As Joni Mitchell once sang, “you don’t know what you’ve got till it’s gone,” and that rings particularly true for our health. In early 2025, I learned this lesson the scary way when what started as a nasty weeks-long cold turned into the following symptoms in my left ear: reduced hearing, a feeling of fullness, occasional tinnitus (ringing in the ear) and a day or two of balance issues, as the inner ear helps with the body’s equilibrium. 

What turned out to be eustachian tube dysfunction — when the tube connecting the middle ear to the back of the nose no longer functions properly — left me frantically googling ways to preserve my ear health. As a wellness writer with 10-plus years of experience and a strong understanding of the importance of taking precautionary health measures, I wanted to do everything in my power to prevent hearing loss from happening again. 

During my search for answers, I found that a common piece of technology may be contributing to my hearing issues: earbuds. I spoke to ear health experts, who said earbuds inserted directly into your ear can cause hearing loss and other issues. Here’s what experts say about earbuds and ear health. 

The ear health risks that come with earbuds 

Earbuds can pose a few risks, according to Dr. Ruth Reisman, a licensed audiologist and New York hearing aid dispenser. They can trap heat and moisture in the ear, increasing the risk of ear infections. With repeated use, earbuds can also push earwax deeper into the ear, leading to buildup or impaction. Plus, if your earbuds don’t fit correctly or you wear them for long periods, they can cause irritation or soreness in your ear canal. 

“Earbuds sit directly in the ear canal, which can increase several risks. The biggest concern is noise-induced hearing loss if volume is too high or listening time is too long,” said Reisman. “I have witnessed all of these problems in the course of my 15 years as an audiologist.”

When you listen to content at high volume, particularly for an extended period, Dan Troast, an audiologist at HearUSA, explains that it can permanently damage the delicate hair cells in your inner ear. Earbud use combined with high volume can cause:

• Noise-induced hearing loss
• Tinnitus (ringing, buzzing or hissing in the ears)
• Sound sensitivity over time

Misusing earbuds is also common. If they don’t have noise cancellation, you might repeatedly turn up the volume to avoid hearing background noise, which can put you in an unsafe listening range fast. However, even listening at a moderate volume can become a problem if you do so for hours each day. 

“Early signs of overexposure include temporary muffled hearing or ringing after listening sessions — both are warning signals from the auditory system,” Troast said. Even if you periodically experience temporary ringing in your ears, it can ultimately increase your risk of developing chronic tinnitus. 

Radiation risk and earbuds

In my search for ear health tips, I came across several articles discussing whether wireless Bluetooth earbuds can cause harm through radiation. I asked Reisman if this is true. 

“Current scientific evidence doesn’t show that the energy from Bluetooth earbuds causes harm,” she said. “These devices emit far less radiation than cell phones and remain well below established safety limits. From an audiology standpoint, sound exposure is a far greater risk than radiation.”

The rule you’ll want to follow if you use earbuds 

Both Reisman and Troast recommend the “60/60 rule” to people who wear earbuds. The 60/60 rule means you listen at no more than 60% of the maximum volume for no more than 60 minutes at a time. 

“Daily use is fine if the volume stays safe and ears are given time to rest,” Reisman advises. “I usually tell patients to take a 15- to 20-minute break for every hour of use.”

If you haven’t already, Troast recommends checking whether your devices have built-in hearing health settings that automatically monitor volume exposure. For instance, on your iPhone, Apple Watch or iPad, you can set up headphone notifications to alert you to lower the volume when you’ve reached the seven-day audio exposure limit (such as 80 decibels for 40 hours over seven days). Or, you can activate the Reduce Loud Audio feature to have your headphone volume automatically lowered once it exceeds your set decibel level.

Safer types of headphones for your ear health

Over-the-ear headphones are generally safer, according to Reisman, because they sit outside the ear canal and don’t concentrate sound as directly on the eardrum. Since they aren’t in the ear canal like earbuds, they’re also less likely to cause irritation or earwax buildup. 

“Over-the-ear headphones can be safer — if they allow for lower listening volumes,” said Troast. “Even better are noise-canceling headphones, which reduce background noise, so listeners don’t feel the need to crank up the volume.” Just make sure you’re still aware of your surroundings, especially if you’re outdoors near traffic. 

Open earbuds could also be a safer option. They use bone-conduction technology, which transmits sound through the earbones and the skull rather than directly to the eardrum. “Several headphone companies claim open earbuds are better for your hearing health and are more hygienic,” said David Carnoy, CNET’s resident headphone expert. 

Since open earbuds don’t sit inside or cover the ear:

• Warmth and moisture, like sweat, won’t build up, which can cause ear infections. 
• Debris, such as dust, won’t transfer from the earbuds into the ear. 
• They won’t push earwax deeper in your ear, which can lead to impaction. 
• Don’t rub or press on the ear canal, reducing discomfort or irritation.

However, if you listen to content at high volumes, no headphone style is completely safe. What matters most for your ear and hearing health is total sound exposure over time, so make sure you’re monitoring your volume level and giving your ears breaks. 

Expert tips if you use earbuds

If earbuds are your preferred headphone type for listening to your favorite music, shows and podcasts, Troast offers the following tips from an audiology perspective:

• Use built-in volume limit settings on smartphones.
• Choose noise-canceling earbuds or headphones to avoid increasing volume in loud environments.
• Take regular listening breaks.
• Avoid sleeping in earbuds.
• Get a baseline hearing test, especially if you use earbuds daily.

If you’re already experiencing tinnitus, it’s especially important that you manage your volume level to prevent it from worsening. 

Carnoy adds that there have also been instances of people being allergic to the materials used for earbud tips. If you have a known allergy, make sure your earbuds don’t use that material, or replace the tips. If you do have an allergic reaction, stop using the earbud tips until you can find a substitute. 

Lastly, Reisman advises keeping your earbuds clean, avoiding sharing them and ensuring they fit properly. Most earbuds come with tips in different sizes, so you can find the right fit for your ear size.

When to see an audiologist or doctor 

If you experience ringing in the ears, muffled hearing, ear pain or frequent infections, Reisman recommends you consider an evaluation with an audiologist. 

You’ll also want to pay attention to 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’re already experiencing hearing loss, Troast said that addressing it with hearing aids can provide relief. Tinnitus, on the other hand, can be treated with evidence-based approaches such as sound therapy or specific counseling strategies. 

“Hearing damage is gradual and cumulative,” Reisman said, “but it’s also largely preventable with smart and healthy listening habits.” And that includes using your headphones — or, in my case, earbuds — responsibly.