Cotton swabs (American) or cotton buds (English) or ear buds (English) consist of a small wad of cotton wrapped around one or both ends of a short rod, usually made of either wood, rolled paper, or plastic. They are commonly used in a variety of applications including first aid, cosmetics application, cleaning, and arts and crafts. The cotton swab was invented in the 1920s by Leo Gerstenzang after he attached wads of cotton to toothpicks. His product, which he named "Baby Gays", went on to become the most widely sold brand name, "Q-tips", with the Q standing for "quality". The term "Q-tips" is often used as a genericized trademark for cotton swabs in the USA. Although doctors have said for years that usage of the cotton swab for ear cleaning or scratching is not safe, such use remains the most common.
The traditional cotton swab has a single tip on a wooden handle, and these are still often used, especially in medical settings. They are usually relatively long, about six inches (15 cm). These often are packaged sterile, one or two to a paper or plastic sleeve. The advantage of the paper sleeve and the wooden handle is that the package can be autoclaved to be sterilized (plastic sleeves or handles would melt in the autoclave).
Cotton swabs manufactured for home use are usually shorter, about three inches (7.6 cm) long, and usually double-tipped. The handles were first made of wood, then made of rolled paper, which is still most common (although tubular plastic is also used). They are often sold in large quantities, possibly 100 or more to a container.
Plastic swab stems exist in a wide variety of colors, such as blue, pink or green. However, the cotton itself is traditionally white.
The most common use for cotton swabs is to clean or scratch the ear canal and/or to remove earwax, despite this not being a medically recommended method for removing earwax. Cotton swabs are also commonly used for applying and removing makeup, as well as for household uses such as cleaning and arts and crafts.
Medical-type swabs are often used to take microbiological cultures. They are swabbed onto or into the infected area, then wiped across the culture medium, such as an agar plate, where bacteria from the swab may grow. They are also used to take DNA samples, most commonly by scraping cells from the inner cheek in the case of humans. They can be used to apply medicines to a targeted area, to selectively remove substances from a targeted area, or to apply cleaning substances like Betadine. They are also used as an applicator for various cosmetics, ointments, and other substances. One recent innovation is to use a special type of double-tipped cotton swab for over-the-counter drug application. These swabs have hollow tubular plastic handles, which are filled with the medicine. Breaking one marked end of the swab breaks an air seal, allowing the medicine to saturate the cotton at the other end so that it can be directly applied with the swab.
A related area is the use of swabs for microbiological environmental monitoring. Once taken, the swab can be streaked onto an agar plate, or the contents of the tip removed by agitation or dilution into the broth. The broth can either then be filtered or incubated and examined for microbial growth.
Cotton swabs are also often used outside of the field of personal hygiene:
- Often used in plastic model kits construction, for various applications during decaling or painting. Special brands of cotton swabs exist for this purpose, characterised by sturdier cotton heads and varied shapes of those heads.
- Can be used in the dyne test for measuring surface energy. This use is problematic, as manufacturers differ in the binders they use to fix the cotton to the stem, affecting the outcome of the test.
- They're frequently used for cleaning the laser of an optical drive in conjunction with rubbing alcohol. Similarly, they're used for cleaning larger computer parts such as video game cards, and fans. They were also used widely in the past to clean video game cartridges.
The use of cotton swabs in the ear canal is associated with no medical benefits and poses definite medical risks. Cerumen (ear wax) is a naturally occurring, normally extruded product of the external auditory canal that protects the skin inside the ear, serves beneficial lubrication and cleaning functions, and provides some protection from bacteria, fungi, insects, and water. A 2004 study found that the "[u]se of a cotton-tip applicator to clean the ear seems to be the leading cause of otitis externa in children and should be avoided."  Attempts to remove cerumen with cotton swabs may result in cerumen impaction, a buildup or blockage of cerumen in the ear canal, which can cause pain, hearing problems, ringing in the ear, or dizziness, and may require medical treatment to resolve. The use of cotton swabs in the ear canal is one of most common causes of perforated eardrum, a condition which sometimes requires surgery to correct. For these reasons, the American Academy of Family Physicians, among many other professional medical associations, recommends never placing cotton swabs in the ear canal.
- Schueller, Randy (1996), "Cotton Swab", History 4, FindArticles.com
- "Cotton Swab", Q-tips History, Unilever Home and Personal Care, 2007–2008
- Rod Moser, PA, PhD, Q-Tips – Weapons of Ear Destruction?, WebMD, Nov. 13, 2006
- Joel Stein, Something Evil in the Ear Canal, Time, Mar. 26, 2001
- Sandle, T. (July 2011). "A study of a new type of swab for the environmental monitoring of isolators and cleanrooms". European Journal of Pharenteral and Pharmaceutical Sciences 16 (2): 42–48.
- Edward Boyle (Sep 1, 1996). "Taking the measure of surface treatment is a learning process". PFFC: Paper, Film & Foil Converter. Retrieved 2010-03-20.
- McCarter, Daniel F.; et al. (May 2007). "Cerumen Impaction". American Family Physician 75 (10): 1523–1528. Retrieved 5 September 2012.
- Earwax at the American Hearing Research Foundation. Chicago, Illinois 2008.
- Nussinovitch, Moshe; et al. (April 2004). "Cotton-tip applicators as a leading cause of otitis externa". International Journal of Pediatric Otorhinolaryngology 68 (4): 433–435. doi:10.1016/j.ijporl.2003.11.014. Retrieved 5 September 2012.
- American Academy of Family Physicians (May 2007). "Information from Your Family Doctor---Earwax: What You Should Know". American Family Physician 75 (10): 1530.
- Smith, Matthew; Darrat (February 2012). "Otologic complications of cotton swab use: One institution's experience". The Laryngoscope 122 (2): 409–411. doi:10.1002/lary.22437.
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