Doctors call the lymph nodes in the back area of the skull “occipital lymph nodes.” Swelling of these lymph nodes may occur for various reasons, such as infection and skin conditions, including psoriasis.

Lymph nodes are small kidney or oval-shaped glands in the lymphatic system that play an important role in the body’s immune response. They filter out bacteria and other invaders before these pathogens can return to the bloodstream.

Most of the time, people may not notice their occipital lymph nodes. When they are normal in size, they are difficult to detect.

However, if the occipital lymph nodes are fighting off an illness or infection, they may get bigger. A person may be able to see and feel them, and they may be painful or tender to the touch.

Usually, if only the occipital lymph nodes become swollen, it means that a person has some kind of infection or inflammation on their head or scalp.

In this article, we look at the causes of swollen occipital lymph nodes, when to see a doctor, and treatment options.

doctor feeling patients swollen occipital lymph nodeShare on Pinterest
Bacterial infections, psoriasis, and ringworm can cause swelling of the occipital lymph nodes.

A variety of skin infections can affect the scalp, which can cause the occipital lymph nodes to swell. In rare cases, the swelling of these lymph nodes can be a sign of cancer.

The most common causes of swollen occipital lymph nodes include:

Bacterial infections

If a person has an open cut or wound on their scalp, bacteria may enter the skin and cause an infection. They can do this, for example, if a person scratches and breaks the skin or hits their head on something and cuts the scalp.

Staphylococcus aureus or Streptococcus pyogenes bacteria cause the majority of skin infections. The occipital lymph nodes may swell as they collect the bacteria. Other signs of a skin infection include:

  • redness around the injury
  • swelling, pain, or warmth
  • red streaks in the skin
  • yellow drainage or crust
  • blister-like sores
  • fever

Some minor skin infections may go away with at-home care, which may involve cleaning the site of infection regularly and using an antibiotic skin ointment.

However, some skin infections can become serious. A person should see a doctor if they have signs and symptoms of an infection that do not get better within 2–3 days.

Head lice

Head lice are tiny insects that attach to human hair and bite the scalp. They spread easily, usually through direct contact with the hair of someone who has head lice.

If a person gets head lice, they may notice intense itching of the scalp. Excessive scratching may cause open sores and a bacterial infection, which can lead to swollen lymph nodes.

To determine whether lice are present, a person should look for tiny insects or their eggs (nits) in the hair and scalp. They often show up behind the ears and at the nape of the neck. Lice can range in color from light tan to black.

Most cases of lice respond well to over-the-counter medications. A doctor can provide information about safe and effective treatment options.


Psoriasis is an autoimmune condition that causes the skin to renew itself too quickly. This accelerated process results in a buildup of skin cells that can cause itchy and painful red scales and patches.

Psoriasis commonly affects the scalp, but it also occurs in other areas of the body, including the face, feet, and skin folds.

According to the Psoriasis and Psoriatic Arthritis Alliance, psoriasis on the scalp can cause swollen lymph nodes if the person also has a bacterial or yeast infection on the scalp.

There is no cure for psoriasis, but many different medications are available to treat it. A person should work with their doctor to find the best treatment to help control the symptoms.

If a person notices swollen lymph nodes, they should see a doctor to check for an infection.


Ringworm is a highly contagious fungal infection. When it affects the scalp, it is called tinea capitis. Tinea capitis can cause swelling of the occipital lymph nodes. Other signs of ringworm on the scalp include:

  • one or more bald patches on the scalp
  • a ring-like rash
  • itching

Ringworm on the scalp usually requires a prescription oral antifungal treatment for 1–3 months, according to the Centers for Disease Control and Prevention (CDC).

Rubella (German measles)

Rubella is a contagious disease that occurs due to a virus. The rubella vaccine has dramatically decreased the number of cases in the United States to fewer than 10 people per year, according to the CDC. However, it is more common in other areas of the world.

Rubella can cause swollen lymph nodes in the head and neck, including the occipital nodes. Other symptoms of rubella include:

  • low grade fever
  • cough
  • sore throat
  • headache
  • runny nose
  • measles-like rash that appears on the face and then spreads

Most people who get rubella will have mild symptoms. However, it can cause serious harm to an unborn baby. Due to this, pregnant women should get the rubella vaccine, and they should talk to a doctor if they think that they may have come into contact with a person with rubella.


This skin cancer can affect any area of the body, including the scalp. If it does affect the scalp, the occipital lymph nodes may swell as they try to filter out cancer cells. Signs of melanoma include a spot or mole on the skin that is:

  • asymmetrical (the two halves do not match)
  • uneven with irregular borders
  • multicolored
  • large in diameter (larger than a pencil eraser)
  • darker in color than other moles
  • evolving or changing over time

Melanoma can be life threatening. In addition, spots on the scalp can be harder to detect if the hair covers them. Anyone who is concerned about their risk can ask a doctor about getting regular skin checks to detect melanoma early.

If a person has any unusual or changing spots on their skin, they should see a doctor.

If a person has swollen occipital lymph nodes, a doctor will try to find the cause. They may check the scalp for signs of infection or cancer.

In some cases, a physical exam may be sufficient. If a doctor wishes to check for cancer, they may perform a biopsy, which involves taking a small sample of skin and sending it to a lab for testing.

The type of treatment for swollen occipital lymph nodes depends on the cause. Minor skin infections may only need at-home care, while more complex infections, such as ringworm, may require a prescription.

Occipital lymph nodes usually go back to normal after a person gets treatment for the underlying cause.

Swollen occipital lymph nodes are usually a sign of an infection or inflammation on the scalp. If they do not go away after several days or occur alongside other symptoms, such as fever, a person should see a doctor.

Anyone who notices that other lymph nodes, such as those in the neck or groin, have become swollen should also see a doctor.

When all the lymph nodes swell, this may be a sign of a body-wide illness, such as mononucleosis (mono), or an immune system condition, such as lupus.

Below are frequently asked questions relating to swollen occipital lymph nodes.

What does an ultrasound of lymph nodes show?

An ultrasound scan shows the size and shape of a lymph node when it is not clear in a physical examination. For example, ultrasound scans may help identify cancerous growths on lymph nodes. These scans can also help guide doctors during biopsies.

Can a radiologist tell if a lymph node is cancerous?

If an imaging scan reveals abnormal cell growth on a lymph node, the radiologist or other healthcare professional carrying out the scan will order a biopsy. While imaging scans can assist in diagnosis, biopsy results are often the only way to tell if a lymph node is cancerous.

Swollen occipital lymph nodes are not usually a cause for alarm. They are a sign that the immune system is fighting off an invader.

However, people should see a doctor if lymph nodes do not go back to normal within a few days. A doctor can help rule out any serious conditions and prescribe treatment if necessary.