Sight, sound, smell, taste and touch are the five basic senses that we rely on. If even one is compromised or damaged, it can affect our quality of life. With increasing age, these senses tend to dull—this is, of course, natural. But there are a number of environmental, occupational and lifestyle factors that can damage these senses, too. This is especially true in the case of our auditory senses, thanks to increasing noise pollution.

Noise exposure and hearing damage (and eventual hearing loss) have been the subject of study for decades. Previously, experts worried mostly about industrial or occupational noises among those working in or living close to factories. With the increase in traffic and the development of listening devices, the focus gradually shifted to include these factors into the idea of noise exposure as well.

Over the decades, listening devices developed to promote personal use and convenience. In the 1980s and 1990s, ENT specialists worried about walkman and headphone usage and the effect they had on the hearing capacity of adolescents. Nowadays, accessing personal listening devices (PLDs) has become even easier with the development of earphones and headphones of many varieties. The latest versions are not only easy to use, but also come with higher decibels (the unit of measurement for sound levels) which are delivered directly into the ears. This can lead to hearing damage and loss.

The World Health Organization (WHO) reports a 5.3% prevalence of hearing loss globally, which amounts to roughly 360 million people. India carries 6.3% of the disease burden for hearing loss—this issue is not one that you should take lightly. This article explains the precise how and why of hearing damage and loss due to earphone damage, and steps you can take to avoid it.

  1. How noise leads to hearing damage
  2. Earphone use and hearing damage
  3. Inner ear damage due to earphone use
  4. Outer ear damage due to earphone use
  5. Tips to reduce ear damage due to earphone use
Doctors for Hearing damage and loss due to earphone use

The volume and duration of exposure are both important when it comes to the effects of noise on health. According to the US Centers for Disease Control and Prevention (CDC), listening to loud noises for a long time can cause hearing loss just as much as a one-time exposure to extremely loud noise.

What essentially happens in the longer run is not just damage to the cells and membranes in the cochlea or inner ear, but also the overworking of the hair cells in the ear which can lead to these cells dying. In fact, 30-50% of these hair cells may already be damaged by the time an auditory test detects a problem.

The longer the exposure, the greater the harm—but that’s not where this ends because the damage can be permanent in the auditory neural system and the effects of the exposure are likely to last even after the exposure has stopped.

According to the UK’s National Health Service, any noise above 85dB (decibels) is considered to be harmful, especially if the exposure to it is for longer durations. A sound is considered to be loud if: 

  • It hurts your ears
  • You can’t hear what people near you are saying
  • You have to raise your voice to talk to people near you
  • You feel a ringing in your ears even after the noise has subsided, i.e., tinnitus
  • You experience muffled hearing after the noise has subsided

The following are some common types of noises and their decibels to give you an idea of why keeping the sound levels below 85dB is good for you:

  • Whispering (30dB) is not harmful
  • Conversation (60dB) is not harmful 
  • Busy traffic (70-85dB) is harmful
  • Motorbike (90dB) is very harmful
  • Listening to music on full volume through a PLD (100-110dB) is extremely harmful
  • Plane taking off (120dB) is extremely harmful

Sound levels above 85dB are harmful. And some studies have revealed that exposure to noise at 85dB for eight hours is likely to lead to hearing loss.

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As a direct source of noise into the ears, earphones or headphones can be harmful to auditory health, especially when they are used over a longer period. Even the most ordinary earphones available today emit an average of 85-100dB of maximum sound. Some of these PLDs (personal listening device) are also kitted out with “noise cancellation” tech, which basically encloses your ears and makes it impossible to hear any surrounding sounds.

Otology experts and ENT specialists agree that if you are unable to hear any other sounds while your earphones are on, it’s likely you are already doing irreparable damage to the nerves and cells of your ears. The development of hearing loss due to earphone use is more likely to be gradual and cumulative, which is why understanding the warning signs is important. The following are the signs of hearing damage that you should take note of—visit an ENT specialist as soon as possible if you notice any of these:

  • Feeling that your ears are ringing, buzzing or hissing without any direct source of noise, also known as tinnitus
  • Difficulty understanding speech at normal sound levels in noisy places
  • Hearing muffled sounds
  • Feeling that your ears are plugged
  • Listening to the television or music at a louder sound level than before

The inner ear contains a snail-shaped structure called cochlea which is filled with fluid. Sound vibrations create waves in the cochlear fluid and the hair cells (which act as receptors), and this transforms the sound vibrations into electrical signals which are then sent to the brain. Any damage to the cochlear fluid and the hair cells can cause hearing loss, and prolonged use of earphones at higher volumes is one of the leading culprits. 

A study published in the journal Noise and Health in 2017 revealed that those who used earphones at 90-100dB thresholds regularly and for prolonged periods of time had the greatest risks of developing hearing impairments due to cochlear damage and tinnitus. Subjects who listened to moderate sound levels for shorter durations were likely to be at a lower risk of hearing damage and eventual hearing loss.

You might assume that since earphones are basically in-ear devices, they would not cause as much long-term damage to the outer ear. But the outer and middle ear funnel the sound waves into the ear canal all the way to the cochlea and the auditory nerve. This means that loud and prolonged noises can affect the hair cells and bones of the outer ear as well. There is, however, an additional way in which earphone use can lead to hearing damage and loss.

When you put the earphones on, it creates an enclosed environment within the ear canal. With prolonged use, the temperature and humidity in the ear canal increases, creating the perfect environment for the growth of bacteria, fungi and all types of microbes that cause infections. If and when earphones with hard earbuds cause scratches, cuts or abrasions inside the ear, it allows the microbes to cause an outer ear infection. A study published in the Malaysian Journal of Medical Sciences in 2002 underlines this risk of outer ear infections, and mentions that chronic outer ear infections can also lead to eventual hearing loss.

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The risk of outer and inner ear damage due to prolonged earphone use is therefore quite high. That said, earphone use is not just associated with leisure activities any more. Given our dependence on laptops and personal computers for work and meetings in almost all fields, it’s associated with our professional lives as well. So, while completely stopping the use of earphones is not in your hands, you can use the following ear and earphone care tips to reduce the damage to your ears and the potential risk of hearing loss.

Keep the volume low

Reduce the volume you listen at, and maintain it well below the prescribed limits. Try to maintain the volume at 60dB and never exceed 80dB.

You can install a sound-level measuring app online to also keep a check on noise levels around you, because often people increase earphone volumes to dull out surrounding noises. Deal with these surrounding noises and you might never have to go above 60dB.

Lessen the duration

The longer the duration of earphone use, the more harm you’re likely to do to your ears. Do not use earphones for eight hours straight, especially while you’re sleeping.

Reduce the duration of earphone use, take breaks and fix a day in the week when you don't use earphones—this will give your ears some time to recover. Also, follow this rule of thumb: If you’re constantly using earphones, reduce the volume every hour instead of increasing it. This will lessen the load on your ears’ nerves and cells and also help you get your work done.

Pick the right earphones

Try not to buy earphones which have a maximum volume of 90dB or above, because those that go beyond 85dB are anyways quite harmful. Also choose earphones that come with soft earbuds to minimise scratches, cuts and abrasions which can cause bleeding as well as outer ear infections.

Clean your earphones

All electronic devices that come in regular contact with your skin pose some risk of transmitting infections, especially if surface transmission of the infection—like in the case of COVID-19—is possible.

Earphones are likely to be cesspools of bacteria, fungi and dust microbes, so they need to be cleaned regularly as per the manufacturer’s instructions.

If your earphones have metallic parts, check them for rust—replace them at the first sign of rust.

Keep your ears clean

Ears have a natural cleaning mechanism. Earwax, also known as cerumen, is made by the outer ear glands to avoid dust, dirt and other substances from getting into the inner ear.

Contrary to popular belief, having earwax in your ears is a sign of good health. The body gets rid of it naturally and humans are unaware of it usually. 

But, keeping your ears plugged with earphones for prolonged periods messes up this natural shedding of earwax, leading to clogging and hardening of earwax. Therefore, those who use earphones for long periods of time need to either get the ears irrigated by an ENT or soften the earwax up with olive oil or almond oil to make its shedding smooth. It must be noted here that poking around your ears with sharp objects or earbuds is not recommended because it’s potentially dangerous and can do a lot of harm to your ears.

Protect your ears

Ears are a sensitive part of your body. It’s important that you protect them at all times—not just while using earphones, but also at high-risk places like concerts, sporting events, nightclubs, airports or near industrial areas. You should also protect your ears from extreme cold and heat.

Get your hearing tested

If you’ve been using earphones for years, you should definitely get your hearing tested regularly. A yearly visit to the ENT specialist is highly recommended, but you can and should also do home audiometry tests using apps that you can download/buy from the various app stores online. These can help you keep a regular check on your hearing abilities and notify you if you need more care and attention from an expert.

Dr. Manish Gudeniya

Dr. Manish Gudeniya

8 Years of Experience

Dr. Manish Kumar

Dr. Manish Kumar

17 Years of Experience

Dr. Oliyath Ali

Dr. Oliyath Ali

7 Years of Experience

Dr. Vikram P S J

Dr. Vikram P S J

5 Years of Experience


  1. Mazlan, R. et al. Ear Infection and Hearing Loss Amongst Headphone Users. Malays J Med Sci. 2002 Jul; 9(2): 17–22. PMID: 22844220
  2. Huh, Da-An, et al. The Effects of Earphone Use and Environmental Lead Exposure on Hearing Loss in the Korean Population: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2010–2013. PLoS One. 2016; 11(12): e0168718. PMID: 28030613
  3. Widen, Stephen E. et al. Headphone Listening Habits and Hearing Thresholds in Swedish Adolescents. Noise Health. 2017 May-Jun; 19(88): 125–132. PMID: 28615542
  4. Portnuff, CDF. Reducing the risk of music-induced hearing loss from overuse of portable listening devices: understanding the problems and establishing strategies for improving awareness in adolescents. Adolesc Health Med Ther. 2016; 7: 27–35. PMID: 26929674
  5. Stevens, Gretchen. et al. Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. Eur J Public Health . 2013 Feb;23(1):146-52. PMID: 22197756
  6. Kumar, Ajith. et al. Output sound pressure levels of personal music systems and their effect on hearing. Noise Health . Jul-Sep 2009;11(44):132-40. PMID: 19602765
  7. Davey S, Maheshwari C, Raghav SK, Singh N, Muzammil K, Pandey P. Impact of Indian public health standards for rural health care facilities on national programme for control of deafness in India: The results of a cohort study. J Family Med Prim Care 2018;7:780-6.
  8. National Health Service [Internet]. UK; 5 ways to prevent hearing loss -
  9. Cleveland Clinic. [Internet]. Cleveland. Ohio; How to Rock Out With Ear Buds or Headphones Without Damaging Your Hearing

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