"…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]