Hopi ear candles: do they remove ear wax?

Ear candling turns up in beauty salons, complementary therapy rooms and online shops, and the idea behind it is appealing. You lie still, feel a gentle warmth by your ear and let the candle draw the wax out. Unfortunately it doesn't work, and holding a flame next to your head carries a real risk of burns.

What are Hopi ear candles?

An ear candle is a hollow tube, usually made of cotton or linen soaked in paraffin wax or beeswax. Some are scented with honey, herbs or essential oils. You will see them sold as Hopi candles, thermo-auricular therapy, ear coning or plain ear candles, but they are the same product.

A typical session goes like this:

1. Lying on your side. You lie with the ear to be treated facing up, usually with a towel over your hair and shoulders.
2. Placing the candle. The narrow end is rested in the entrance of the ear canal, sometimes through a small paper or foil disc meant to catch drips.
3. Lighting it. The top is lit and left to burn down for several minutes while the person doing it holds the candle upright.
4. Putting it out. The candle is taken away and put out before the flame gets near the ear. The stub is often cut open to show you what is inside.

Therapists often finish with a gentle massage of the face or neck, and the session is sold as a relaxing treat as much as a way to clear the ears.

Are ear candles really a Hopi tradition?

The name suggests an old Native American remedy. The Hopi people of Arizona have said publicly that ear candling is not, and never has been, one of their practices, and asked a manufacturer to stop using their name. Candles like these have been linked to several other cultures over the years, usually on thin evidence. Where the idea came from matters less than whether it works.

What ear candles are supposed to do

The main claim is that the lit candle works like a chimney. Warm air rises up the tube, and this is said to create a gentle suction at the ear end that pulls wax and debris out of the canal. Some sellers go further and say candling can:

• ease sinus pressure, headaches or the blocked feeling after a cold
• help with tinnitus or ear infections
• balance pressure in the ears
• draw out toxins

None of these claims has good evidence behind it. The suction claim is the one that has been put to a direct test.

Do ear candles work? What the evidence says

They don't. In a study published in The Laryngoscope in 1996, researchers measured the pressure inside a model ear canal while candles burned and found no suction at all. They then tried candling on eight ears. Not one had any wax removed, and some were left with candle wax inside that hadn't been there before.

The same team surveyed ear, nose and throat (ENT) specialists about problems they had seen, and 21 injuries caused by ear candles were reported, including burns, ear canals blocked by candle wax and a perforated eardrum.

It was a small study, and nothing published since has shown that candles remove wax. The NHS position is short: there is no evidence that ear candles get rid of ear wax. In the UK they are sold as a complementary therapy, and the NHS doesn't offer them.

So what is the residue?

Cut open a used candle and you will find a sticky, orange-brown deposit that looks convincingly like ear wax. It is what is left of the candle itself: melted wax and burnt fabric. Burn a candle without putting it anywhere near an ear and the same residue appears.

The risks of ear candling

Because candling doesn't remove wax, there is nothing to set against its risks, and those risks are real:

There is a quieter risk too. Someone with a blocked ear who spends time and money on candling may put off getting it looked at. Muffled hearing is often wax, but not always. An infection, fluid behind the eardrum or a sudden drop in hearing needs checking by a pharmacist, GP or ear care clinician.

Why some people still like ear candling

Plenty of people who have tried candling say they enjoyed it, and that is easy to believe. You lie in a quiet room, feel warmth by your ear and hear a soft crackle, often followed by a massage. Many people feel relaxed afterwards, and some say their ears feel lighter.

That feeling is real, but it isn't evidence that wax has gone. Warmth and rest are pleasant in themselves, and a blocked feeling can come and go as wax shifts. The residue in the stub then seems to confirm that something came out. If it's the relaxation you're after, a massage gives you that without a flame beside your head. If you want the wax gone, a candle won't do it.

What to use instead of ear candles

Most ear wax never needs removing, because the ear clears it by itself. If yours is causing symptoms, such as muffled hearing, a blocked feeling or ringing, work through these in order:

1. Softening drops at home. The NHS suggests 2 to 3 drops of olive or almond oil in the affected ear, 3 to 4 times a day for 3 to 5 days. Over about 2 weeks, lumps of wax should come out by themselves. Our guide on how to use ear drops shows you how to get them in.
2. A word with a pharmacist. They can suggest other drops, such as sodium bicarbonate, and tell you whether your symptoms sound like wax or something else.
3. Removal by a clinician. If symptoms haven't cleared after 5 days, the NHS advises seeing a nurse at your GP surgery. Many surgeries no longer remove wax, so you may be pointed to a community service or a private clinic, where it is usually done by microsuction, electronic ear irrigation or manual removal with fine instruments.

For everything else that is safe to try at home, and what to leave alone, see our page on removing ear wax at home. And leave the cotton buds in the cupboard: they push wax further in, as our guide to why cotton buds make ear wax worse explains.