Tuesday, February 26, 2008

A Confession, an apology, and a challenge

I'm a Q-tip user. Every day.

It's my favorite part of the morning routine. Ok, maybe coffee trumps, but it's my favorite part after that. Out of the warm shower, wrap up in a fuzzy robe, and grab those Q-tips. A little swish, a little swirl, check to see what goodies I found, and I'm ready to start the day.

Hmmm. Except that doctors say you're not supposed to use Q-tips. "Don't put anything in your ear smaller than an elbow," I was taught to instruct patients.

So I'm sorry. Sorry to all those people who feel guilt about using Q-tips. I've tainted a most enjoyable ritual. I'm guilty of propogating a medical myth.

Just like your dear grandma is full of conventional wisdom, so is medical education. We as a physician community believe a lot of things that just aren't proven, but have been passed down from generation to generation. There was recently an article exposing eight common medical myths, but they didn't include the Q-tip.

Here's what I think. Some people make soft earwax, that drains easily. Some people make hard earwax, that gets stuck, dries out, and gets impacted. Both sets of people use Q-tips. When someone comes into the office with impacted earwax, they get asked the question. And when they guiltily admit to Q-tip usage, they get a finger wagging admonishment.

I did a cursory journal search regarding this issue. As expected, it hasn't been studied too much. I did find one article from 1994 that showed that Q-tip use was associated with cerumen impaction in left side but not on the right side. Hmmm. Not sure I buy that one.

Now, there are of course some common sense caveats. Don't push the Q-tip in too far. Don't use Q-tips if your ear hurts. And if you break the tip of a Q-tip off in your ear (not sure how one does that) please do not try to get it out with another one. And if you do try to get it out with another one, don't wait several weeks to fess up to your doctor about what you did ('cause then by the time she fishes it out it's pretty nasty.)

If you're one of those unlucky people who makes dry, sticky ear wax that gets impacted, it's probably best to avoid Q-tips, and see your doctor regularly to get cleaned out. If you're like most people, be smart, and swish away. Guilt-free.

And now the challenge: to all you docs out there, stop ruining this most innocent of pleasures.


Eric, AKA The Pragmatic Caregiver said...



I got something to show you.

You know you want really clean ear canals.

This won't hurt you.

Yeah, I know. They say it's for kids. Babies even. But we know better.

See how the big, wide fluffy tip is just perfectly the size of an adult ear canal? So with one swab, you get 360 degrees of contact at once? So everything gets all clean and dry at once?

Yeah, it really is satisfying. Give it a try. The first one's free. When you want more, you come find me.

You don't want to end up looking like this, do ya? Of course you don't.

Eric, Panderer.

(these are a great product - I LOVE them. I seriously cannot imagine how I lived before them.)

Rob said...

I use Q-Tip as well. However, I just rationalize it by saying I am a licensed trained professional with years of experience cleaning ears. This is true. It feels so good, too.

rlbates said...

Eric! You have me rolling on the floor (okay figuratively)!

And, yes, I am a Q-tip user.

Dr. Smak said...


I'm a little embarassed to tell you how excited I am to try those.

Eric, AKA The Pragmatic Caregiver said...
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Eric, AKA The Pragmatic Caregiver said...
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Eric, AKA The Pragmatic Caregiver said...
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Eric, AKA The Pragmatic Caregiver said...

$2. Wal-Mart baby care aisle, suspiciously close to the Butt Paste.

The advanced course, especially for those that have the ABCC11 SNP for dry-type earwax, is found in $140 of Japanese gadget salvation .

As an aside, my mother, lifelong believer that you'll poke your eardrum out with a Q-tip, got to have *sharp dissection* of two huge, nasty plugs of cerumen resistant to lavage, the whole thing shown to two utterly-rapt ENT residents via HDTV, as part of her semi-annual maintenance at The Sandwich Spread Clinic, while I looked on in horror - it was truly spectacular. A dainty wiping around the outside of the ear is no substitute for a good thorough scrub. I have threatened to get her a t-shirt that says "I Came To The Sandwich Spread Clinic For Boobaloma Treatment And All I Got Was A Thorough Ear Cleaning". She does not find this amusing in the least, and would just *DIE* if she knew I was spreading such a vicious character attack online. Which makes it all the more fun.

(sorry for all the deletes - something was not liking that last link and turned the whole thing into a link)

Anonymous said...

A friend of mine's husband shared with me something that always gives me a smile as I use my Q tips in the morning.

He calls the experience "eargasmic"--what a thrilling sensation. And those of us who are addicted to Q-tip use in the morning know exactly of what I talk.


SOCKS said...

Dr Smak,

I am so glad that "ear wax" predominates your thoughts - if only for a fleeting "eargasm".

You are hysterical.

Dr. Smak said...


Looks like Eric has figured out the truth about eargasms - size really dose matter.


Dr. Smak said...


That may have been the most disturbing YouTube video I've ever watched.


Eric, AKA The Pragmatic Caregiver said...

Don't you want to know they're *REALLY* clean?


Anonymous said...

Of course size matters........

janet said...

delurking to say that this is the funniest post and comment thread i have seen in a long long time.

you guys are fracturing me...

Anonymous said...

Confess your sins online at: http://iconfessmyself.blogspot.com

TBTAM said...

ACtually, there is research on how one's ear wax may portend health risks beyond impacted cerumen.



PS - I am a Q-tipper, and like brushing my teeth, can't leave the house in the morning without doing it.

drytears said...


Not sure you will get this because this is an older post... but I just found your blog... and love it! So I'm currently reading through everything instead of studying for my Spanish test. :)

Anyway, the 1994 study you found suggested that impactation of the ear wax was more likely to occur with q-tip use. You mentioned that you didn't really buy that.... my take on that would be that because more people are right handed, when cleaning out their right ear they have more control over what they are doing... the left ear is a bit trickier and therefore more prone to impactations.