They’re soft and fluffy. And for the most part, cotton swabs don’t appear to be all that dangerous.

In fact, when used properly, the small hygiene tools work well to collect unsightly ear wax. The problem occurs when the tip is inserted too far into the ear canal, resulting in a ruptured eardrum.

Also called the tympanic membrane, the eardrum is thin and oval-shaped, and separates the middle ear from the outer ear. A hole in the eardrum often hinders normal hearing and can cause other ear and facial issues.

At the recent Combined Otolaryngology Spring Meeting in Chicago, a study involving more than one-thousand-five-hundred patients who had been diagnosed with a perforated ear drum revealed a correlation between improper use of the cotton swabs and the ruptured membrane. The patients were separated into two groups — those who received no intervention and those who underwent surgery. Both groups were followed over a ten-year period. When evaluating the patients, the doctors classified successful outcomes as either a healed eardrum, or the disappearance or improvement of conditions like vertigo, tinnitus or facial nerve paralysis.

In the final analysis, most perforated eardrums healed with no intervention within two months. The more severe cases were treated with surgery. The rate for surgical success was almost perfect, with only one patient continuing to suffer from mild dizziness.

Because the findings indicated such a strong link between improper use of the swab and a ruptured eardrum, the doctors recommend using other methods to clean your ears. Irrigate the ears with peroxide and warm tap water monthly, and use a mixture of vinegar and water as ear drops once a week. Or visit the doctor, who can easily remove your ear wax.

Save the cotton swabs for cleaning your jewelry.