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Date of last update: 10/18/2017.

Forum Name: Dermatology Topics

Question: Scalp Pimples & Itch w/Swollen Lymph Nodes

 flyingtim01 - Mon Nov 02, 2009 11:06 am


First I'd just like to say that I do have an appointment to see my doctor regarding this issue, but its not for a couple of weeks, so in the meantime I'm just looking for some information in the hopes that I can stop stressing over it.

Last week, I noticed that I had developed what felt like pimples on my scalp, mostly on the back of my head. It might be noted that on the day before the pimples started in earnest, I was out in the rain, wearing a wet baseball cap for approximately 2-3 hours. They felt irritated and a bit painful. I assumed that like pimples, it would go away on its own. Instead, they seemed to get even more inflamed and more painful, to the point where even if I rocked my head back (as though I was looking up) they would be very painful.

After a couple of days of that, I noticed that the lymph node behind my left ear had become swollen. Its not particularly tender, though I haven't spent much time prodding and poking it. By now, the pimples on my scalp had become much worse, with perhaps 1-2 dozen of them, of varying sizes, populating the back and crown of my head. The very top of my scalp has remained relatively clear, with only one or two pimples showing up and then clearing up over the past 7 seven days, though the rest of my scalp seemed to be mildy itchy. For sure, the worst of the pimples were on the back of my head. I also noticed that while not as pronounced as the enlarged lymph node behind my left ear, there were also lumps on the back of my neck. These also weren't particularly tender.

The scalp pimples didn't strike me as exceedingly odd (at 29 years old I still have pimples that show up on my face, despite my good hygiene) but the swollen lymph nodes seemed to me like something else might be going on, so I made an appointment to see my doctor. In the meantime, I looked up my symptoms online, and all the signs point to a fungal infection. I started using a shampoo with tea tree oil and drying my hair completely. I've also stayed away from hats and changed the pillow cases on my bed and bought a new comb, just to cover my bases.

As of today, 7 days after I first noticed the pimples, they are decidedly better. There are a few smaller pimples that seem to be just scale at this point and there are just a few of the larger and more inflamed ones, seeming localized along the bottom of my hairline along the back of my head. I still have somewhat of an itchy scalp, but nothing terrible. Whether that is due to any of the steps I took to treat my symptoms or the infection just running its course, I have no idea. The lymph node behind my ear seems to be a bit less pronounced, though I can still feel the nodes in my neck, if I move my head in the correct direction and bring them closer to the surface.

Just a few pieces of history: over the last year or so, I have noticed that sometimes the lymph node behind my left ear has gotten swollen. I can't say that there were any other symptoms along with it (perhaps a sore throat at one point) but the lymph node always went down in a matter of days. I never noticed any of the other ones in the back of my neck swelling. I've also had scalp pimples, but it was fairly infrequently, so I always attributed it to a clogged pore or ingrown hair. Also, I usually keep my hair short, perhaps 1" long on top and very closely cropped on the sides and back. However, my hair is longer now, as I haven't had time to visit the barber. Not sure if that has anything to with it.

For as long as I can remember, I've had mild dandruff in the winter when the weather turns cold and dry. I've used Head & Shoulders for the past 5 years or so, and I was using it daily when I noticed this latest round of pimples, and had been since last winter. I also have generally dry skin in the winter, mostly on my back and shoulders. I was a swimmer for 4 years in high school, and always thought the chlorine in the pools contributed to this condition. I deal with the itch in winter with lotion, and forget about it for the rest of the year. Also from my years on the swim team, I acquired a nail fungus on my left small toe. I saw a dermatologist (it was probably nearly 15 years ago by now) who at the time prescribed Lamisil cream. I used it then, but the fungus never seemed to clear up completely and I still have the symptoms today. A yellowed, flaky nail and sometimes itching and splitting of the skin between my small toe and the neighboring one. I keep the nail clipped very short (so that its almost not there) and when it gets itchy, I use the OTC Lamisil cream.

I also don't know if this has anything to do with anything, but my girlfriend has had a yeast infection that lasts for the 4-5 days before her period, and then clears up, for the last 4 months. She saw her doctor about it last week and is now addressing that issue by decreasing the amount of sugar she is eating (among other things) and using a suppository.

Like I said, I have an appointment to see my doctor, but any light anyone sheds on this for me would be greatly appreciated. Thanks!
 Dr.M.jagesh kamath - Wed Nov 11, 2009 11:00 am

User avatar Hello,The scalp pimples are mostly folliculitis,and you have a reactive lymphadenopathy.The chances of fungal infection of scalp is less likely because the lesions are more circumscribed and scaly in tinea capitis.One of the most important causes in my experience is pediculosis of scalp and secondary folliculitis.Do check with your parner for the same and if so may need application of permethin.Of course your doctor would be in a better position to advice,but you can always discuss this possibility.Best wishes.

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