Abstract

Self-ear cleaning is widespread in Saudi Arabia, yet public knowledge about proper ear hygiene and associated risks remains variable. This study aimed to assess knowledge, attitudes, and practices regarding self-ear cleaning among adults in the Northern Border Region and to situate the findings within the context of previous studies from other Saudi regions. A cross-sectional online survey was conducted among 534 adults (ages 18–60) residing in the Northern Border Region of Saudi Arabia. Data were collected using a validated questionnaire that assessed sociodemographic characteristics, knowledge, attitudes, practices, and self-reported complications related to self-ear cleaning. Knowledge was evaluated using 8 items, with 1 point per correct response (total score 0–8), and good knowledge was defined as ≥5 correct responses. Most participants (89.1%) reported practicing self-ear cleaning, predominantly using cotton buds (73.7%). Although many recognized potential harms (81.4% believed cotton buds could push wax deeper and 78.1% were aware of the risk of eardrum perforation), 64.1% still believed regular self-ear cleaning was necessary, indicating a knowledge–practice gap. Reported complications included otitis externa (50.6%), pain (44.0%), and bleeding (18.9%). In multivariable logistic regression, higher knowledge was independently associated with postgraduate education, healthcare employment, non-smoking status, and a history of hearing problems. Comparative synthesis with previous surveys from other Saudi regions revealed broadly similar prevalence, preferred tools, and complications, suggesting that self-ear cleaning is a common and often risky behavior nationwide. In conclusion, self-ear cleaning is prevalent in the authors’ region despite substantial awareness of its risks, and a persistent knowledge–practice gap was observed. While the cross-sectional, convenience-sample design limits causal inference and generalizability, these region-specific findings may help inform targeted educational messages and future interventional studies aimed at promoting safer ear hygiene and reducing avoidable ear-related morbidity in similar settings.

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