Remember how your doctor has always been up in arms about cleaning your ears with a cotton swab? It looks like the recommendation to skip the Q-tip and leave your earwax alone is here to stay.

Updated clinical guidelines from the American Academy of Otolaryngology released last Jan. 3 echoed the dangers of using cotton swabs, ear candles, and other “unimaginable things” on one’s ears, including temporary or permanent hearing damage due to impacted cerumen or earwax.

In the updated guidelines published in the journal Otolaryngology-Head and Neck Surgery, the researchers reminded it’s wrong to clean one’s ears to begin with – it’s misinformation that earwax indicates uncleanliness and should therefore be eradicated.

Impacted earwax, which affects about 12 million people in the United States per year and cost $46.9 million in 2012 alone, is marked by a painful buildup of the substance that coats the outer ear canal naturally. It occurs in one out of 10 children and one in 20 adults, as well as in more than a third of seniors and less able populations.

Its symptoms include ear pain, itching, ringing in the ear, fullness in the ear, loss of hearing, and discharge and odor coming from the sensitive organ.

“[The] effort to eliminate earwax is only creating further issues because the earwax is just getting pushed down and impacted further into the ear canal," said Dr. Seth R. Schwartz, chair of the guideline update panel, in a statement.

The team has an interesting take on the advice and in updating the 2008 guidelines long overdue for an update, explaining the “Why not” part further and even including a consumer representative on the panel. “Nothing very dramatic” changed in the updates despite the presence of new randomized trials, added Schwartz.

And here’s why not: those little objects people put in their ears can lead to cuts in the ear canal, perforating the eardrum and dislocating hearing bones. These things could pave the way not only for hearing loss, but also dizziness and other ear injury symptoms.

The prevailing advice is to let nature run its course. Earwax is produced in the body to keep the ears clean, protected, and lubricated. When dirt and other foreign matter enter this section, they get stuck to the natural wax and bar such particles from getting into the ear canal.

Here are the do’s and don’ts provided for clinicians to educate their patients on the matter:

• DON'T overclean the ears, a bad habit that may irritate the ear canal, result in infection, and even up the likelihood of earwax impaction.
• DON'T put anything smaller than your elbow in your ear. Things from cotton swabs to hairpins can injure the organ and lead to undesirable consequences.
• DON'T use ear candles, as there is a lack of proof that they remove impacted cerumen and candling can actually lead to cause serious ear canal and eardrum damage.
• DO seek medical attention once you detect symptoms of hearing loss, fullness in ears, and ear pain particularly if you are quite certain they are not an earwax issue.
• DO ask your doctor about at-home ways to address cerumen impaction at home.
• DO seek medical help once you feel ear pain, drainage, or bleeding, which are not earwax impaction signs and thus require further evaluation.