Inserting a bud could damage the ear canal and eardrum and push wax further down, according to the British health watchdog.
The draft guidance from the National Institute for Health and Care Excellence (Nice) also says that ear syringing, in which a large metal syringe is used to pump water manually into the ear to clear out wax, is potentially harmful and should no longer be used.
Its committee agreed that buds might be a “hazard” that could cause infections or push wax further into the ear canal.
The guideline says the ear canal is “self-cleaning”, with excess wax falling out on its own, and that the entrance to the ears can be cleaned with a damp facecloth.
Rather than manual syringing, which can cause trauma, Nice recommends “ear irrigation”, in which an electronic machine pumps water safely into the ear at a controlled pressure to remove problem wax.
Cotton buds have also proved controversial because of their plastic stems. They are one of the most common types of plastic waste found on beaches.
The current Wildlife Photographer of the Year exhibition at London’s Natural History Museum features a photo of a seahorse with its tail wrapped around one of the buds.