Whether we’re listening to music while working out, turning on our favorite podcast, watching online videos at 2 a.m. or taking a work call, earbuds keep us plugged into our digital world.

But as much as we use earbuds, we have to wonder, “Do they cause any health problems?”

Of course, listening to the volume too high is a cause for concern. But in some cases, using earbuds can actually cause ear infections, as well.

How can earbuds cause an ear infection?

Our ears are full of things that serve a purpose to our ear health, like bacteria, moisture and earwax. Usually, any bacteria and moisture have a chance to clear out on their own, but earbuds can stand in the way.

“Bacteria and fungi thrive in moist, warm areas, such as the ear canal, and that’s where earbuds sometimes trap moisture and fluid,” said Hayley Ralph, MD, a family medicine provider at OSF HealthCare.

“When that happens, you’re at risk for an ear infection.”

Earbuds can also push earwax further into our ear canal, which can cause a buildup and is another way an infection can develop.

Signs of an ear infection

“You’ll know you have an ear infection when you have ear pain, itching, drainage or discharge from the affected ear or hearing loss,” Dr. Ralph said.

Other symptoms of an ear infection may include a clogged feeling in the ear, a stabbing pain from the inside of the ear and, in some cases, nausea. You may also develop a fever. Anything over 100.4 degrees is considered a fever by the American Academy of Pediatrics.

“External ear infections are treated with either topical antibiotic drops, antifungal drops or a topical steroid drop depending on the suspected underlying cause of the problem,” Dr. Ralph said.

Avoiding an ear infection

You can still use your earbuds to listen to all your favorite media, but Dr. Ralph has some tips for lowering your risk of getting an ear infection.

No earbuds with an ear infection: Do not use earbuds while you have an active ear infection. You should also avoid using earbuds for several weeks after an ear infection as it can take a while to fully heal.

Clean earbuds regularly: If you’ve ever looked at your earbuds closely, you may notice that there is earwax built up on the inside. What you can’t see is the other bacteria that builds up as well. To better avoid getting an ear infection because of earbuds, it’s important to clean your earbuds regularly.

“We suggest cleaning ear devices at least once weekly with an alcohol wipe,” Dr. Ralph said.

Some earbud distributors sell special products to clean out your earbuds. But if you want an easier option, you can always use a screen cloth (the same kind you would use to clean a phone or computer screen) or a cotton swab.

It’s especially important to clean your earbuds after doing any activity that makes you sweat.

“Since earbuds trap moisture and fluid, this can be worse if you wear them while exercising and working up a sweat,” Dr. Ralph said.

Choose external headphones: If you want another option, try listening devices that don’t go into the ear.

“Headphones that sit over the outside of the ears instead of inside them may help reduce the risk of ear infections,” Dr. Ralph said.

Proper ear care: Dr. Ralph also recommends keeping your ears clean. But before you go sticking a cotton swab in your ear, she warns, “Stop!”

“They can actually cause injury to the ear canal and pack wax down deeper. If you feel or see wax at the outer of edge of your ear, you can use a clean washcloth over the tip of your finger and very gently wipe it loose,” Dr. Ralph said.

“If you suspect an earwax blockage is deeper, ask your physician for more direction on safe home treatment and removal, or they can safely remove it in the office.”

Article originally appeared on OSF HealthCare