As Joni Mitchell once sang, “you don’t know what you have until it’s gone,” and that is especially true of our lives. In early 2025, I learned this lesson in a shocking way when what started as a bad cold that lasted for weeks turned into the following symptoms in my left ear: reduced hearinga feeling of fullness, at times tinnitus (ringing in the ears) and a day or two of balance problems, as the inner ear helps balance the body.
My eustachian tube dysfunction — when the tube that connects the middle ear to the nose stops working properly — left me scrambling for ways to preserve my ear health. As a health writer with 10 years of experience and a strong understanding of the importance of taking safety precautions, I wanted to do everything in my power to prevent hearing loss from happening again.
During my search for answers, I discovered that a common piece of technology can contribute to my hearing problems: earbuds. I spoke to an ear health expert, who said that earbuds placed directly in your ear can cause hearing loss and other problems. Here’s what the experts have to say about earbuds and ear health.
Ear health risks that come with earbuds
Earbuds can pose a few risks, according to Dr. Ruth Reisman, a licensed audiologist and neuroradiologist in New York. They can trap heat and moisture in the ear, increasing the risk of ear infections. With repeated use, the earbuds can also push earwax into the ear, leading to build-up or contact. Also, if your earbuds don’t fit well or you wear them for a long time, they can cause irritation or pain in your ear.
“Earbuds sit directly in the ear, which can increase several risks. The biggest concern is hearing loss caused by noise if the volume is too high or the listening time is too long,” said Reisman. “I’ve seen all these problems over the course of 15 years as a neurologist.”
If you listen to content at high volume, especially for long periods of time, Dan Troast, a hearing expert at HearUSA, explains that it can permanently damage the delicate hair cells in your inner ear. Earbud use combined with high volume can cause:
- Hearing loss caused by noise
- Tinnitus (ringing, buzzing or hissing in the ears)
- Noise sensitivity over time
Misuse of earbuds is also common. If they don’t have it noise cancellationyou may repeatedly turn up the volume to avoid background noise, which can quickly put you in an unsafe listening distance. However, even listening with a limited voice can be a problem if you do so for many hours each day.
“Early signs of overexposure include transient hearing loss or ringing after listening sessions — both warning signs from the auditory system,” Troast said. Even if you experience a temporary ringing in your ears, it can eventually increase your risk of developing chronic tinnitus.
Radiation hazard with earbuds
In my search for ear health tips, I came across several articles that discuss wireless Bluetooth earbuds can cause damage by using radiation. I asked Reisman if this was true.
“Current scientific evidence does not show that the energy from Bluetooth earbuds is harmful,” he said. “These devices emit much less radiation than mobile phones and remain below the established safety limits. From an audiological point of view, exposure to noise is much more dangerous than radiation.”
I am wearing my beloved AirPods Pro 2.
A rule you’ll want to follow when using earbuds
Both Reisman and Troast recommend the “60/60 rule” for people who wear earbuds. The 60/60 rule means that you don’t listen to more than 60% of the maximum volume for less than 60 minutes at a time.
“Daily use is fine if the volume remains safe and the ears are given time to rest,” advises Reisman. “I usually tell patients to take a 15-20 minute break for every hour of use.”
If you haven’t already done so, Troast recommends checking if your device has built-in health settings that automatically monitor volume exposure. For example, on your iPhone, Apple Watch or iPad, you can set up headphone notifications to let you know to lower the volume when you’ve reached a seven-day noise exposure limit (such as 80 decibels for 40 hours in seven days). Alternatively, you can activate the Loud Noise Reduction feature so that your headphone volume is automatically reduced when it exceeds your set decibel level.
Safe types of headphones for your ear health
External headphones they’re generally safer, according to Reisman, because they sit outside the ear canal and don’t focus sound directly on the eardrum. Since they are not in the ear canal like earbuds, they are also less likely to cause irritation or earwax build-up.
“Over-the-ear headphones can be protective — if they allow low-level listening,” Troast said. “It’s even better noise canceling headphoneswhich reduces background noise, so listeners don’t feel the need to turn up the volume.” Just make sure you’re aware of your surroundings, especially if you’re out near traffic.
Turn on the earbuds it may also be a safer option. They use bone conduction technology, which transmits sound through the eardrum and skull rather than directly into the eardrum. “A lot of headphone companies say that open earbuds are better for your hearing health and cleaner,” says David Carnoy, CNET’s headphone expert.
Since open earbuds do not stay inside or cover the ear:
- Warmth and moisture, such as sweat, will not build up, which can cause ear infections.
- Debris, such as dust, will not transfer from the earbuds to the ear.
- They won’t push the earwax deep into your ear, which can lead to contact.
- Do not rub or squeeze the ear, reduce discomfort or irritation.
However, when listening to content at high volumes, no style of headphone is completely safe. Most important for your hearing health and hearing is perfect sound exposure over time, so be sure to monitor your volume level and give your ears a break.
If you continue to wear earbuds, make sure you do so safely — and that they fit properly.
Pro tips when using earbuds
If earbuds are the preferred type of headphones for listening to your favorite music, shows and podcasts, Troast offers the following tips from an audiology perspective:
- Use the built-in volume limit settings on smartphones.
- Select noise canceling earbuds or headphones to avoid turning up the volume in noisy places.
- Take frequent listening breaks.
- Avoid sleeping on earbuds.
- Find a foundation hearing testespecially if you use the earbuds every day.
If you already have tinnitus, it is very important to control your volume level to prevent it from getting worse.
Carnoy adds that there have been cases of people being allergic to the materials used in the earbud tips. If you have a known allergy, make sure your earbuds don’t use that material, or change the tips. If you are allergic, stop using the earbud tips until you find a replacement.
Finally, Reisman advises to keep your earbuds clean, avoid sharing them and make sure they fit properly. Most earbuds come with different sized tips, so you can find the perfect fit for your ear size.
When do you see an audiologist or doctor?
If you experience ringing in the ears, tinnitus, ear pain or frequent infections, Reisman recommends considering an audiologist.
You’ll also want to pay attention to the early warning signs of inner ear damage from noise exposure, such as ringing in the ears, difficulty hearing or needing to turn up the volume over time.
If you already have a hearing problem, Troast said what he was talking about hearing aids it can provide relief. Tinnitus, on the other hand, can be treated with evidence-based methods such as sound therapy or certain counseling techniques.
“Hearing damage is gradual and progressive,” says Reisman, “but it’s also largely preventable with smart and healthy listening habits.” And that includes using your headphones — or, in my case, earbuds — responsibly.
