in case it is their right ear and aim the shower head at their ear for some time. Sometimes it can just "fall out" (really, seen it happen!). Regardless, I just do the syringe one and paper tissue + finger.
Thank you for this recommendation. My ears have been acting up again, so I ordered this as soon as I saw your comment. It took a couple showers, but I can hear again! This thing works.
I absolutely agree to that. However, the boxes of all brands I've seen state to not use inside the ear. I skull-fuck myself almost daily (unless I run out) and my doctor merely praises me for having such clean ears. Even if I go weeks without using a Q-Tip in the ear, they still come out only barely dirty. I mostly just do it because it feels great. I can understand how if you have thick wax buildup it could be packing the wax deeper in, but for me that's not the case. When I insert the Q-Tip, I feel the cotton making direct contact with skin the whole way in.
I'm the same as you, but the past two three years, my ears dry from using a q-tip. I literally start to have cracked dry skin and bleeding in my ear canal from excessive q-tip usage and these days I can't even use them weekly without issues.
I have never felt the need to scoop anything out of my ears. And I don't see anything visible from the outside of the ear that would need scooping. I assume any wax further in the ear probably belongs there as defensive barrier.
I never do either, until I grab a pair of in ear headphones and recoil in horror at the globs of ear wax that they yank out. I have actually killed apple earbuds like that from clogging up the mesh barriers with wax. Regular maintenance keeps that from happening.
I always operated under the assumption that it was just safer for them from a liability standpoint. Between the risk of somebody unable to properly handle the physical feedback loop and/or respect for their anatomy required to safely clean one's ears, the risk of a strand of cotton getting stuck in some wax and somehow turning into a weird infection... just a lot to go wrong.
People still buy them for cleaning their ears, so at least a subset of their sales are not research dependent. One cynical hypothesis would be that they tried to prove they were beneficial, failed, and that’s why we have an absence of research to that point.
It also could be just as the original poster mentioned, maybe no one has really felt like the investment to ask the question would be worth it.
Doing a good research study would be expensive. At the end, people would either: see a good outcome, and keep doing what they're doing (sticking Q-tips in their ears), or a bad outcome, and buy fewer Q-tips.
I think this understates how many people could be avoiding q-tips because they're potentially bad. A good outcome of a study could have a material impact on sales.
I honestly doubt it. The unpleasant sensation of having my ears filled with goop is far stronger than any caution advised on the package. And those who don't experience this don't have a reason to use them, even if they are advertised as safe.
Soon after I moved to Vietnam, I discovered "ray tai" through a friend there. Nearly every barbershop has this service. I nicked named it the 'eargasm'. It is one of those things foreigners can't understand, but once you try it... omg... so good.
You sit in a chair or lay down on a table (my preference) and someone who does this all day long, puts a bright light near your ear and uses a razor to cut off the hair on the outsides of your ears (if you have any) and then uses a bunch of different tools [0] to extract out all the ear wax and anything else in there. I always come out feeling like my hearing is more 'clear'.
They literally touch your eardrum and the feeling is somewhere on the edge of uncomfortable, but oh so good at the same time. At the end, they use a very fuzzy q-tip and it makes this wonderful noise and feeling.
Of course, I've heard horror stories about this not going well. Punctured eardrums, infections, etc... but the fact is that literally millions of people every day get this service in Vietnam. You see people all over getting it in shops. You also learn quickly that if you don't like something, move your head away and they stop immediately.
If you get this often enough, you should purchase your own set of 'tools' (about $4-6) that you carry with you and have them sanitize them each time before use. I went to a whole bunch of different people and eventually found a few places that I liked a lot. For the most part the service is the same all over, but everyone has their own unique different technique too.
I once woke up at 3:30 in the AM to the sensation of something crawling on my face. I sat up quickly and attempted to brush it off, but missed and the thing dashed into my ear. It went all the way in and nestled up to my ear drum. After getting over the initial uncertainty of not knowing whether it was that kind that bites, I thought I'd hang tight until the urgent care facility opened at 8:30 and have them take it out. But it moved around frequently, which made a significant sound as it rubbed against the tympanum, so there was no way I was going to sleep.
Yes, it is as unpleasant as you imagine it would be.
I couldn't stand the various maladies I dreamed up that might befall my hearing and after about an hour, I drove myself to the emergency room.
Here's where it's relevant to the story. At first, they couldn't see it with their otoscope, so they cleaned my ear out. In order to open space for a better look, they scooped out a disturbingly large amount of ear wax. I was surprised at this, as I do use Q-Tip daily and couldn't imagine that I'd missed that much wax when cleaning (I hadn't, Q-Tip doesn't reach there). And I'd recently had a full audiologist exam that found no issues. I asked the Dr. about it as he was locating the bug and he said that actually, the earwax in the ear canal is part of the body's protections against germs & viruses, and the amount removed was typical. Once the wax was out, he could see the thing.
They then 'paralyzed' it by squirting in an anesthetic so it wouldn't cling to my ear canal, then washed the ear out, and the bug came out.
$1,850 lighter, I headed home.
So. Learning that I could have had an eargasm and saved that small fortune, well, it's good to know for next time I'm in Vietnam with a bug in my ear.
For those who absolutely have to know... it was a silverfish. Ick.
1) For a PCP that does ear cleanings, you could have done that for peanuts. I used to know an FM guy who would do it regularly for patients (maybe a touch too regularly).
2) Heh, it's actually a standard board exam question about "homeless guy comes in with scratching in one ear." The official answer is that you /don't/ scope first, because if it's a roach, the sudden light can make them scrabble deeper. Which is actually funny, since different bugs respond differently - there have been case reports where people have reported repeated success with taking the patient to a darkened room, opening the ear as much as possible, and having a light pointed near the outside of the ear - luring the bug to crawl out on its own.
Actually, on second thought, I don't know if it's a "standard" board question. Rather, it was something I studied for boards once upon a time. I'm not in EM/FM, so it's not something I've ever had come up again.
I’m not a doctor but listening to the Meat Eater podcast with Steve Rinella they mentioned talking to a doctor about this. One simple and effective method for killing the bug is to use a non-toxic oil to drowned the bug. Once dead one can flush out the oil and the bug.
Never had a bug in the ear, but I remember someone telling me that if it ever happens to dilute some isopropyl or peroxide and pour it in there. I sure wouldnt want to spend $2k; anyone know if this method is the most reliable to use at home?
I have issues with wax covering my eustachian tube and so I do exactly this - it loosens up the wax and allows whatever process moves it to the outer ear to work better.
would certainly try this before anything else. I use 1/4 3% peroxide, 1/4 70% isopropyl, and 1/2 water - if its too strong it will be uncomfortable.
South-East Asians have 'dry' earwax, as determined by the ABCC11 gene. This is the same gene that makes their sweat have no odour. Just because Vietnamese people go around with sweaty shirts, doesn't necessarily mean you should... And just because they get their ears cleaned, doesn't mean you should.
The Wikipedia article for ear picks implies that it is necessary because of the dry earwax type. The source says:
> Dry wax, most common in Orientals and Native Americans, is gray and dry. It is flaky and may form a thin mass that lies in the ear canal.
After living in Vietnam for 4 years, I can guarantee that at least some of them have odor.
I have quite clean ears already, but usually what I see removed (they put it on the back of your hand usually) is flaky dry skin. That said, I go for the eargasm experience more than the ear cleaning itself. It is a nice relaxing thing for me and fits into the culture of grooming there.
There is something in China with airwax treatments and I just heard too many negative stories from foreigners even though Chinese people do it a lot, to not try it. It is just really sensitive equipment up there: not sure what works and what does not.
I wonder if this has anything to do with Asian's having a dryer/waxier ear wax? Not something I know much about but I remember learning about it in an anthropology class.
Given the proximity of China to Vietnam, pretty much anything that comes from China is also done in Vietnam. ;-) Who started it is always up for debate as a favorite pastime.
I had this procedure done (also in Vietnam) and found it highly unpleasant. It was like tickling/scratching deep in my ear canal, and left my ears uncomfortably sensitive, painful, and itchy for 24 hours; fortunately I didn’t get an infection. My companions at the salon had no such issues. Other commenters have remarked on genetic differences in earwax consistency; perhaps that’s the reason I found it so awful.
I don't know why you're getting down voted. My friend who introduced me to ray tai also gets that. Sadly, that one crossed a squeamish line for me, but he swears by it.
It is one of the 'standard' grooming things that you can take advantage of se asia. Grooming is really common because it is so inexpensive. Why cut your own toe nails when you can have someone who does it all day long do it for $2?
Never tried it so can't say about it. Regarding ear wax, I have a friend who is a musician. Since he was frequenting loud rehearsals his hearing begun to deteriorate but it was so gradual that it took him a while to realize he was loosing his hearing somewhat so he decided to got to an ENT. The ENT removed a large ball of wax from each one of his ears and his hearing went back to normal after that. It is possible that the ear wax was building up to protect his hearing from the loud environment he was in.
"Loud noises do not cause the ear to produce earwax as a protection mechanism. Instead, earwax secretion is triggered by physical contact. This means that people who wear in-ear headphones, earplugs or hearing aids are more likely to find an increase in earwax. For loud noises to stimulate earwax production, it has to produce significant sound waves that trick the ear into thinking there is physical contact. However, for this to occur, the noise would have to be so loud it would cause permanent damage to the eardrum as well as excruciating pain."
I personally get quite waxy when I listen to loud music. I never let it build up but immediate notice more wax than usual. Oh, and I use over-ear headphones. I tend to believe that frequent lound sound could produce waxy buildup, whether it is for protection or not I have no knowlede of but I am open to the possibility
Interesting. I religiously wear earplugs every night for sleep and haven't found an increase in earwax. I also tend to have pretty clean ears, not much comes out that is visible. I clean my ears with q-tips, every day after my shower so maybe that is part of it.
So neat how everyone is different in this relatively small regard.
There are many things that doctors do not recommend because they don't believe the average person can use it correctly.
For example, a doctor prescribed two medications (A, B) to take twice per day. Yet there is an alternate medication (C) for one of them (B) that can be given 3 times per day, which reduces blood level fluctuations resulting in better symptom management. She told me that they don't usually prescribe that one because they don't trust the parents of their patients to correctly administer one drug only twice per day (A) when giving the other drug (C) 3 times (they are worried about overdoses of the twice daily medication A).
> There are many things that doctors do not recommend because they don't believe the average person can use it correctly.
> ...She told me that they don't usually prescribe that one because they don't trust the parents of their patients to correctly administer one drug only twice per day (A) when giving the other drug (C) 3 times (they are worried about overdoses of the twice daily medication A).
I wonder if they're not even worrying about "the average person", but a kind of "lowest common denominator" person. Depending on how severe an "overdose" is, that might be totally the right call. Even if only 1 in 100 patients would mess up and OD, prescribing the less-effective combination would actually end up helping a lot of patients.
IMHO, software engineers also end up infantilizing their users with similar "lowest common denominator" thinking, but usually with less justification.
Have you ever dealt with support tickets or read "normal" user forums for a consumer product that you work on? PEBKAC is often times a kind way to describe the problem.
Now engineers can (& do) get the analysis wrong (the famous "I can't send e-mail more than 500 miles). I don't think it happens with any less regularity than doctors. Thankfully our problem domain allows us to adjust the guard rails for a problem domain, or build better guard rails.
> Have you ever dealt with support tickets or read "normal" user forums for a consumer product that you work on? PEBKAC is often times a kind way to describe the problem.
I totally understand that, but I think it's far less justifiable to design non-safety-critical systems for a brainless lowest common denominator user than it is for things that are arguably safety-critical (like the dosing mentioned in the GGP), because then you end up with something like a world where the only books available (even to adults) are children's books.
Users also want free support. The more knobs you add the more complex your support becomes (both front line and automated tests) and your support costs skyrocket (now 1% of your users are turning on knobs you haven’t tested and those are 30% of your support costs). There’s a balance to be struck for sure and OSS can some times try to ignore the support cost because it’s just “spare time”. There’s still a cost though.
There’s also something to be said for sensible abstractions. Even if the power users don’t have the control they want, the solution works for 90% of all other users. For an example of this look to Apple. They regularly sacrifice the power users for the security and convenience of the general customer. From a profit, support and just pure “% of satisfied users” that’s the right balance. Don’t get me wrong. They don’t get it right for every single little thing, but in aggregate when there’s a conflict and your market is the “general” user, trying to stay appealing to the power users is still likely the wrong choice.
> There’s also something to be said for sensible abstractions. Even if the power users don’t have the control they want, the solution works for 90% of all other users.
There's something to be said for writing some things in some kind of Simple English [1], but it's quite different to take the position that most things should be written in it. Too often modern system designers seem to take something analogous to the latter position.
IMO this is infantilizing is completely justified in many fields, but not all.
Ignorant people are like children, infantiles. And we are ignorant in different things, by in many things. There's a reason you infantilise infantiles, do you not?
Exactly. Anytime you are giving guidance to the public, you need to factor in that the average punter is capable of incredible feats of stupidity or craziness.
If you've had issues with your ear, you'll know that many treatments sound alot like the problems describe. People with lots of issues will have a procedure where they cut the eardrum and insert a tube. Or have a vaccuum or waterjet pull out earwax.
Are there people who will compulsively clean their ears and cause a buildup of wax? Probably. The only difference between that and people who damage their teeth or nose by picking is that they are using an implement to do so.
I believe an example is the use of alcohol to delay the onset of frostbite, at the cost of hastening the onset of hypothermia. Given the later is more immediately lethal and is accompanied by a loss of rationality, it would be irresponsible for doctors to admit that the vasodilative effects of alcohol will stave off frostbite by increase bloodflow to extremities (the same effect that hastens the onset of hypothermia.)
For prescriptions that are pills, I'd like to see a smartphone/tablet app to help with things like that.
At the simplest, it would just remind me when it is time to take pills and tell you which pills to take. That could help with the confusion of having pill A on a twice a day schedule and pill C on a thrice a day schedule.
Better would be if you could also show the app your pills using your device's camera when you first start a new prescription. Then when you take your scheduled doses you could show the app what pills you are going to take and it could check that you have the right number of pills and they are the right colors and shapes and sizes.
For anybody who actually deals with earwax buildup issues, the Debrox ear drops they sell at Target/Walgreens/CVS along with the irrigation bulb/warm water will resolve the issue in about 10 minutes. Keep your head tilted and enjoy the strange bubbly sound. Make sure you make the water lukewarm, closer to skin temperature before you spray it in your ear (if it's too cold, you'll be dizzy for 10 minutes). I've had temporary hearing loss resolved with this before.
When I was a kid, I used to get chronic ear infections. At some point, they did some testing that involved forcefully streaming cold water into my ear. As you stated, it made my head spin something serious.
As an adult I got a cholesteatoma in that same ear, which is probably directly related to the issue that caused so many infections in my younger days. I had surgery to remove it, and now I have to visit the surgeon once a year for ear cleaning because that ear doesn't self-clean so efficiently anymore.
I have to use oil drops the night before so it isn't painful. I really dislike getting it done, but it sure feels better afterward.
I've tried those effervescing concoctions, and I'm not convinced they actually do very much at all. It does sound really cool though.
Incidentally, Debrox is carbamide peroxide, which is basically equivalent to hydrogen peroxide. Debrox is $11/oz on Amazon, while hydrogen peroxide is around $.50/oz.
I've tried substituting peroxide contact lens cleaner with the cheap hydrogen peroxide and while I made sure the concentration was the same, the feeling in the eyes was much rougher. I'm not sure if the optical peroxide goes through another process.
For something that's not often done, $11 isn't too bad for not having to play chemist.
I used to use Q-tips all the time because my ears were always itchy from the earwax (ew, sorry.) My doctor told me the q-tips were irritating the inside of my ear, and that's why they were itchy. I stopped using Q-tips, and after a few months the itching went away. shrug ymmv.
My understanding [please correct me, I'm not a doctor] is that it's recently come to light that there is very, very little evidence, if any, that salt is bad for you (aside from people with certain heart conditions), yet the whole medical profession loudly proclaims that salt is in general bad for you.
Regardless of whether future evidence may demonstrate that salt is bad for you, or that q-tips are bad for you, this sort of thing seems to be the medical field's version of the urban legend. Everybody believes X because they heard someone else -- maybe a professor at school -- stating it, but ultimately it has little scientific basis, and it takes years to root it out. I wonder how often this happens, and what can be done to counter it.
Actually, blood pressure is the determiner of whether high intake of salt is bad for you.
High sodium intake is only associated with increased risk in people with high blood pressure. However, having too little sodium is associated with increased risk regardless of blood pressure. Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
It's not about mechanically causing build-up or impaction. It's about not disturbing the natural cerumen flow (epithelial migration).
Cerumen will thinly coat the ear canal to protect it. When you mess with that flow, you create little build-ups, kind of like road traffic. This accumulates and create the equivalent of a traffic jam.
This is also why Q-tips users swear by them: they are creating the issue that requires the Q-tips in the first place.
Worth noting that not all humans have the same kind of cerumen. There is wet cerumen (dominant, 50%) and dry cerumen (20%). It depends on your genetic. If you are asian, chances are that your cerumen will be harder and require scooping out. Again, this is done with a little spoon by a third-party or by using one carefully (they also come with cameras and flashlights). You remove the build-up with accuracy, you don't just jam cotton in there and randomly scrape at your ear canal.
> "Cerumen will thinly coat the ear canal to protect it. When you mess with that flow, you create little build-ups, kind of like road traffic."
I think the issue is that there is little evidence for Q-tips causing problems. With sincere respect, to me, this sounds like a "just-so story", a plausible-sounding explanation without actual basis.
> "Again, this is done with a little spoon by a third-party or by using one carefully (they also come with cameras and flashlights). You remove the build-up with accuracy, you don't just jam cotton in there and randomly scrape at your ear canal."
It sounds like the issue is not "little spoon" versus "cotton swab" but "accuracy" versus "jamming". Anyone jamming anything in their ear is gonna have problems, whether or not it's a little spoon or a cotton swab. If you can acknowledge that people can carefully use a little spoon on their own just by care and feel, then logically you would have to acknowledge that some people, perhaps those with wet earwax, can do the same with cotton swabs.
Apologies, this was very poorly worded. I edited that post many times and those parenthesis lost their meanings. Wet cerumen is 50% lipid and dry cerumen is 20% lipid.
If you want demographics, I've found online that: "dry earwax is very common (80-95 per cent) among East Asians, but is lower (30-50 per cent) in southern Asia, Pacific Islands, Central Asia and Asia Minor, and in Native North Americans and Inuit peoples of Asian ancestry. It's very uncommon among Europeans and Africans (0-3 per cent)". http://www.abc.net.au/science/articles/2015/04/14/4213402.ht...
Take a walk along the beach. A small proportion by volume but a large proportion by number, of the pieces of plastic you will find, will be the stems of Q-tips. If you're going to use them, get the paper kind and leave the ones with plastic on the shelf.
Q-Tip brand q-tips are made of paper. As far as I'm concerned, they're the superior product all around, all the alternatives I've seen have inferior fluffiness. I'm not usually one for brand loyalty, but in this instance I haven't been able to find any generic version that's satisfactory.
One aspect that's often left out in conversations about earwax (cerumen) is that there are basically two very different types -- and they're determined by genes.
> There are two distinct genetically determined types of earwax: the wet type, which is dominant, and the dry type, which is recessive. While East Asians, Southeast Asians and Native Americans are more likely to have the dry type of cerumen (gray and flaky), African and European people are more likely to have the wet type (honey-brown, dark orange to dark-brown and moist).
So, the effectiveness of any tool is going to be wildly different for a 'wet' type vs a 'dry' type. And, the ability to be "impacted" will vary as well.
I use them after every shower, so basically every day. In my experience, there's never enough build up for there to be anything to push in and get impacted.
well, yeah, there's never enough buildup because you're cleaning it every day, what about the anti bacterial and foreign object protection you're giving up for no good reason.
I've been using q-tips every day for as long as I can remember, and have never had any wax buildup (according to my doctors, who look in my ears) and I've never had an ear infection either. This is despite spending 12 years as a competitive swimmer (ear infections are common for swimmers, probably because they let gross public pool water fester in there instead of using a qtip!)
Datapoint of one... but why should I change what I'm doing if it's working? Some times I've gone on trips without qtips and the resulting sensation after a few days is distractingly unpleasant. (Incidentally a little rolled up toilet paper works alright in a pinch.)
After twelve years of being in a high risk group with no trouble at all, I just don't take this supposed risk seriously. If I was ever going to get an ear infection, I think it would have happened by now. My 'single datapoint' is more like 30 years of data.
> You experience discomfort immediately upon stopping cleaning
In the case of qtips, I experience a sensation of satisfaction immediately after stopping. The discomfort, several days later, comes from the ear wax, and is immediately relieved with another qtip. There is no trend of it getting worse. My frequency of use has not changed in 30 years. It is comparable to cleaning my teeth, my mouth feels gross when I don't, so I do.
The primary reasons I was aware of was that alcohol dries the mouth out (which makes sense, it also dries hands out), and dry mouth grows more bacteria than a saliva rich mouth.
These links also indicate alcohol can lead to oral cancer, killing of good bacteria.
Sometimes too much, sometimes probably not enough. Ear infections are pretty common for swimmers, but I made a point of shaking water out of my ears whenever I got out of the pool and swabbing them dry after practice, and I never had any problems. Some people use earplugs, and I guess caps might offer protection for some people (in my experience they didn't keep water out for long.)
For what it's worth: I have an incredible ENT with 40 years of experience, and she's consistently recommended Q-tips for her patients and held that the AAO is overcautious here (though it's certainly possible to cause impaction by, e.g., using a dry Q-tip in a dry ear canal).
It's completely the opposite at my local ENT. There are many signs saying to NOT use Q-Tips. In the exam rooms, at the reception, in the waiting area, down the hall, etc. It's funny but it does align with being overly cautious. I wonder if they've had too many cases of people puncturing their eardrums.
'Choke up' on the q-tip, holding it closer to the business end such that your fingers prevent it from being inserted further than intended. That's what I do anyway.
YMMV of course, particularly since earwax consistency is apparently something that varies considerably between different populations.
And make sure the bathroom door is locked. I know someone that has permanent ear damage because her boyfriend bumped the door open and it hit her elbow.
Also don't jump on a couch at the dentist with your new tooth brush in your mouth and land face first requiring an emergency room visit to stitch a hole ripped into the back of your mouth.
I had a classmate in grade school that was deaf in one ear. He said he was cleaning his ear with a q-tip when his sister walked up behind him with a paper bag and popped it as a joke.
I've cleaned my ears with q-tips every single day for almost 30 years and haven't had a single issue. In fact, every visit to the doctor I get a comment about how clean they are followed by a word of caution.
Maybe letting it build up then trying to use a q-tip causes impaction?
> Maybe letting it build up then trying to use a q-tip causes impaction?
I did this a while ago and it absolutely made the problem 100x worse, had to get it vacuumed out at the ENT. The earwax had apparently gotten stuck to my eardrum. Consistent q-tip use (like brushing teeth) seems fine, but I'll NEVER again attempt to clear out any kind of blockage with them.
Has the author considered asking people instead of speculating and blindly discrediting studies? As with others in this thread, I have had earwax compaction issues from attempting to use q tips to clean. Don’t do it, use the squirt bottles. They’re great and like $20 for infinite uses.
This looks very interesting but does one really need one in most cases? I've stopped using Q-tips when I found about Bamboo Oriculi which I could get in any Chinatown (now they're everwhere, just found them on etsy). They're reusable and a lot less problematic than Q-tips. Q-tips sometimes push the wax in rather than take it out.
When you stick things in your ear the risk of puncturing your own eardrum is real. It's a lot better when you can see what you're doing. And you can verify that you got everything.
Similarly (and obliquely referred to near the end):
Dietary cholesterol is not bad for you. At all.
Saturated fat is not bad for you. At all.
Sugar is all kinds of bad. The more they look, the worse it gets. Particularly fructose and sucrose. (Glucose is fine.)
Meat still causes heart trouble, but it's not the saturated fat at fault. After all these decades, we still don't know what is. Nobody was looking, because "sat fat!"
Obviously make sure you are alone and in a place where you won't be startled or jostled or otherwise put yourself in a situation where you jam the bobby pin into your ear drum.
The amount of junk that gets built up in your ears is pretty impressive.
I never had any use for them; is that buildup something that is different per individual or? I would not really want to poke my ear if not absolutely necessary.
Oh definitely. I have TONS of buildup after a few days. There is a (anecdotally) significant difference in hearing ability post cleaning via q-tip. If I don't use the q-tip, Airpods get very gross within a few days.
Along the same vein, I tried to find studies on what dry beans you can cook directly in a modern slow cooker to save effort and there's not a lot out of evidence to go on. All online articles on it uses similar quotes that trace back to a couple of old studies that aren't that comprehensive.
The common parroted advice is not to use slow cookers for this because they don't get hot enough to destroy toxins in some bean varieties - this seems to be based on slow cookers not reaching above 80C though, when I'd say most slow cookers get much hotter than this.
Has anyone ever heard of anyone, in their childhood or adult life, who suffered problems from using cotton swabs to clean their ears? Punctured eardrum out of clumsiness is not a qualifying case.
This warning always struck me as exaggerated caution, like telling kids to never ever touch a pair of scissors, just to avoid the possible risk of them running with scissors, which has a possible risk of them tripping onto scissors.
> Has anyone ever heard of anyone, in their childhood or adult life, who suffered problems from using cotton swabs to clean their ears? Punctured eardrum out of clumsiness is not a qualifying case.
> This warning always struck me as exaggerated caution, like telling kids to never ever touch a pair of scissors, just to avoid the possible risk of them running with scissors, which has a possible risk of them tripping onto scissors.
That's definitely a qualifying case.
It's quite valid to want to avoid rare but extreme outcomes. For instance: maybe most kids can run with scissors with only minor issues, but then there's that one kids who gives themselves a horrible injury one day in kindergarten that's traumatic to everyone (e.g. ends up stabbing themselves in the eye, possibly resulting in blindness or even brain damage).
And your approach is to teach children to fear scissors instead of teaching them to use scissors carefully; to teach people that cotton swabs are "dangerous" and must never be used. This mindset is problematic and does not help one bit.
> And your approach is to teach children to fear scissors instead of teaching them to use scissors carefully; to teach people that cotton swabs are "dangerous" and must never be used.
No, that's not my approach. Literally no one but you is saying that "cotton swabs are 'dangerous' and must never be used." What people are saying is to not jab them in your ear canal (e.g. avoid using them in risky ways akin to running with scissors).
> This mindset is problematic and does not help one bit.
The mindset of exaggerating everyone else's position into a straw man of hyperbole is problematic and does not help one bit.
You have several meatus. You pee through one and have several inside your nose as well. There are actually 2 meatus per ear, which probably comes as a bit of a surprise.
>There’s that pesky left/right ear difference again.
The left/right ear differences may have to do with the majority of people being right handed. If you are using a Q-tip on your own ear, you have to use the same sided hand to clean the ear. Thus, you probably do a better job with your right ear than with your left ear, if, like most people, you are right handed.
The study mixed older children with younger ones. The younger ones have no handedness bias but the older ones may have. The presence of these older children may have been sufficient to cause the asymmetric p values that we saw.
I just want to take issue with the first thing said in the post:
> Disclaimer: I am not a doctor; even if I’m 100% right in my argument and you are 100% convinced by it, you shouldn’t listen to me over actual doctors; it’s a bad habit that might actually kill you.
At least in the U.S., with for-profit medicine, you cannot and should not trust doctors. There is a financial motivation that is misaligned with trying to help you; they (and their employers) have very twisted incentives to try to get you to do procedures that are at best unnecessary and expensive, but at worst potentially damaging to your health.
I've seen and dealt with it enough times in my life, and came to the frustrating conclusion that you really just have to look out for yourself. Don't rely on doctors unless you know them personally.
Not that it's super related to this Q-Tip thing. I just had to take issue with this, because I hear it so often, and it is really just a lazy cover-your-ass line.
These days the overwhelming majority of doctors work for managed care and are salaried. There are are some specialities that feature private practice (notably derms and plastic surgeons) but for ears, in particular, you’re seeing an internist or GP or ER doc who is in almost every case is purely salaried.
> At least in the U.S., with for-profit medicine, you cannot and should not trust doctors. There is a financial motivation that is misaligned with trying to help you; they (and their employers) have very twisted incentives to try to get you to do procedures that are at best unnecessary and expensive, but at worst potentially damaging to your health.
This is an insanely over-cynical take. While there definitely are doctors who run their practices like a crudely-capitalist business [1], that's not what typically gets people into medicine. You mainly just need to be engaged in your own care and seek second opinions for anything major or if you're having doubts. IMHO, it's more likely you'll have find yourself with an incompetent doctor than one who's trying to screw you.
This is one of those times where standard medical advice seems to be out of sync with common sense, like with masks.
Maybe the advice is a white lie—e.g. to protect PPE supply in the case of masks—or maybe it has a certain delicious counter-intuitiveness that makes the speaker feel wise, which means it gets repeated more frequently over time, thus crowding out competing ideas. Or maybe it's an attitude on the part of doctors of "common people can't be trusted to do it correctly," so they default to the standard advice of "don't."
I'm here to clarify how many (but not all) of us use medical research: the "pyramid of evidence."
The idea is that I rely upon the best available evidence, which (roughly in order) is: meta-analysis, randomized controlled trials and other prospective data, retrospective analyses, expert consensus, and (finally) clinical experience.
This is rough because there are good critiques of meta-analyses as a tool, the available data may be a bad fit for that patient, research biases, etc. A big one is that many questions don't have a big commercial upside, so nobody will ever fund a good prospective blinded trial. Which takes us to the last point: absence of evidence is not evidence of absence. Just because all the of the studies about Q-Tips are low quality doesn't mean a better study would find something different. We don't know the answer to that, and that would be a big assumption to make.
So, sometimes the best available evidence is not statistically ironclad. It falls on us to use a reasonable approach about how hard a line to take. Some do a better job than others.
That was long and rambling, but hopefully it helps to clarify some misconceptions. As an applied science, we have to go with the data we've got, which is almost always not an ideal fit for the patient in front of us.