What alternative health practitioners might not tell you

Why Ear Candling Is Not a Good Idea

Concludes that candling is both ineffective and dangerous. Article by Lisa M. L. Dyer (Quackwatch)

FDA - Ear Candling: Ineffective and Risky

U.S. Food and Drug Administration video (1:37 mins)

Ear candles are illegal in Canada

“The fact that Health Canada has classified ear candles as Class III medical devices and actively works to stop their illegal sale indicates that they take them fairly seriously. This is welcome news to skeptics who are concerned about dangerous and ineffective devices and treatments, and who are so often dissapointed by their lack of regulation. It also means that by reporting the illegal sale or import of ear candles, skeptics can make a real difference in protecting the public from dangerous pseudoscience.” Canadian activist website.

Ear candling busted

Video demonstration using a life size model ear with a window so you can see what is going on in the ear. (13th October 2011)

Ear Candling - risk without benefit

“Numerous websites sell inexpensive ear candling kits, and some beauty salons and spas offer it as a “relaxation” service. Also called coning, earcandling involves inserting the narrow end of a hollow cone, impregnated with paraffin or beeswax, into the ear canal and lighting the other end.  This supposedly creates a vacuum that draws wax out of the ear. Proponents claim it also treats tinnitus, migraines, postnasal drip, allergies, coughs, and many other ills. There’s no evidence to support any medical benefits of ear candling, however. According to some research, ear candling does not create enough suction to extract earwax—and it can leave candle wax behind. Worse, ear candling can burn the ear canal, perforate the eardrum, and cause infection.  And it’s a fire hazard. Serious injuries have been reported to the FDA and Health Canada, and the FDA has taken legal action against marketers and seized ear candling products. A review in the Journal of Laryngology & Otology a few years ago concluded that ear candling “clearly does more harm than good” and should be banned.” Berkeley University of California health alert (16th July 2010)

Doctors call for ‘ear candling’ therapy to be banned

Doctors want a ban on ear candling, a procedure that is said to relieve sinus problems and headaches but can lead to burns or temporary hearing loss…“You can burn your skin, you can burn your hair, the candle can perforate the eardrum,” said Dr Ahmad Alamadi, the head of the ear, nose and throat department at Al Baraha Hospital in Dubai. One patient needed surgery days after having the treatment last year. Her hearing was reduced to 50 per cent, Dr Alamadi said. “I saw her ears completely blocked, but from the candle wax,” he said. “The candle itself melted and went down the canal. It solidified and packed the whole ear. She was lucky it didn’t burn the eardrums.” After administering general anaesthesia on the patient, Dr Alamadi took about two hours to scoop out “about three to four cubic centimetres of wax. “Trying to avoid damaging the skin of the canal was tricky work. It wasn’t fun,” he said.” Matt Kwong, United Arab Emirates press (2nd June 2010)

Ear Candling

“A review of the literature identified one systematic review of the available evidence on ear candling. Seely et al (1996) found that ear candling does not produce any negative pressure (the purported mechanism of action) and does not remove cerumen (ear wax) from the ear canal. They found no existing evidence to evaluate regarding claims that ear candling treats other medical conditions such as sinus infections. Safety concerns associated with ear candling include danger of burns, of depositing melted wax into the ear canal, and perforated eardrum. During the past few years, the FDA has banned the importation of auricular candles marketed by at least four Canadian companies.” Clinical practice guideline from American Speciality Health Inc. [ASH] (last revised 27th May 2010) [pdf]

FDA: That Wax in Your Ear Shouldn’t Be a Burning Candle

“Warning from the FDA: Consumers should “steer clear of ear candles — hollow cones that are about 10 inches long and made from a fabric tube soaked in beeswax, paraffin, or a mixture of the two.” The FDA adds that injuries stemming from sticking a burning candle in your ear are “likely underreported.”… The regulators said today they have seized some ear candles and sent warning letters to three big manufacturers saying that such products weren’t approved in the US. Canada is also stepping up enforcement…The FDA said it was particularly concerned that children could be harmed using ear candles.” Wall Street Journal blog (18th February 2010)

Click here for the FDA’s advice on ear candling for consumers

Ear Candles and Candling: Ineffective and Dangerous

“Ear candling is dangerous (even when used as directed by the manufacturer) and serves no legitimate purpose and there is no scientific evidence showing effectiveness for use. It is of significant concern that some ear candles are advertised for use with children (including babies), potentially placing them at great risk — with no known or documented benefit. As hearing professionals and doctors, we strongly recommend prior to undertaking ear candling, consumers and patients are urged to discuss the matter with their physician, audiologist, or hearing aid dispenser. Bottom line: Ear candling is ineffective and potentially dangerous and we do not recommend it at any time for any reason.” Opinion editorial by Jackie Clark, PhD, Douglas L. Beck AuD, and Walter Kutz, MD, American Academy of Audiology (2010)

Ear Candles? One Flame You Should Put Out

“We have all fallen for something at one point in time. Nothing to be ashamed of – it is human nature to believe in something that ultimately fails you. When it come to your health and hearing health there are many phony claims out there and some that can be dangerous. One being ear candles…. It doesn’t work. A flim-flam – and a very dangerous one at that. And unlike the individuals who believe in the benefits of ear candling, and strongly profess the benefits of this bizarre process, the dangers of ear candling have actual scientific data to back up the claims of hearing health professionals who have seen the results of this supposed “miracle cure.” People are seeking alternative solutions for issues that can’t be handled by modern medicine and they want solutions to their problems – preferably simple solutions. Ear candling is not a solution. It’s a dangerous false solution. If you do have an excessive build up of ear wax, learn more about safe ear wax removal and discuss the issue with your physician or audiologist. In other words, ear candling is dangerous and it doesn’t work. Seeing your physician or a qualified hearing professional (Otolaryngologist or audiologist), when you have an excessive amount of ear wax does work. Remember – never stick anything smaller than your elbow into your ear canal and that includes a large coned candle.” Carolyn Smaka Au.D. Associate Editor, Healthy Hearing (10th August 2009)

Ear Candling

TV segment featuring New Zealand MD, Shaun Holt, discussing the dangers of ear candling. (21st June 2009) [3:36mins]

Earwax — Let It Be

“…earwax is there for a reason and doesn’t ordinarily need to be removed. So, in general, your best bet is simply to clean your outer ear with a washcloth and leave earwax removal to your ear’s own self-cleaning mechanism. No cotton-tipped swabs—and no candles—necessary.” Robert Shmerling, M.D., Harvard Health Publications (2009)

Ear candle scam Part 1

5:54 mins YouTube video segment. (December 2009)

Ear candle scam Part 2

7:50 mins YouTube video segment. (December 2009)

A small study of the properties of ear candles

"During the course of investigating ear candling we often encountered the belief that ear candles create a vacuum that draws fluids and wax from the ear canal, which in turn produces beneficial health effects. To investigate this notion, we obtained several ear candles from a local health food store and investigated their properties….. CONCLUSIONS: The ear candle, when burned, produced a brown waxy substance that looks like ear wax. However, since the wax appears whether or not the candle is placed in a human ear, we conclude that the source of the wax is the candle and not the ear. It is possible that the candle produced wax but also extracted solid material from the ear was mixed with the candle wax. However, since the candle remnant of the control candle and the one inserted into a human volunteer weighed exactly the same, we conclude that this did not happen. The human subject reported no feeling of a vacuum which is purported to occur during the burning of the candle. The control candle produced smoke that poured from the bottom of the tapered end, suggesting that positive, not negative pressure was being produced. The subject reported no subjective feelings invoked by the treatment, suggesting that the ear candle was ineffective in a controlled environment." Jeffries, W., et al.

Ear Candling

"Researchers agree ear candling is a dangerous and ineffective procedure for removing cerumen (ear wax) from the outer ear. Its efficacy and safety have been questioned for more than a decade…..Ear candling is condemned by the FDA, which prohibits the sale or import of ear candles with medical claims…..Despite the documented dangers of ear candling, however, the sale of ear candles and the purported benefits of the process can be found on dozens of Web sites. In fact, one popular search engine came up with 246,000 citations for the benefits of ear candling, while the same search engine came up with only 13,300 citations for the dangers. ….Nurses, your patients are reading these Web sites, and in many cases looking for natural remedies. Some hate to have their ears flushed by their doctor and are looking for cheaper, alternative methods. Many will consider ear candles. Be prepared to relay the facts to your patients — this procedure is dangerous and pointless." Two-page article by Jess Dancer, EdD, professor emeritus of audiology at the University of Arkansas-Little Rock and Heather Shenk, AuD, staff audiologist at Advanced Tech Hearing Aid Centers, Lancaster, PA. Advance for Nurses (1st April 2009)

Evidence-based clinical practice guideline on cerumen impaction

"…The most popular alternative practice for cerumen removal is ear candling, also known as "ear coning" or "thermo-auricular therapy…..No reliable prevalence data is available on candling, but data from wholesale distributors, thousands of Internet references to ear candling, and a survey of 122 US otolaryngologists showing that they were aware of ear candle use in at least one of their patients support the assumption that the prevalence of ear candle use is high…..Adequate research on the effect of ear candling is limited. However, a series of experiments have concluded that candling does not eliminate wax from the ear, but rather the material deposited at the end of the cone is from the candle itself, and not wax from the external auditory canal. Additionally, Seely et al concluded that the burning of the candle does not produce negative pressure. Comparison of photographs from each subject's ear canals taken before and after the ear candling procedure revealed that no cerumen was removed from these ears. These investigators also surveyed a small sample of otolaryngologists regarding the use and safety of ear candles in their patient population. Fourteen out of 122 otolaryngologists who responded to the survey had treated 21 patients for complications from ear candles, which included: 13 burns of the auricle; 7 ear canal occlusions; and 1 tympanic membrane perforation. External otitis and temporary hearing loss were secondary complications in three and six patients, respectively. In summary, these studies have shown that although ear candling is heavily promoted, the mechanism of action is implausible. Furthermore, it has no observable positive effects and ear candling use may be associated with considerable risks. The Food and Drug Administration (FDA) concluded that there is no validated scientific evidence to support the efficacy of the ear candles and warns against their use." Otolaryngology-Head and Neck Surgery, Vol 139, No 3S2 (September 2008) [pdf]

Hopi Ear Candling

"Hopi Ear Candling, or thermo-auricular therapy (TAT) as it is known, is a rather strange technique that involves sticking a burning candle in your ear. The mundane reason for doing this is that it can allegedly draw out the nasty wax from your ears. Quacks never like to restrict their techniques to the obvious, so the candle apparently acts on the 'energetic level' and can also detoxify you and treat all sorts of ailments unconnected with your ear. The main manufacturer of ear candles is a German company called Biosun. Their web site tells us about the Hopi tribe of native Americans and their ancient wisdom. Pictures on their web site show tribe members and ancient murals showing the Hopi sharing candles. The problem is that all this is just made up nonsense. All of it…..ear candling looks like it is little more than twenty years old and is just abusing an American tribe to make believe that the stupid practice of sticking a candle in your ear is ancient and justified." Article by Andy Lewis, The Quackometer (27th March 2008)

Ear candling-should general practitioners recommend it?

"Ear candling appears to be popular and is heavily advertised with claims that could seem scientific to lay people. However, its claimed mechanism of action has not been verified, no positive clinical effect has been reliably recorded, and it is associated with considerable risk. No evidence suggests that ear candling is an effective treatment for any condition. On this basis, we believe it can do more harm than good and we recommend that GPs discourage its use." J. Rafferty, MB CHB, A. Tsikoudas, FRCS DLO, and B.C. Davis, FRCS ED. Canadian Family Physician. (December 2007)

Ear Candling: A Fool Proof Method, or Proof of Foolish Methods?

"Ear candles do not remove earwax, have no known scientific or medical benefit, and indeed pose a significant risk. They are quite dangerous and serve no apparent beneficial purpose." Heather L. Shenk, Au.D. & Jess Dancer, Ed.D. Audiology Online (12th December 2005)

The Lowdown on Ear Candling

"Ear candling is a solution in search of a problem. And the solution doesn't even work." Tom Valeo, WebMD Feature (December 2005)

Ear Candling

Health Canada's position on ear candling: "Health Canada's Medical Devices Regulations state that certain types of medical devices, including ear candles, require a licence from Health Canada before anyone can sell them for therapeutic purposes. Health Canada has not issued any licences for ear candles. Therefore, the sale of this product for therapeutic purposes in Canada is illegal. As well, both Canada and the United States have issued directives that ban the importing of ear candles..... Report any complaints or concerns about ear candles, or any other medical devices, to Health Canada through a toll-free hotline at 1-800-267-9675." Health Canada website (November 2005)

Ear Candling: Conflicting Information, Confused Consumers

A news article which explores "a little bit of the outrageous claims and expectations consumers are exposed to regarding ear candles". Includes two experiments, illustrated by several photographs, which proved that ear wax was not removed from the ears via candling. Heather Shenk, Au.D., and Jess Cancer, Ed.D., healthyhearing.com (31st October 2005)

Ear Candling Not Effective, Can Cause Burns

Medical News Today (11th October 2005)

What's the evidence? (Ear Candling)

"There have been no trials so far evaluating the benefits of ear-candling so there is no evidence whatsoever that it has any clinical effect other than through a placebo response… Apparently both the Canadians and the Americans have officially banned the sale of ear-candles as the adverse reactions seem to far outweigh the possible benefits — although they remain available over the internet." Dr George Lewith, Head of the Complementary Medicine Research Unit, Southampton Medical School, UK (The Times, 8th October 2005)

Waxing sceptical

"If you find, while having your ear candled, that you experience a sudden loss of hearing, and agony followed by bleeding: that'll be the deafening sound of your own painful credulity." Ben Goldacre MD, The Guardian (4th March 2004)

Ear candles: a triumph of ignorance over science

"Ear candles are hollow tubes coated in wax which are inserted into patients' ears and then lit at the far end. The procedure is used as a complementary therapy for a wide range of conditions. A critical assessment of the evidence shows that its mode of action is implausible and demonstrably wrong. There are no data to suggest that it is effective for any condition. Furthermore, ear candles have been associated with ear injuries. The inescapable conclusion is that ear candles do more harm than good. Their use should be discouraged." E. Ernst M.D., Ph.D., F.R.C.P., F.R.C.P.(Ed), Journal of Laryngology & Otology (1st January 2004)

On Ear Cones and Candles

Three experiments melt a New Age claim of ear wax extraction. By Philip Kaushall and Justin Neville Kaushall, Skeptical Inquirer (September 2000)

Listen up: Beware of the 'ear candle'

Toronto ear-nose-and-throat specialist Dr. Rick Fox first heard about ear candling when a patient arrived in his office in incredible pain. The candle had burnt right through his ear, leaving a chunk of wax lodged in it. The patient "had suffered a significant burn throughout his canal and drum," says Fox. "He had perforated his tympanic membrane so we had to do a surgical repair and graft his drum." Fox spent that Christmas day reconstructing the man's ear for a treatment he says doesn't work at all: "Many of the proponents, they cut open the candle and they show you this incredible amount of wax. What they don't show you is that if you don't put it into the ear, and you still light it on fire and you open it up, it looks the exact same. "All the junk that's in the candle is simply the beeswax and the residue," says Fox. "It's not human ear wax." CBC News (22nd February 2000)

Untoward otological and audiological consequences of ear candling

Case report of a 55-year-old lay midwife seen at the Brigham Young University Audiology Clinic after she had burned her ear using an ear candle. Includes photographs of the ear candles used by the patient, the ear candle wax on the tympanic membrane, the tympanic membrane 5 days after removal of the ear candle wax, and remnants of 10 ear candles used by the patient over a 10-day period. Also includes audiometric and tympanometry readings before and after the removal of the ear candle wax. Richard Harris, Ph.D. (5th March 1999)

The pseudoscience of ear wax removal

Article by Stephen DeMeo, Skeptical Inquirer (Nov-Dec 1998)

Ear candles — efficacy and safety

A survey of 122 otolaryngologists identified 21 ear injuries resulting from ear candle use. Ear candles have no benefit in the management of cerumen and may result in serious injury. Laryngoscope (1996)

The Ear Wax FAQ

Douglas Hoffman, MD, PhD

The Dangers of Ear Candling

A cautionary tale. Part 3 of a 5-part article. All 5 parts of the article are available via this link. (Advance for audiologists)

What's the harm in ear candling?

Reports of people who were harmed by ear candling.