If you use IEMs daily and are not blessed with a near complete absence of earwax then I'd assume you'll probably need to clean your ears daily. I know I do. I clean my ears with Q tips at least once a day and often twice a day if I've worn my SE530s for a long period of time such as when I usually wear them all day long at work.
Maybe I just have tons of earwax, but I have a hard time imagining not doing this. My Comply tips might last two weeks tops without such regimented cleaning. You can barely clean them at all without ruining their memory-ness and most of their isolation and comfort. They'd be filthy in no time at all. Even the silicone and rubber tips would need an extensive wipe down every time I took them out of my ears if I went a two weeks without daily cleanings. Even after allowing for that, I'd have to dismiss any IEM that didn't have a user replaceable filter because the nozzle would be clogged with earwax in no time and I'd be out a few hundred or so rather quickly.
Unless your ear canals are tiny (mine shouldn't be especially large since I only use the medium Complys), its easy to insert the Q tip down the center without pushing up against the sides or impacting the ear wax and then remove the ear wax by either spinning it or pushing the Q tip against the side of your ear canal and pulling out the wax. I also use Murine earwax removal drops every so often in case any ear wax might have got impacted or left behind somehow but I pretty much never see anything else come out.
I have a few serious questions to the people here who are for a lack of a better term, "anti-Q-tip". Do you use IEMs daily? How much ear wax do you have? What practical alternative is there to Q tips? Also note that the murine drops take way to long to count as practical and do twice daily.
I'm actually curious. I think that if you didn't have much ear wax and didn't use IEMs then you wouldn't need to clean your ears very often but different people in different situations may need to. I'm perfectly aware that some sort of freak accident (Because I'm not stupid enough to walk around while I'm doing it. There would need to be a very precisely time earthquake or collapsing chair...) while I happen to have the Q tip in my ear could lead to a ruptured eardrum but given the lack of feasable alternatives I can't see how its any different than a not-so-freak accident that could kill me as I drive to work. Life is inherently risky...