The best thing you can do to clean your ears is to leave them alone. 
 
 No, really. On Jan. 3, the American Academy of Otolaryngology released updated guidelines about the treatment of impacted earwax, a condition characterized by a painful buildup of the substance that naturally coats our outer ear canal. According to the new guidelines, published as a supplement in the journal Otolaryngology-Head and Neck Surgery, impacted earwax affects around 12 million adults per year in the US, and costing $46.8 million (paywall) in 2012. The best way to prevent it, according to an analysis of the latest research? Don’t clean your ears to begin with. 
 
 “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. 
 
 But earwax, or cerumen as it’s known in the scientific community, helps us stay clean. It’s a mix of oil from glands in the outer ear canal (the part you can touch with your finger), hair, and dead skin cells. Admittedly, all of these sound like substances you wouldn’t want anywhere on your body; however, the wax they form protects the ear from certain bacterial and fungal infections by acting like a sticky trap (not unlike mucus does for our lungs) before flushing them out with our jaw movement. As the BBC explains, way back before humans lived in insulated homes, earwax may have kept insects from crawling into our inner ears while we slept. 
 
 And yet, most of us (including yours truly) have cleaned out our ear canals—or at least had them cleaned out by our parents when we were children—with cotton swabs. According to the Washington Post, when sterilized cotton swabs made by Q-Tips first hit the market in 1923 (perplexingly called “Baby Gays” at the time), they were advertised to clean ears, as well as noses, eyes, and gums. Fifty years later, manufactures of cotton swabs started printing warnings on their boxes telling adults to only clean the outside of the ear canal; today there’s an explicit warning on packaging to not use them for ear cleaning at all. 
 
 The reason for this change of tune is because people often accidentally go too deep, damaging their ear drums, and sometimes end up clogging their ears with earwax instead of clearing it out. 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. These clumps can cause ear pain and ringing, loss of hearing, and infection, which leads to odorous discharge. 
 
 At this point, doctors intervene by irrigating ears with water or oil, or carefully use tools to scrape, scoop, pick, or suction out the mass. Ear candles, which are foot-long cones of linen or cotton soaked in beeswax, inserted in the ear, and lit on fire on the outer end to create a vacuum to draw out extra wax, are not recommended. They are not proven to work, and can be dangerous because they cause burns and even more wax buildup, this time coming from an external source. In one case study, a woman who attempted to clear her ears using candling had to have candle wax surgically removed from her ear, which damaged her hearing. 
 
 Doctors have been saying for years that placing anything smaller than your elbow into your ear is a bad idea. (Though they don’t always take their own advice: One small 2013 survey found that practitioners reported inserting the tips and covers of pens, matches, bobby pins, and even chicken feathers into their ears to clean them.) Schwartz explained in an email that the primary purposes of the American Academy of Otolaryngology updates were to assess any new evidence about ear care found since 2008, when the guidelines were last updated. 
 
 The guidelines suggest that doctors shouldn’t remove any earwax unless it’s causing any problems. They should, however, advise patients on how to use non-prescription drops to remove earwax on their own in certain cases. People with hearing aids, for example, tend to have more earwax buildup, which can be safely removed with drops or rinsing if done correctly. 
 
 The main takeaways of the report are listed below. 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: ||||| (CNN) The doctors' advice hasn't changed much, but it's still so unsatisfying: You should not use cotton swabs to clean your ears. 
 
 Updated clinical guidelines published Tuesday in the journal Otolaryngology-Head and Neck Surgery say they're not appropriate for earwax removal. In fact, information for patients in the guidelines say no to putting anything "smaller than your elbow in your ear." 
 
 Regardless, most of us hoard a stash of the soft-tipped paper sticks; they seem so perfectly suited to that dirty job. 
 
 So the authors of the guidelines -- an advisory panel of the American Academy of Otolaryngology-Head and Neck Surgery -- have injected a little bit of freshness into the usual advice, giving more explanation as to "Why not?" They even included a consumer representative on the panel. 
 
 "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. 
 
 Here's why not: Cotton swabs, hair pins, house keys and toothpicks -- the many smaller-than-our-elbow-objects we love to put in our ears -- can cause cuts in our ear canals, perforate our eardrums and dislocate our hearing bones. And any of these things could lead to hearing loss, dizziness, ringing or other symptoms of ear injury. 
 
 Instead, most people can just let nature do its job. Our bodies produce earwax to keep our ears lubricated, clean and protected: Dirt, dust and anything else that might enter our ears gets stuck to the wax, which keeps any such particles from moving farther into the ear canal. 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. 
 
 The guidelines published in 2008 were overdue for an update. 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 are more clear about why the decisions we made are made and what data there is to support it." 
 
 Patient are apparently interested in the nitty-gritty of ear care: More than 50,000 people downloaded the old guideline, Schwartz said. 
 
 "It's kind of amazing how many people were interested in reading that," he said. 
 
 The do's and don'ts 
 
 To be "a little bit more patient-friendly," the guidelines now include lists of "Do's and Don't's" for everyone and a list for people who have had problems with cerumen impaction, the official term for earwax buildup, a condition that is more common among the elderly, according to Dr. James Battey, director of the National Institute on Deafness and Other Communication Disorders. 
 
 Impaction can occur when the ear's self-cleaning process doesn't work very well. The resulting waxy buildup blocks the ear canal, causing difficulty hearing. 
 
 "For those with impacted ear wax, the use of cotton-tipped swabs may push the earwax deeper into the ear canal and harm the eardrum," Battey said. He added that "about 2% of adults with impacted earwax may go the doctor with hearing loss as their symptom." 
 
 "Impacted earwax is best addressed by a health care professional," he said. 
 
 In the all-important "Don't" section, you'll find warnings against "overcleaning" your ears. Excessive cleaning may increase earwax impaction, according to the authors. 
 
 "It's cultural" to want clear ears, Schwartz said, but "wiping away any excess wax when it comes to the outside of the ear is enough to keep it clean." 
 
 Another warning in the new guidelines: Do not use ear candles. Not only can they cause "serious damage" to your eardrum, "there is no evidence that they remove impacted cerumen," wrote the authors. 
 
 "Home therapies are fairly effective," Schwartz said, adding that the "whole host" of over-the-counter wax-softening drops as well as home-use irrigators are effective and safe. "Even drops of water in the ear can be effective to soften the wax," he added. 
 
 Join the conversation See the latest news and share your comments with CNN Health on Facebook and Twitter. 
 
 Still, among the items on the "Do" list is to ask your health care provider about how to treat earwax impaction at home, since "you may have certain medical or ear conditions that may make some options unsafe." 
 
 "It's not a bad thing to have wax in your ears. Everybody does and should. It's more of an issue when it becomes too much," Schwartz said. 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. 
 
 "If it's causing symptoms, absolutely go to your doctor ," Schwartz said, repeating what is likely the most important "Do" list recommendation. Still, some people attribute their symptoms to wax buildup when it's just not the case. 
 
 Among older people , "hearing loss becomes very, very common," said Schwartz. 
 
 In fact, aging, along with infections and exposure to loud noise, is one of the most common causes of acquired hearing loss, according to Battey. 
 
 Yet many people cannot imagine that they've begun to lose their hearing, and as a result of this disbelief, Schwartz said, "a patient has wax cleared, and then their doctor needs to look deeper." ||||| (Reuters Health) - It may be tempting to clean your ears with Q-tips or try ear candling to clear away any clogs, but it’s best to check with a professional before taking matters into your own hands, doctors advise. 
 
 “Patients may try to blindly instrument their ears with cotton ear buds, bobby pins, or other tools,” said Dr. Seth Schwartz, chair of a committee that drafted new guidelines for diagnosing and treating earwax for the American Academy of Otolaryngology – Head and Neck Surgery. 
 
 “These are generally ineffective and potentially dangerous,” Schwartz, director of the Listen For Life Center at Virginia Mason in Seattle, said by email. 
 
 “Scratching of the ear canal skin can lead to pain and infection,” Schwartz added. “Sometimes they just push the wax in further, and there also is the potential for damage to the ear drum.” 
 
 The body makes earwax, or cerumen, to keep ears clean and trap substances like dust and dirt, preventing debris from getting further into the ear where it can cause damage. As new skin grows in the ear canal, it pushes old earwax from the inside of the ears closer to the opening where it naturally flakes off or washes away during bathing. 
 
 Often, there’s nothing wrong with having a little earwax near the opening, doctors stress in guidelines published in Otolaryngology–Head and Neck Surgery. 
 
 But when the ear’s self-cleaning process doesn’t work well, too much earwax may accumulate and partially or fully block the ear canal. This can cause problems including pain, itching, discharge from the ear, ringing in the ear or hearing loss. 
 
 Roughly one in 10 children and one in 20 adults suffer from excessive earwax buildup, as do more than one third of elderly people, according to the guidelines. 
 
 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. 
 
 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. 
 
 People should also get a checkup if they have ear drainage or bleeding because these symptoms aren’t tied to impaction and may be an indication of other problems. 
 
 “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. 
 
 “Generally people still erroneously believe that the cotton-tipped applicator or Q-tip is the primary weapon of choice to get rid of earwax,” Taylor, who wasn’t involved in the guidelines, said by email. 
 
 In most cases, though, wax that’s naturally found near the outer part of the ear can be wiped away with a damp cloth, Taylor added. Cotton-tipped applicators can compact the wax and push it deeper into the ear, making it harder to remove. 
 
 Certain hearing aids, or wearing earbuds instead of over-the-ear headphones, can also inadvertently push wax deeper into the ear, Taylor said. 
 
 At home, people may be able to use wax removal drops, baby oil or a few drops of hydrogen peroxide to prevent buildup, but it’s best to consult a doctor first. 
 
 “In most cases, primary care clinicians are the first line of evaluation for this condition and are adequately equipped to manage it,” Taylor said. “When it is noted to be more complicated or there is a risk of injury there should be a referral to an Ear, Nose and Throat physician for removal.” 
 
 SOURCE: bit.ly/2ianu3d Otolaryngology–Head and Neck Surgery, online January 3, 2017. ||||| 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. 
 
 “This update is significant because it not only provides best practices for clinicians in managing cerumen impaction, it is a strong reminder to patients that ear health starts with them, and there are many things they should do as well as many things that they should stop doing immediately to prevent damage to their ears,” said Seth R. Schwartz, MD, MPH, chair of the guideline update group. “There is an inclination for people to want to clean their ears because they believe earwax is an indication of uncleanliness. This misinformation leads to unsafe ear health habits.” 
 
 Earwax or cerumen is a normal substance that the body produces to clean, protect, and ‘oil’ ears. It acts as a self-cleaning agent to keep ears healthy. Dirt, dust, and other small matter stick to the earwax which keeps them from getting farther into the ear. Chewing, jaw motion, and growing skin in the ear canal help to move old earwax from inside the ears to the ear opening where it then flakes off or is washed off during bathing. This normal process of making wax and pushing the old wax out is continual. 
 
 At times, the ear’s self-cleaning process might not work very well and may lead to a buildup of earwax. When this happens, earwax can collect and block, or partly block, the ear canal. Excessive or impacted cerumen is present in 1 in 10 children, 1 in 20 adults, and more than one-third of the geriatric and developmentally delayed populations. 
 
 “Patients often think that they are preventing earwax from building up by cleaning out their ears with cotton swabs, paper clips, ear candles, or any number of unimaginable things that people put in their ears. The problem is that this effort to eliminate earwax is only creating further issues because the earwax is just getting pushed down and impacted further into the ear canal,” Dr. Schwartz said. “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. 
 
 The update provides a table of dos and don’ts for clinicians to further educate patients about cerumen impaction. Following are a few of those listed in the update: 
 
 DON’T overclean your ears. Excessive cleaning may irritate the ear canal, cause infection, and even increase the chances of cerumen impaction. 
 
 DON’T put anything smaller than your elbow in your ear. Your mother was right! 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. 
 
 DON’T use ear candles. There is no evidence that they remove impacted cerumen, and candling can cause serious damage to the ear canal and eardrum. 
 
 DO seek medical evaluation if you have symptoms of hearing loss, ear fullness, and ear pain if you are not certain that they are from cerumen. 
 
 DO ask your provider about ways that you can treat your cerumen impaction at home. You may have certain medical or ear conditions that may make some options unsafe. 
 
 DO seek medical attention with ear pain, drainage, or bleeding. These are not symptoms of cerumen impaction and need further evaluation. 
 
 The primary purpose of the updated guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention. New evidence, systematic reviews, randomized control trials, observational studies, and an evolved methodology, which included a consumer representative, were at the foundation of the update. 
 
 “The update to the 2008 guidelines encompasses a variety of tools for clinicians in treating and communicating with their patients,” said Dr. Schwartz. “This includes an algorithm showing the interrelationship of key action statements in a cohesive and understandable way as well as enhanced information on patient education. Having the consumer perspective on the guideline update group provided us a value-added opportunity to incorporate more extensive patient counseling within our treatment protocols.” 
 
 The update is endorsed by American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American Geriatric Society (AGS), American Neurotology Society (ANS), American Otological Society (AOS), American Society of Geriatric Otolaryngology (ASGO), and Society of Otorhinolaryngology and Head-Neck Nurses (SOHN). Additionally, it is supported by American Speech-Language-Hearing Association (ASHA). 
 
 The guideline authors are: Seth R. Schwartz, MD, MPH; Anthony E. Magit, MD, MPH; Richard M. Rosenfeld, MD, MPH; Bopanna B. Ballachanda, PhD; Jesse M. Hackell, MD; Helene J. Krouse, PhD, RN; Claire M. Lawlor, MD; Kenneth Lin, MD, MPH; Kourosh Parham, MD, PhD; David R. Stutz, MD; Sandy Walsh; Erika A. Woodson, MD; Ken Yanagisawa, MD; and Eugene R. Cunningham Jr, MS. 
 
 Members of the media who wish to obtain a copy of the guideline or request an interview should contact: Tina Maggio at 703-535-3762, or newsroom@entnet.org. Upon release, the guideline can be found at www.entnet.org. 
 
 About the AAO-HNS/F 
 
 The American Academy of Otolaryngology—Head and Neck Surgery, one of the oldest medical associations in the nation, represents about 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The AAO-HNS Foundation works to advance the art, science, and ethical practice of otolaryngology-head and neck surgery through education, research, and lifelong learning. The organization's vision: "Empowering otolaryngologist-head and neck surgeons to deliver the best patient care."
– 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.)