We all know that youre not supposed to clean your ears with a Q-tip. And yet, people still do it all the time. Surely youve heard the horror stories about a friend of a friend of a friend piercing their eardrum (or maybe you watch Girls and have yet to scrub the memory of Hannahs Q-tip scene out of your head). But do you really know whats at stake? And how bad is it that no matter how many times youre told to stop you know that youre never going to drop the habit?

Here are the ear-cleaning dos, donts, and please-dont-but-if-you-dos you need to know.

OK, so first of all, you dont actually need to clean your ears.

Generally speaking, the ear canal is self-cleaning, Dr. Christopher Chang, an otolaryngologist in Warrenton, Virginia, told SELF. You really dont have to do a whole lot. In certain individuals, earwax can build up in the ear canaland you dont want it to build up to the point where you cant hear. But the majority of folks dont have to do anything.

That said, we know youre cleaning your ears with Q-tips, even though everyone says you shouldnt.

Everyone knows youre not suppose to use them, and yet everyone does it, Chang said. Im not going to get all bent out of shape if someone admits to using Q-tips. You just want to make sure that your ear is safe.

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The dangers of sticking a cotton swab into your ear are real. And theres a range of damage you can do.

The most basic issue is that using a Q-tip is probably doing the opposite of what its supposed to do. Your intention is to get earwax out, but youre probably just packing it deeper in there, which can plug up your ear canal and make you feel stuffy or itchy, or can interfere with your hearing. If the ear canal is totally blocked with wax you can get tinnitus, a ringing or buzzing in the ear.

And dont think your doctor isnt going to notice, either. You can actually see the impression of the Q-tip on the earwax, when you look at it with a scope, Chang said. Busted.

The skin inside your ear canal is also really, really sensitive, so scraping around in there with a stick wrapped in cotton can scratch it, which leaves you open to ear infections. If an infection gets really bad you can get swimmers ear, which is when the skin swells up so much that it completely closes the ear canal. Its also really painful.

The worst thing you can do is to pierce the eardrum with the end of the Q-tip, which hurts like hell and can take weeks or months to heal (and thats assuming you dont also get some massive infection).

If you go too far down the ear canal with the swab, you can literally put a Q-tip-sized hole in your eardrum. Chang said that usually when he sees this its because the patient was cleaning her ear, and her boyfriend came into the bathroom, startling her and causing her to jerk her arm. Or she was multitasking and accidentally bumped her elbow into the wall.

The result: very sharp pain and bleeding. Hearing loss is not uncommon. The good news, according to Chang, is that the vast majority of the time the body will heal the hole closed on its own. Depending on how big the hole is, it may close up completely in a week. More severe cases can take a couple months to heal, and in the worst-case scenario, surgery is required. If it happens to you, call a doctor right away and definitely dont put any water in your ear because it could trigger an infection.

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So whats the right way to clean your ears?

If theres wax buildup thats bugging you, Chang recommends buying an ear syringe at the drugstore and flushing the ear gently with body-temperature water. (Water is a good enough solvent, and though getting water stuck in your ear is annoying, its really not dangerous, Chang said.) You can also use an ear bulb to suction stuff out, but theyre harder to clean. Hydrogen peroxide and other OTC solutions (like Debrox and Murine) are OK, but they can irritate and dry out your skin. Make sure you follow the directions carefully, and you should probably consult your doctor first.

(Dont even bother with ear candling. Chang is adamant that it doesnt do anything.)

Since no matter what we say, youre going to keep cleaning your ears with cotton swabs, heres how to do it without massacring yourself:

For one thing, be gentle. That soft cotton tip can leave grooves and scratches in the fragile skin. (And your doc will totally notice them and call you out.)

As a rule of thumb, Chang said not to put the swab in so far that you cant see the cotton anymore. The eardrum is only about 2 to 3 cm in from the opening of the ear canal. The first centimeter in is cartilage, which has a little give when you press against it, and the skin is slightly tougher there. After that, the canal is surrounded by bone. Theres no give there, and thats where the eardrum connects, so consider it the danger zone. Conveniently, the cotton head on a Q-tip is about 1 cm long, so stopping there ought to keep you relatively safe.

Of course, this doesnt mean that were condoning cleaning your ears this way. You should probably just leave them be, and go to an ENT if the wax situation is getting out of hand. But if you are going to practice aural penetration, we want you to be safe.

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