Potential Health Risks
of Headphone Use
and Ways to Avoid Them
Over one billion young people worldwide, aged 12 to 34, may be at risk of hearing loss. A major contributor is listening to music or other audio on personal devices at high volumes, frequently, and for extended periods, research indicates.
Beyond hearing loss, regular use of headphones or earbuds can lead to other ear-related issues, including tinnitus and ear infections, according to a review of 23 studies.
The good news is that making simple adjustments to how you use these devices can significantly reduce the risks. Here are four potential hazards associated with headphone or earbud use—and tips on how to avoid them.
1. Hearing Loss
The most significant risk associated with using headphones or earbuds is potential damage to your hearing. Prolonged exposure to loud audio can harm the delicate hair cells inside the inner ear, explains Ross Cushing, a clinical audiologist based in Germantown, Maryland, and CEO of Live Better Hearing + Balance, a family-owned audiology practice.
Within the inner ear, the cochlea, a fragile, spiral-shaped structure that enables the brain to interpret sound. Tiny hair cells inside the cochlea detect sound vibrations and convert them into electrical signals, allowing us to hear.
Once these hair cells are damaged, they do not regenerate. This is why maintaining a safe listening volume is critical, that they emphasize.
How to Lower Your Risk
Using headphones or earbuds does not automatically lead to hearing loss—the key factors are volume and listening duration.
“You can prevent hearing damage by keeping the volume at a safe level,” says Cushing. “I advise my patients to follow the 60/60 rule: listen at no more than 60 percent of the maximum volume for no longer than 60 minutes at a time, including short breaks.”
Guidance from the Cleveland Clinic is slightly more flexible. They recommend limiting listening to about 90 minutes when volume is set at roughly 80 percent of the maximum. Listening at 50 to 60 percent of maximum volume, however, is considered safe for much of the day.
For earbud users specifically, there is another easy test you can try. “Hold an earbud at arm’s length and If you can clearly identify the song, that’s a sign the volume may be too loud.” says Anish V. Thakkar, founder and director of audiology at the Los Angeles Center for Hearing & Balance.
You may also benefit from upgrading your headphones or earbuds. According to researchers, high-quality models labeled as “studio” or “mixing” headphones are often better for hearing health because they are more accurately tuned and avoid excessive bass. “Strong bass frequencies can encourage listeners to turn the volume up to unsafe levels,” they explained.
2. Tinnitus
Tinnitus—the perception of sound when no external noise is present, often described as “ringing in the ears”—can also result from headphone or earbud use.
Some cases of tinnitus are permanent, but it can also occur temporarily after listening at volumes that are too high. If you experience ringing in your ears after using headphones, it is a warning sign that the volume was excessive. Continued overexposure may eventually lead to permanent hearing loss.
Tinnitus becomes more common with age and is closely linked to presbycusis, or age-related hearing loss Higher rates are frequently observed in individuals between the ages of 40 and 80.
How to Lower Your Risk
You can reduce your risk of tinnitus in the same way you protect against hearing loss: by keeping the volume on headphones or earbuds below 60 percent of the maximum.
3. Earwax Buildup and Ear Infections
When was the last time you cleaned your earbuds? While it may seem obvious, many people overlook this important habit. Audiologists emphasize that keeping earbuds clean is essential for preventing hearing problems and reducing the risk of ear infections.
Earbuds can push earwax deeper into the ear canal, leading to blockages and temporary changes in hearing. In addition, residue left on earbuds can increase the risk of infection, because earbuds can trap moisture and create a warm, damp environment where bacteria and fungi can thrive.
Research supports this concern. A small study of 50 earphone users in Nigeria found that earbuds can harbor various microbes, including bacteria such as Streptococcus, Staphylococcus, and E. coli, as well as fungi like Aspergillus. Frequent users were more likely to show microbial growth on their earphones.
According to research, these bacteria and fungi can enter small cuts in the ear canal and raise the risk of outer ear infections, commonly referred to as swimmer’s ear.
How to Lower Your Risk
Using earbuds can increase the likelihood of earwax buildup because they may push wax deeper into the ear canal. So they recommend using over-the-ear headphones instead, since they do not sit inside the ear and are less likely to cause blockages.
Regular cleaning is also critical. Many manufacturers, including Bose, recommend wiping headphones with warm water and mild dish soap, followed by rubbing alcohol. Always consult the manufacturer’s website for cleaning instructions specific to your device.
If you notice discomfort, muffled hearing, pain, or itchiness, stop using headphones or earbuds and consult an audiologist or an ear, nose, and throat specialist. These symptoms may indicate earwax buildup or an ear infection that requires professional treatment.
For those who continue using earbuds, cleaning them daily or at least weekly with an alcohol wipe to reduce the risk of infection. Also cautions against using cotton swabs for earwax removal, as they often push wax deeper into the ear canal and worsen buildup.
4. Dizziness and Vertigo
Although less common than other risks, the use of headphones and earbuds may contribute to dizziness or vertigo, a sensation of imbalance or spinning.
A recent case report found a possible link between earbud use and benign paroxysmal positional vertigo (BPPV), the most common form of vertigo. In the reported case, a patient’s dizziness, tinnitus, and tingling sensations in the ear resolved completely after he stopped using earbuds and switched to bone-conduction headphones. These devices transmit sound through the bones of the skull rather than through the ear canal.
It’s possible that loud sounds can trigger dizziness or vertigo because sound pressure may affect the part of the inner ear responsible for balance.
How to Lower Your Risk
If you experience episodes of vertigo, consider taking a break from using earbuds or headphones and monitor whether your symptoms improve.
Regardless of which symptoms you may notice, it recommends that all headphone and earbud users undergo regular hearing evaluations. Routine testing can help identify potential issues early, before they worsen or become permanent.
Conclusion
Headphones and earbuds are generally safe when used correctly, but improper use or poor hygiene can increase the risk of health issues such as tinnitus, vertigo, and hearing loss.
To protect your hearing, many audiologists recommend following the 60/60 rule: listen at no more than 60 percent of the maximum volume for no longer than 60 minutes at a time, including short breaks.
Earbuds, in particular, can trap moisture and bacteria, creating an environment that promotes earwax buildup and infections if they are not cleaned regularly.
If you experience ongoing symptoms or have concerns about your hearing, schedule an evaluation with an audiologist or an ear, nose, and throat specialist for a comprehensive hearing assessment.
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