# Ear candling

Ear candling, also called ear coning or thermal-auricular therapy, is a pseudoscientific alternative medicine practice claiming to improve general health and well-being by lighting one end of a hollow candle and placing the other end in the ear canal. Medical research has shown that the practice is both dangerous and ineffective and does not functionally remove earwax or toxicants, despite product design contributing to that impression.

## Procedure

One end of a cylinder or cone of waxed cloth is lit, and the other is placed into the subject's ear. The flame is cut back occasionally with scissors and extinguished between five and ten centimeters (two to four inches) from the subject.
The subject lies on one side with the treated ear uppermost and the candle vertical. The candle can be stuck through a paper plate or aluminium pie tin to protect against any hot wax or ash falling onto the subject. Another way to perform ear candling involves the subject lying face up with the ear candle extending out to the side with a forty-five-degree upward slant. A dish of water is placed next to the subject under the ear candle.
Proponents claim that the flame creates negative pressure, drawing wax and debris out of the ear canal, which appears as a dark residue.
An ear candling session lasts up to one hour, during which one or two ear candles may be burned for each ear.
Treatment is also performed by some naturopaths in Canada, although import and sale are prohibited by Health Canada. Jonathan Jarry from the Office for Science and Society says that the Association des naturopathes agréés du Québec (ANAQ) states in its code of ethics that "its members can only use natural health products that conform to the rule of Health Canada". Results from an inquiry performed by Jarry showed that out of 50 naturopaths in Quebec, two offered the treatment and five said the consumer should buy the candles and do it himself. Only one said that the use of ear candles is unethical.

### Conventional removal of earwax

The conventional removal of earwax in medicine is done through an apparatus which creates a vacuum with which a doctor can remove excess earwax through suction. If the patient has a skin problem or the earwax is too sticky, an oil can be used to solubilise it so that excess earwax can be wiped off without inserting any object into the ear canal such as a cotton swab, which can damage the ear canal.

## Safety and effectiveness

Professor of Complementary Medicine Edzard Ernst wrote about ear candles: "There is 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."
According to the US Food and Drug Administration (FDA), ear candling is sometimes promoted with claims that the practice can "purify the blood" or "cure" cancer. Health Canada has determined the candles have no effect on the ear, and no health benefit; instead they create risk of injury, especially when used on children. In October 2007, US FDA issued an alert identifying ear candles (also known as ear cones or auricular candles) as "dangerous to health when used in the dosage or manner, or with the frequency or duration, prescribed, recommended, or suggested in the labeling thereof ... since the use of a lit candle in the proximity of a person's face would carry a high risk of causing potentially severe skin/hair burns and middle ear damage."
A 2007 paper in the journal Canadian Family Physician concludes:
   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.
A 2007 paper in American Family Physician said:
   Ear candling also should be avoided. Ear candling is a practice in which a hollow candle is inserted into the external auditory canal and lit, with the patient lying on the opposite ear. In theory, the combination of heat and suction is supposed to remove earwax. However, in one trial, ear candles neither created suction nor removed wax and actually led to occlusion with candle wax in persons who previously had clean ear canals. Primary care physicians may see complications from ear candling including candle wax occlusion, local burns, and tympanic membrane perforation.
The Spokane Ear, Nose, and Throat Clinic conducted a research study in 1996 which concluded that ear candling does not produce negative pressure and was ineffective in removing wax from the ear canal. Several studies have shown that ear candles produce the same residue — which is simply candle wax and soot — when burnt without ear insertion.
At least two house fires (one fatal) have been caused by accidents during ear candling.
A survey of ear, nose and throat surgeons found some who had treated people with complications from ear candling, and that burns were the most common.

## Product regulations

In Europe, some ear candles bear the CE mark (93/42/EEC), though they are mostly self-issued by the manufacturer. This mark indicates that the device is designed and manufactured so as not to compromise the safety of patients, but no independent testing is required as proof.
While ear candles are widely available in the US, selling or importing them with medical claims is illegal.
In a report, Health Canada states "There is no scientific proof to support claims that ear candling provides medical benefits. ... However, there is plenty of proof that ear candling is dangerous". It says that while some people claim to be selling the candles "for entertainment purposes only", the Canadian government maintains that there is no reasonable non-medical use, and hence any sale of the devices is illegal in Canada.

## Origin

Ear candle manufacturer Biosun referred to them as "Hopi" ear candles, but there is no such treatment within traditional Hopi healing practices. Vanessa Charles, public relations officer for the Hopi Tribal Council, has stated that ear candling "is not and has never been a practice conducted by the Hopi tribe or the Hopi people." The Hopi tribe has repeatedly asked Biosun to stop using the Hopi name. Biosun ignored the request for over a decade until sometime after 2014 when the product was rebranded as "traditional earcandles" in Germany although the product is still marketed by third-party US resellers as "Hopi".
Many advocates of ear candles claim that the treatment originates from traditional Chinese, Egyptian, or North American medicine. The mythical city of Atlantis is also reported to be the origin of this practice, which has no documentation. The earliest records state that it was first practiced by Americans in the 20th century from some European immigrants. It developed largely in Arizona.