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For decades, people cleaned their ears with cotton swabs. Now, doctors reveal why these should not be used.

In the updated clinical guidelines published in the journal Otolaryngology- Head and Neck Surgery, health experts say that q-tips or cotton swabs are not appropriate for earwax removal. In fact, the guidelines state that it's not recommended to put anything smaller than the elbow in the ear.

"This update is significant because it not only provides best practices for clinicians in managing cerumen impaction, it is a strong reminder to patients that ear health starts with them, and there are many things they should do as well as many things that they should stop doing immediately to prevent damage to their ears," Dr. Seth R. Schwartz, chair of the guideline update group, said in a press release by the American Academy of Otolaryngology- Head and Neck Surgery.

"There is an inclination for people to want to clean their ears because they believe earwax is an indication of uncleanliness. This misinformation leads to unsafe ear health habits," he added.

Cotton swabs, house keys, hair pins and toothpicks, which are smaller than the elbows, can cause cuts in the ear canals, perforate the eardrums and dislocate the hearing bones. If any of these happens, it may lead to hearing loss, dizziness, ringing and other symptoms of ear injury, CNN reports.

So, how to get rid of earwax? Doctors say that earwax is a normal substance in the body. It's there for a reason and that is to protect, clean and "oil" ears. It acts as a self-cleaning agent to keep the ears healthy.

The body has its own ways to expel the cerumen in the ears through some activities. Moreover, chewing, jaw motion and growing skin help move old earwax from the inside of the ears to the opening where it flakes off or washed off during bathing.

However, in some people, they experience cerumen build-up which can block the ear canal and cause hearing problems. Though the cases of impacted cerumen is not an uncommon complication, which is present in 1 in 10 children and 1 in 20 adults, the academy suggests visiting a medical expert.