A cotton swab seems so harmless, yet it can really do some damage to your ears if you use it incorrectly. There are legitimate reasons why you might use a cotton swab on your ear, but the real issue is when people use the swabs in their ear canals to clean out wax. Do not do that. It may not feel like it, but you could be doing more harm than good. You don't want to end up needing hearing aids because of a little bit of cotton on a stick.
How Your Ear Is Set Up
That thing on the side of your head that you call an ear is actually a pinna, which acts as a collector for sound waves. It helps funnel sound into your ear canal, which is divided into two sections. The outer one-third has a thin layer of skin over cartilage, plus some small hairs that help nudge bits of earwax out of your ear. The inner two-thirds have thin skin over bone and no hairs. At the end of the canal is the tympanic membrane or eardrum, and behind that is the middle ear with its chain of small bones that help move sound vibrations into the inner ear.
Scrapes and Shoves
When you insert a swab into your ear canal, it may feel to you like nothing is happening. Maybe you rub the side of the canal because of an itch, and then you rub a bit to pick up bits of wax. Or so you think.
But what is really happening is that the swab, as soft as it seems to you, is scraping against the thin layer of skin. Rub too hard or too suddenly, and you could scrape the skin and draw blood. You could also cause an infection, and that infection can actually affect your hearing, both temporarily and permanently. Damage to your ear canal can make it harder to wear smaller in-the-canal hearing aids, too.
The other thing that is likely happening is that some of that wax is getting shoved down into the portion of the ear canal that has no hairs. The wax can't move out of there on its own, so it sits there, dries up, and compacts as more wax joins it. Eventually, you can have a full plug of wax that blocks your ability to hear out of that ear. If you have this plug, you need an ENT or an audiologist trained in cerumen (earwax) management to remove it because the dried wax can rip out the thin layer of skin if you're not careful. With proper removal, your hearing should return to where it was before.
Sadly, it's also possible for something to hit your hand when you have the swab in your ear -- sending the swab down the canal and through the tympanic membrane. That is as painful and gross as it sounds, and you can do permanent damage to your middle ear that way. While you can eventually get a hearing aid to help you, having those middle-ear bones damaged makes it rather difficult to fit you with a good hearing aid. However, it can be done, though that still doesn't mean you want to have to do that because of damage.
Keep swabs out of the ear canal. It is much better to talk to an ENT or audiologist if you're having wax problems or if the canal seems constantly irritated. Contact an ENT and audiologist like Mark Montgomery MD FACS if you have been having hearing issues, especially if you've been using swabs.