Ear candling: should general practitioners recommend it?

Ear wax accumulation is one of the most common otologic conditions seen in primary care; removing ear wax is the most common ears, nose, and throat procedure carried out in the community. With the increasing use of and interest in complementary medicine in the United Kingdom1 and elsewhere, it is not surprising that ear candling has developed such a following. Ear candling involves placing a hollow candle (made from a fabric tube soaked in beeswax) in the external auditory canal. The candle is then lit and burned for about 15 minutes.2 After the procedure is finished, a brown waxy substance, believed by ear candling practitioners to be a mixture of ear wax, debris, and bacteria, is left in the candle stub.3 Ear candling can be performed by beauticians, alternative therapists, or by patients using kits at home. It is used mainly to remove ear wax, though it has also been used to try to relieve sinus pain, cure ear infections, help relieve tinnitus and vertigo, and even strengthen the brain!4 Patients considering such alternative therapies might want to get advice from their GPs first. We present a case of ear candling with a complication and discuss the current literature.