Does This Practice Really Hold A Candle To Evidence-Based Medicine?

In Tuesday’s newsletter, we asked you your opinion of ear candling, and got the above-depicted, below-described set of responses:

• Exactly 50% said “Under no circumstances should you put things in your ear and set fire to them”
• About 38% said “It is a safe, drug-free way to keep the ears free from earwax and pathogens”
• About 13% said “Done correctly, thermal-auricular therapy is harmless and potentially beneficial”

This means that if we add the two positive-to-candling answers together, it’s a perfect 50:50 split between “do it” and “don’t do it”.

(Yes, 38%+13%=51%, but that’s because we round to the nearest integer in these reports, and more precisely it was 37.5% and 12.5%)

So, with the vote split, what does the science say?

First, a quick bit of background: nobody seems keen to admit to having invented this. One of the major manufacturers of ear candles refers to them as “Hopi” candles, which the actual Hopi tribe has spent a long time asking them not to do, as it is not and never has been used by the Hopi people. Other proposed origins offered by advocates of ear candling include Traditional Chinese Medicine (not used), Ancient Egypt (no evidence of such whatsoever), and Atlantis:

Quackwatch | Why Ear Candling Is Not A Good Idea

It is a safe, drug-free way to keep the ears free from earwax and pathogens: True or False?

False! In a lot of cases of alternative therapy claims, there’s an absence of evidence that doesn’t necessarily disprove the treatment. In this case, however, it’s not even an open matter; its claims have been actively disproven by experimentation:

• It doesn’t remove earwax; on the contrary, experimentation “showed no removal of cerumen from the external auditory canal. Candle wax was actually deposited in some“
• It doesn’t remove pathogens, and the proposed mechanism of action for removing pathogens, that of the “chimney effect”: the idea that the burning candle creates a vacuum that draws wax out of the ear along with debris and bacteria, simply does not work; on the contrary, “Tympanometric measurements in an ear canal model demonstrated that ear candles do not produce negative pressure”.
• It isn’t safe; on the contrary, “Ear candles have no benefit in the management of cerumen and may result in serious injury”

In a medium-sized survey (n=122), the following injuries were reported:

• 13 x burns
• 7 x occlusion of the ear canal
• 6 x temporary hearing loss
• 3 x otitis externa (this also called “swimmer’s ear”, and is an inflammation of the ear, accompanied by pain and swelling)
• 1 x tympanic membrane perforation

Indeed, authors of one paper concluded:

❝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❞

~ Dr. Joy Rafferty et al.

Source: Canadian Family Physician | Ear Candling

Under no circumstances should you put things in your ear and set fire to them: True or False?

True! It’s generally considered good advice to not put objects in general in your ears.

Inserting flaming objects is a definite no-no. Please leave that for the Cirque du Soleil.

You may be thinking, “but I have done this and suffered no ill effects”, which seems reasonable, but is an example of survivorship bias in action—it doesn’t make the thing in question any safer, it just means you were one of the one of the ones who got away unscathed.

If you’re wondering what to do instead… Ear oils can help with the removal of earwax (if you don’t want to go get it sucked out at a clinic—the industry standard is to use a suction device, which actually does what ear candles claim to do). For information on safely getting rid of earwax, see our previous article:

Ear Today, Gone Tomorrow

Take care!