Cotton swab

The first mass-produced cotton swab was developed in 1923 by Polish-American Leo Gerstenzang after he watched his wife attach wads of cotton to toothpicks to clean their infant's ears.[1][2] His product was originally named "Baby Gays" in recognition of them being intended for infants before being renamed "Q-tips Baby Gays", with the "Q" standing for "quality". The product eventually became known as "Q-tips", which went on to become the most widely sold brand name of cotton swabs/buds in North America. The term "Q-tip" is often used as a genericized trademark for a cotton swab in the United States and Canada.[2] The Q-tips brand is owned by Unilever and had over $200 million in US sales in 2014.[3] Johnson's buds are made by Johnson & Johnson.

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 6 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 3 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, 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 the ear canal by 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. They are also handy for touching up nail polish that gets on the surrounding skin.

Medical-type swabs are often used to take microbiological cultures. Pharmaceutical grade cotton swabs are necessary for medical applications.[4] These medical grade swabs are rubbed 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.

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.[5]

Cotton swabs are also often used outside of the field of personal hygiene:

• They are often used in the construction of plastic model kits, for various applications during the application of decals or painting. Special brands of cotton swabs exist for this purpose, characterised by sturdier cotton heads and varied shapes of those heads.
• They 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.[6]
• They are frequently used for cleaning the laser diode lens of an optical drive in conjunction with rubbing alcohol. Similarly, they are used for cleaning larger computer parts such as video cards and fans. They were also widely used in the past to clean video game cartridges.

The use of cotton swabs in the ear canal has no associated medical benefits and poses definite medical risks.[7][8][9][10] 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.[11][12]

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.[9] The use of cotton swabs in the ear canal is one of the most common causes of perforated eardrum, a condition which sometimes requires surgery to correct.[13]

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."[14] Instead, wiping wax away from the ear after a shower almost completely cleans the outer one-third of the ear canal, where earwax is made.[15] In the US between 1990 and 2010, an estimated 263,338 children went to hospital emergency rooms for cotton swab injuries, accounting for an estimated annual hospitalization of 13,167 children.[16]

Plastic cotton swabs are often incorrectly flushed down the toilet, increasing the risk of marine pollution. Some manufacturers and retailers have stopped the production and sale of plastic swabs and are only selling biodegradable paper versions.[17] Several countries have introduced legislation to ban plastic-stemmed cotton swabs.

Summary of plastic-stemmed cotton swab bans

Country/Union	Continent	Date	References
European Union	Europe	2021	[18]
Italy	Europe	2019	[19]
Monaco	Europe	2020	[20]
United Kingdom	Europe	October 2019 (Scotland), October 2020 (England), 2021 (Wales), 2021 (Isle of Man)	[21][22][23][24]

• Ear pick
• Cotton pad
• Phantom of Heilbronn