Why Are My Occipital Lymph Nodes Swollen

Overview

(Consider rephrasing this sentence) The lymph nodes contain white blood cells that form part of the immune system as these white blood (lymphocytes) will attack and neutralize pathogens (harmful substances) such as bacteria and viruses to help prevent them from causing disease within the body. The area in which the lymph nodes are swollen is most likely to be where the infection has occurred. So as the occipital lymph nodes are located at the base of the skull, any infection is likely to have occurred in a nearby region such as the throat or skull.  So they swell, not because they themselves are infected but because they are carrying out their role of dealing with infection. Infections that cause them to swell are very common, for example, throat infections (such as strep throat) or infections of the scalp such as head lice, ringwork, and impetigo. These are all contagious infections and easily spread from person to person. However, these infections are also easily dealt with by using corticosteroid topical treatments such as creams and lotions or by antibiotics. Rarely does swelling of the lymph nodes indicate anything more serious, but can be an indirect consequence of conditions like skin cancer or autoimmune diseases.

What are occipital lymph nodes?

The word occipital means the area at the lower part of the back of the head at the base of the skull. Lymph nodes are part of the lymphatic system, one of many systems that have a specific function in the body like the respiratory system or the nervous system. The lymphatic system has several roles which include fat transport and absorption, maintaining fluid balance, and production of immune cells. Just as the circulatory system is made up of vessels that carry blood, the lymphatic system is also made up of vessels that carry fluids and at specific parts of the body, the vessels are connected to lymphoid organs such as the tonsils, thymus, and occipital lymph nodes. The bean-shaped lymph nodes act as filters to cleanse the fluid that passes through them. They do this by using the white blood cells they contain to fight bacteria, viruses, or other pathogens that might cause harm to the body. When fighting pathogens the lymph nodes will become swollen and inflamed and this is given the term lymphadenopathy. 

Swollen occipital lymph nodes

Causes of swollen lymph node

The location of the lymph nodes that are swollen will give an indication of where the infection has started and what the likely cause is. Therefore an infection that started in the region of the occipital lymph nodes causing inflammation or swelling is most likely to have started either in the throat, skin, or scalp.

Bacterial infection 

Bacterial infections in local areas such as impetigo in the scalp or bacteria transferred to the skin when an individual is scratched by a cat, can cause swelling on the occipital lymph nodes. Other bacterial skin infections are caused by Staphylococcus aureus and Streptococcus pyogenes which can also infect the throat.  The immune response can usually neutralize cat scratch disease but it can be cured with antibiotics as can impetigo and other bacterial infections. 

Ringworm

Ringworm can infect the scalp which will also cause the occipital lymph nodes to swell due to their location at the base of the skull. Ringworm is caused by a fungus that causes a red, itchy rash that is circular or in the shape of a ‘ring’. It can be treated with a cream, lotion, or powder.

Head Lice

Head lice are parasitic insects that are passed on from close contact with another person who has them and they live on and feed on the blood of the scalp. This can cause an allergic reaction, triggering an immune response in the occipital lymph nodes or if scratched can develop into a bacterial infection.

Scalp psoriasis

Psoriasis is a condition caused by an over-reactive response of the immune system that causes skin cells to grow too quickly. This causes an excess of cells that become thick, itchy and flaky, and sore. Open sores can be infected with bacteria or yeast which will also cause the occipital lymph nodes to swell.

Rubella

Rubella is caused by a virus.  It causes a pink rash to appear on the body, including the face that is similar to (although milder than) measles. Lymphadenopathy is a common sign of rubella including in the occipital lymph nodes.

Mononucleosis

Mononucleosis is caused by the Eppstein-Barr virus which is passed on when saliva is shared through kissing or sharing utensils that have infected saliva on them. Mononucleosis is a disease that definitely presents itself in the swelling of the occipital lymph nodes so much so that it can cause them to protrude.

Lymphoma

Cancers of the lymphatic system are called lymphomas and are caused when the white blood cells within the nodes grow out of control. According to a study in the Chinese Journal of Cancer cancer of the occipital lymph nodes is uncommon and is often caused by cancer of the skin or cancer of the nasopharynx1.

Melanoma

Melanoma is cancer of the pigments in the skin. According to StatPearls² (move to end of the senabout 30% of melanomas start in the back of the head and neck and therefore will cause the occipital lymph nodes to swell or may even metastasize (spread) to them.

Autoimmune Disorders

Autoimmune disorders cause the immune system to overreact and identify healthy cells as pathogens and attack them. Autoimmune conditions include coeliac disease, rheumatoid arthritis, lupus, psoriasis, and type 1 diabetes. As these conditions can all cause an overactive immune response they can also cause the swelling of the occipital lymph nodes.

Signs of a swollen occipital lymph node

Signs of swollen occipital lymph nodes are:

• Aches and pains at the base of the skull and back of the neck
• Protrusions in the same area are painful when pressed
• Symptoms of localized infections such as itching of the scalp, skin, or sore throat

Diagnosis

A physical examination of the area where the occipital lymph nodes are located and questions about medical history are usually all that is needed to diagnose swollen occipital lymph nodes and find a potential cause. In most cases this will be a bacterial or viral infection of another part of the body in the local area and blood tests might also be used to help diagnose these. If there are more serious concerns a biopsy or x-ray might be required.

Treatments

The diagnosis will find the underlying cause of the swelling of the occipital lymph nodes, which in most cases are doing their job of filtering out infections. Many infections can be treated with topical treatments of antibiotics.  

When to see a doctor

You experience symptoms of an infection (pain, fever, nausea), along with pain and swelling in the location of occipital lymph nodes then you should visit their GP. Sometimes the swelling of the lymph nodes is temporary whilst they successfully neutralize pathogens. However, if they remain swollen for longer than a couple of weeks, even without other symptoms it would also be wise to see a GP.

Summary 

Swollen lymph nodes, including occipital lymph nodes, are quite a normal occurrence and often simply indicate that the body is dealing (in most cases successfully) with infection. If they struggle to do this then most infections can be treated with antibiotics or topical treatments such as creams or lotions. It is very rare that swollen occipital lymph nodes are an indication of something more serious.