Itchy bumpy scalp with inflamed lymph nodes

[nyt726]

I am a healthy female in my late-20's and I have had itchy, dry scalp with dandruff for years now, but since about 1 month ago, I've noticed that the itchiness and dryness have gotten worse and I also noticed that I have bumps on the back of my head.  In addition, it feels as though my left occipital lymph node and post-auricular lymph nodes are slightly swollen compared to the right, but they are not tender.  The smaller bumps are tender however, and my scalp on the back of my head feels sensitive to pressure. A few years ago, the dandruff disappeared after I started using Head & Shoulders so I have not had dandruff since then but have always had dry, itchy scalp.  I don't think the worsened itchiness and dryness are due to an allergic reaction b/c I haven't changed my shampoo or conditioner. However, I'm a bit alarmed by the swollen lymph nodes. Could this be some sort of infection? If so should I be taking antibiotics/antifungals? Any professional advice would be greatly appreciated. Thank you.

[Bhupinder Kaur, MD]

Hello,
Since you’ve got the complaint of itchy, dry scalp, you may be suffering from Tinea Capitis or Ringworm (fungal infection) of the scalp. The symptoms of Ringworm or Tinea Capitis include a dry itchy scalp, scaling, crusting, inflamed nodules, hair loss and tender enlarged lymph nodes on the neck.  Because of the scratching that is involved with the condition it can become secondarily infected with a bacterial infection.

An outer ear infection can also result in the enlargement of the lymph nodes although in majority of the people, there are symptoms of pain in the ear.

I think in your case it could be fungal scalp infection and secondary bacterial infection. My sincere advice is to consult a dermatologist and get the diagnosis confirmed.
I hope it helps. Take care and please do keep me posted on how you are doing or in case you have any additional doubts. Kind regards.