Occipital Lymph Nodes: Causes, Symptoms & Care

What are occipital lymph nodes?

Lymph nodes have always been underrated - but did you know that the lymphatic system is immanent for our survival? In general, it acts as a transport and drainage system for the body by transporting fluid that has leaked out of the blood vessels, regulating the fluid levels in the body, as well as providing necessary immune responses.  

This article will leave you with a clear understanding of occipital lymph nodes, possible causes of inflammation in the nodes, the diagnosis an indication of how to handle the onset of any undermentioned health conditions, and hopefully, will answer any questions you have relating to this topic. 

Specifically, occipital lymph nodes, also known as the posterior cervical lymph nodes, are classed as superficial lymph nodes, which are located at the base of the skull,¹ alongside lymph vessels.

These lymph nodes, accompanied by other superficial lymph nodes, create a canal-like drainage system, draining the occipital part of the scalp. 

What are swollen occipital lymph nodes?

Swelling of the occipital lymph nodes typically indicates scalp infection or inflammation. If accompanied by fever, pain, redness, or tenderness, or if the node suddenly increases in size, hardens, or there's unexplained weight loss, it's essential to see a medical professional. Regular self-checks can help in early detection and treatment.

Swollen occipital lymph nodes are lymph nodes located at the back of the head, near the base of the skull. Positioned near the occipital bone of the skull, these nodes, like others in the body, are vital for the immune defence system. They can become swollen for various reasons, including infections, inflammation, or cancer.

Diagnosis

Diagnosis of swollen occipital lymph nodes may involve a physical examination by a healthcare professional who may feel the lymph nodes for swelling, tenderness, or any other abnormalities.

Other diagnostic tests or procedures that may be used to diagnose the underlying cause of the swelling include:

• blood tests
• imaging tests such as ultrasound, CT scan or MRI
• biopsy of the lymph node

Treatment

Treatment of swollen occipital lymph nodes is primarily determined by the underlying cause. Over-the-counter pain relievers such as paracetamol or ibuprofen may help to alleviate pain or discomfort associated with the swelling.

Prescription medications such as antibiotics or anti-inflammatory drugs may be necessary if the swelling is due to an infection or inflammation. In some cases, surgical removal of the lymph node or treatment for underlying cancer may be required.

Prevention

Prevention or management of swollen occipital lymph nodes may involve:

• practicing good hygiene
• washing your hands regularly
• avoiding close contact with sick people
• covering your mouth and nose when coughing or sneezing

If you are prone to swollen lymph nodes, identifying and avoiding the triggers such as allergens or irritants that may cause inflammation may also be helpful.

Complications

Complications of swollen occipital lymph nodes may include the spread of infection or the development of abscesses. If left untreated, the underlying cause of the swelling may also worsen and lead to further complications. It is important to seek medical attention if you notice persistent or worsening swelling of the lymph nodes.

Causes of swollen occipital lymph nodes

Occipital lymph nodes usually swell up as an inflammatory response to foreign matter entering the body. This is due to the fact that the superficial occipital lymph nodes are primary sources of contact² for these foreign materials and they act as the initial immune responses to combat these.

The inflammation in the area is part of a defence mechanism whereby the immune system acts to prevent the spread of the condition. The inflamed lymph nodes enable increased blood flow to the infected or injured area, allowing white blood cells (the body’s attack system) to fend for the body more effectively.

This is effective because when blood flow to the area increases, the permeability of the blood vessels increases, allowing more white blood cells to exit the vessels and combat the diseases.

Bacterial infections

Bacterial infections such as tuberculosis (TB)² are an example of bacterial conditions that can inflame the occipital lymph nodes. As mentioned by Bruzgielewicz et al,³ cervical lymph node tuberculosis occurs in 35.6% of people who are diagnosed with TB.

During the initial stages, patients are most likely to experience lymphadenopathy, (the enlargement of the lymph nodes due to them being swollen). Ultrasonography and fine needle biopsies are then carried out to determine the nature of the inflammation of occipital lymph nodes.³ 

Treatment is then carried out on bacterial infections, specifically based on the results of the tests. For instance, patients who have contracted tuberculosis are given strong antibiotics for extended periods of time to completely eradicate all bacteria from the body. 

In terms of when to see the doctor, tuberculosis should not be taken lightly, as there as many strains of the bacteria which are antibiotic resistant. Therefore, it is advised by the WHO to see a doctor straight away if one feels the onset of it.

Similarly to other bacterial infections, it’s important to let the body heal of its own accord, but not to an extreme extent where the condition becomes hard to handle, so it’s advised to see a doctor if one’s condition hasn’t improved after one week.⁶ 

Ringworm

Ringworm is a fungal infection caused by close contact with infected people, things, or animals. Ringworm in the scalp, neck and face area tends to cause swollen occipital lymph nodes,⁴ as well as skin conditions, predominantly circular-shaped rashes. The inflammation of the lymph nodes also occurs to prevent the spread of the fungal infection as most diseases can spread through the lymphatic system quite easily.

Ringworms are primarily treated with oral antifungal medications, such as Griseofulvin,⁷ prescribed by doctors. These tend to be quite effective and usually have antibiotic properties as well. Griseofulvin specifically has previously been used on both animals and humans and has had positive outcomes. 

In terms of the diagnosis, dermatologists (skin specialists) are usually the ones to ascertain ringworms on patients, as they are able to obtain a skin swab from the area, which is taken for testing. Doctors should be visited when the rashes typically appear to be oval-shaped rashes, accompanied by a dry and itchy feeling. 

Head lice

Head lice are insects that use the human body as their host by feeding on the blood from our scalp to continue living. In doing so, these parasites make the skin on our scalp tender, which causes people to itch and scratch, allowing secondary infections to take place. These secondary infections are the main reason for the inflammation of the occipital lymph nodes. 

Head lice are mainly treated using insecticidal-based treatments such as permethrin. However, over the years, these common medications have started becoming redundant due to resistance developed by the head louse.⁹ So further research is being done into using natural-based treatments, yet the efficacy of these remains varied. 

Doctors should be consulted when and if the condition worsens to the extent that patients start to develop conjunctivitis, lymphadenopathies (swelling of occipital lymph nodes), and secondary infections as a result of head lice.⁸ 

Psoriasis

Psoriasis is an inflammatory skin condition that can manifest in many ways, such as plaque, guttae, pustular, inverse, and erythrodermic.⁵ Symptoms show dry, red, scaly, and itchy patches on the scalp that have a tendency to spread. These patches when itched can cause further infections, leading to the inflammation of the occipital lymph nodes. 

Psoriasis is usually identified by dermatologists when skin cells from the affected area are taken and tested. The onset of this disease typically causes a beta-hemolytic streptococcal infection, which is sometimes confused with an allergy to the antibiotics used to combat the infection. Other treatment options consist of phototherapy and topical steroids (steroid creams), both of which are effective.⁵

A doctor should be contacted at any suspicion of inflammation of the lymph nodes as this means that secondary infections have occurred.

Rubella

Rubella, known as German measles, is a virus that manifests itself in spots on the skin and is most commonly known to be part of the vaccination trilogy MMR. Symptoms include swollen occipital lymph nodes, body pain, high temperature, and dry skin. The WHO aims to eliminate rubella in the near future, however, due to its multiple genotypes, it has been challenging.

Rubella has an incubation period of up to two weeks and tends to affect the face first, then spreads to other limbs of the body. Swollen occipital lymph nodes tend to inflame during this period and persist for two weeks, even after the rash has disappeared. Patients are known to get better on their own within a week if they have a functioning immune system, however, it'll take longer for people who have immunocompromised health conditions.¹⁰

It is advised to have taken the MMR vaccination as a child and take the recommended MMR boosters as an adult in order for people to recover more effectively and avoid the spread of Rubella. Almost about 95% of people with the vaccination develop immune responses.¹⁰ There is still no antiviral drug available to treat Rubella. Seek a doctor if you have further health complications and if the symptoms persist for longer than one week.

Mononucleosis

Mononucleosis, also known as glandular fever, is a contagious, infectious disease caused by the Epstein-Barr virus. It is mainly spread through bodily fluids such as saliva, and transmission can be prevented by taking precautions when sharing cutlery and glasses, and by avoiding kissing. As the name suggests this virus causes an inflammatory response from the body, hence causing swollen occipital lymph nodes as well as inflammation of the other glands near the face and neck.¹¹ 

Other symptoms include high temperatures, swollen tonsils, extreme fatigue, and swollen glands. Currently, there is no cure for mononucleosis, so the only solution is rest. It’s essential to take plenty of fluids to regulate the body temperature and over-the-counter painkillers to combat the symptoms. Though steroids are available, they are usually only prescribed for extreme cases.¹¹ 

A doctor should be visited if symptoms persist for longer than three weeks as this virus is quite resistant, and symptoms such as swollen glands can last for months at times.

Lymphoma

Lymphoma is a cancer of the lymphatic system, which as described above, is the transport and drainage system of the body. Cancer is the abnormal, uncontrolled division of body cells, in this case of the lymph cells, which results in masses of tissue that are malignant. Lymphoma is unfortunately usually fatal as cancer cells can easily spread through this transport system and cause cancer in other parts of the body. As occipital lymph nodes form a major part of the lymphatic system, usually this is where the tumour is found, hence causing inflammation in the node.

Diagnosis usually occurs after several tests including fine-needle aspiration and surgical biopsies which are immanent in determining the nature of the cells. Tests however need to be repeated, especially surgical biopsies, as both procedures can cause total lymph node infarctions, so surgical biopsies are preferred.¹² A doctor should be seen if the swollen lymph nodes persist, as earlier treatment is ideal in comparison to later treatment.

There are a few treatment routes where early-stage treatment requires radiation therapy, whereas further developed lymphomas require chemotherapy, immunotherapy, or radioimmunotherapy.¹³ Achieving a cured state is quite rare but is possible, however, a prolonged life is not rare.

Melanoma

Melanoma is a cancer of the skin cells, where an abnormal, uncontrolled division of melanocytes (skin cells in the epidermis of the skin) causes masses of tissue to form (malignant tumours). These are usually caused due to mutations in the melanocytes (which are melanin-producing cells that protect the skin from UV exposure).¹⁴

Did you know that melanoma is considered to be a modern disease? As people with fewer melanocytes decided to migrate towards the equator due to a preference for more sun, their bodies were not adapted to deal with that atmosphere and melanoma became prevalent in that population.

The occipital lymph nodes swell as a result of this disease, however, biopsies are not carried out until it goes past the papillary dermis and into a deeper, cutaneous level.¹⁴ Diagnosis usually consists of biopsies being done, as well as the observation of moles. Due to the development of technology, there are now new, non-invasive methods to determine whether one has melanoma, such as through the use of apps. 

The disease is usually treated through surgery of the tumour, however, in later stages, radiotherapy will be required. If it is at a critical stage, then certain medications can be given to inhibit the growth of melanoma. Although doctors should be seen immediately when patients have symptoms concerning melanoma, an early diagnosis leads to a higher chance of survival.¹⁴ 

Autoimmune conditions

Autoimmune conditions occur when the human body’s defense mechanism fails and begins attacking normal human cells without being able to differentiate between foreign matter and cells. This can be fatal, as the immune system can attack vital organs.¹⁵

The efficiency of the immune system, on the other hand, is due to the organization of the lymphatic system, which is central in delivering immune responses. This is why the occurrence of an autoimmune disorder in the body is first detected by the lymphatic system in the body, thus resulting in swollen occipital lymph nodes.¹⁶ 

Autoimmune conditions are usually always misdiagnosed as they manifest in very particular forms, for example, systemic lupus erythematosus (SLE) may present itself as rheumatoid arthritis, which is another autoimmune condition. Lupus in particular can mimic many conditions and hence misdiagnosis is common.¹⁷ However, high levels of certain white blood cells and inflammatory markers in the body determined through blood tests can result in the diagnosis of autoimmune conditions.

There are not many treatment options available for autoimmune disorders, and patients are mainly treated symptomatically, according to which disorder they have. Although, in order to reduce the impacts of the faulty immune system, patients are prescribed immunosuppressants¹⁷ which, as the name suggests, suppress the immune system, and shut down the body’s defense mechanism completely, making them vulnerable to any other diseases and the environment itself. It is advised to see a doctor if symptoms persist for extended periods of time.

Summary

Though occipital lymph nodes are usually not directly a part of any of the aforementioned diseases, they are essential in determining the presence of disease in the body, being the first point of contact. Therefore, treatment relies on the diagnosis of the underlying condition and so it’s very important that if swollen occipital lymph nodes are to persist, you get them checked out, as it is an indicator that your body may be unwell.