Four Seasons Pediatrics

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What’s Hot – Swimmer’s Ear and Measles


This summer has introduced us to high humidity and now higher temperatures.   This usually leads to swimmer’s ear, typically in August.  This year there has been a 50% increase in swimmer’s ear over June 1 to July 10th, as kids seek relief from the heat.   What is there to know and what can you do about it?


Swimmer’s ear is a condition that occurs when the ear canal becomes irritated. The ear canal is the part of the ear that leads from the outer ear to the ear drum (figure 1).  “Swimmer’s ear” is the name for external otitis that occurs in a person who swims frequently.


Several factors can increase your risk of swimmers ear.

Cleaning the ear canal removes ear wax. Ear wax serves to protect the ears from water, bacteria, and injury. Excessive cleaning or scratching can injure the skin, potentially leading to infection.

  • Swimming on a regular basis removes some of the ear wax, allowing water to soften the skin. Bacteria, which normally live in the ear canal, can then enter the skin more easily.
  • Wearing devices that block the ear canals, such as hearing aids, headphones, or ear plugs, can increase the risk of external otitis (if worn frequently) by injuring the skin.


The most common symptoms are:

  • Pain in the outer ear, especially when the ear is pulled or moved
  • Itchiness of the ear
  • Fluid or pus leaking from the ear
  • Difficulty hearing clearly


If you think that your child could have swimmer’s ear, you should call us to make an appointment.  We will examine the outside and inside of your ear to confirm the diagnosis.


Treatment aims to reduce pain and eliminate the infection.  In some cases, we will flush out your ear with water and hydrogen peroxide before you begin treatment; this speeds healing by removing dead skin cells and excess ear wax.

Ear drops — Ear drops are usually prescribed to reduce pain and swelling caused by external otitis. It is important to apply the ear drops correctly so that they reach the ear canal:

  • Lie on your side or tilt your head towards the opposite shoulder.
  • Fill the ear canal with drops.
  • Lie on your side for 10-20 minutes or place a cotton ball in the ear canal for 20 minutes.
  • Finish the entire course of treatment, even if you begin to feel better within a few days.

You should begin to feel better within 36 to 48 hours of starting treatment. If your pain worsens or does not improve within this time period, call us.

Pain medication — If you have bothersome ear pain, you can take a non-prescription pain medication.

Avoid getting ears wet — During treatment, you should avoid getting the inside of your ears wet. While showering, you can place a cotton ball coated with petroleum jelly in the ear. However, you should not swim for 7 to 10 days after starting treatment (or until your child has NO pain with wiggling the ear and pressing on the part of the skin that protrudes from the ear).  Avoid wearing hearing aids and in-ear headphones until pain improves.


The old saying, “Don’t put anything smaller than your elbow in your ear” to clean the ear is true. The ear is self-cleaning; fingers, towels, cotton-tipped applicators, and other devices should not be used to clean the inside of the ears.

If you swim frequently, we recommend the following tips to reduce the chance of developing swimmer’s ear:

  • Shake your ears dry after swimming
  • After a day of swimming apply 2-3 drops of a preventive solution.  This can be purchased, or you can make it up yourself by adding 1 part of rubbing alcohol to 1 part of white vinegar.  Mix this into a eye dropper bottle and keep it in your swim bag.


From January 1 to July 3, 2019, 1,109  individual cases of measles have been confirmed in 28 states. This is an increase of 14 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000.  The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Texas, Tennessee, Virginia, and Washington.  These outbreaks are linked to travelers who brought measles back from other countries such as Israel, Ukraine, and the Philippines, where large measles outbreaks are occurring.  The largest number of cases have occurred in New York.  They are traced to travelers who brought measles into communities where vaccination rates were lower.  In these communities, there was a strong anti-vaccine movement that influenced parents to avoid vaccination.  In many cases, there continued to be a belief that the vaccine(s) cause autism.   Four Seasons Pediatrics wants to thank the downstate medical communities who have worked hard to reverse these views and have improved vaccination rates with evidence based medicine.    Please remember that not all children produce antibodies to protect them after the first MMR vaccine.  That is the reason for a second vaccine.  Although rare, there are even a few children who do not produce protection to a second vaccination.  This is why it is important to have high vaccination rates (called herd immunity) to make it harder for measles to make its way to these children.  It is also to protect children who cannot get protection – such as those with cancer, those with immune deficiencies and those too young to vaccinate.   With all that said, we want to remind the community that vaccines do not cause autism.  Vaccines cause Adults!

Group FSP Vaccines cause adults
All Staff
Group FSP Vaccines cause adults back
Vaccines Cause Adults!
Group FSP Vaccines cause adults Reception
Reception Staff from Left to Right:
Yvonne, Barbara, Samantha, Tatiana, Gabrielle, Katina, Kara
Group FSP Vaccines cause adults Nurses
Nursing Staff from Left to Right:
Olivia, Megan, Cassandra, Chelsea, Stephanie, Jessica, Lynn
Group FSP Vaccines cause adults providers
Provider Staff from Left to Right:
Dr. Miller, Dr. Elmer, Dr. Apruzzese, Dr. Lange, Dr. Sohn

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