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

"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)

"…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, 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 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 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)

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

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)

Medical News Today (11th October 2005)

"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)

"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 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)

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

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)

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)

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

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)