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Swollen lymph nodes behind the ear: Causes & treatment

Last update on Apr, 12, 2023

Where are lymph nodes found?

Lymph nodes are small bean-shaped organs, about 1 cm in size, located throughout the body. They are part of the lymphatic system and work in conjunction with the immune system to fight off pathogens. The functions of the lymph nodes include filtering the lymph and are characterized by the presence of white blood cells, which are useful in fighting diseases. The lymph nodes behind the ear are located on the temporal bone and under the posterior auricular muscle. If they are swollen, you can feel them behind the ear with your fingers.

Usually, a healthy person's lymph nodes are not detectable. Swollen lymph nodes are perceptible to the touch and might cause a slight pain. When you touch them you can feel a bump under the skin. If you feel this bump, this may be a sign that there is an infection of some kind in the affected area. In fact, the lymph nodes often fight against infectious agents. If this is the case, the area may also be red and warm to the touch.

The lymph nodes behind the ear should cause concern when the size of their diameter increases above 2 centimeters, reaching up to 3 centimeters (above 1 centimeter we speak simply of reactive lymph nodes). If the swelling, regardless of size, does not subside over three weeks and there is no indication of infection, you should visit a doctor.
Lymph node behind the ear

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Causes: Why do lymph nodes behind the ears hurt and swell?

A swollen lymph node behind the ear may be a sign that there is an infection in the affected area. You may suffer from a bacterial, viral, or fungal infection in the ear, throat or eye. The infections that may affect the lymph nodes behind the ear are:

  • Bacterial infection of the pharynx, tonsils or larynx
  • Gum inflammation, tooth abscess
  • Infection in the ear, i.e. otitis media
  • Fungal infections in or around the head that cause itching of the scalp or hair loss
  • AIDS and HIV
  • Mononucleosis
  • Rheumatoid arthritis

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Symptoms: How do I know if my lymph nodes are swollen?

Swollen lymph nodes behind the ear can be temporary or chronic. Symptoms can be different and vary in severity depending on the cause, the most common symptoms of swollen lymph nodes are:

  • Swelling
  • Possible pain on palpation and pain behind the ear
  • Reddened and overheated skin

Other symptoms associated with swollen lymph nodes behind the ear may occur in the mouth or throat, like cough, sore throat, jaw pain, toothache. In addition, fever, fatigue, and ear pain may occur.

Lymph node swelling may occur only on one side of the body.  This is referred to as localized swelling and may indicate an infection or allergic reaction occurring on that same side of the body. 

Swollen lymph nodes are more likely to be benign than malignant. A lymph node can only be determined to be malignant with a biopsy and pathology exame performed by a physician. Benign lymph nodes don't contain cancer cells, while malignant ones do. For swollen lymph nodes, some potential signs they can be malignant are:

  • The lymph nodes are larger than one centimeter
  • The lymph nodes have been swollen for more than three weeks
  • The swelling has appeared suddenly and the gland feels hard to the touch, with or without pain
  • The skin in the affected area is red, itchy, or overheated
  • Unexplained weight loss
  • Fever, night sweats and persistent fatigue
  • Shortness of breath

If you note any of these symptoms, please see your doctor immediately.

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Treatment of abnormal lymph nodes behind ear

In most cases, swollen lymph nodes resolve on their own within a few days/weeks without complications. If treatment is required, a physician must first determine the cause of the swollen lymph node.

For an acute infection, anti-inflammatory drugs (such as NSAIDs), warm compresses and rest accompanied by antibiotics, when necessary, are often sufficient.

Lymph node abscesses may require surgical drainage. Swollen lymph nodes caused by inflammation or autoimmune disorders are treated with anti-inflammatory drugs such as NSAIDs, cortisone or other types of immunomodulators can be used.

Lymph nodes should usually reduce in size within two-three weeks. For this reason, if the swelling of the nodes persists for more than two to three weeks, the affected person should book an appointment with the doctor, even if the nodes are not sensitive to pressure or pain.

Swollen lymph nodes can also occur in babies, but this is usually harmless, in most cases they have an infectious origin and resolve in a few weeks. They can be caused by bacteria (staphylococcus aureus, streptococcus pyogenes or cat or dog scratch disease) or viruses (cytomegalovirus, herpes simplex, hepatitis B).

An appointment with the pediatrician is necessary if lymph nodes are larger than two centimeters, increase in size for more than two weeks, do not to resolve completely after 2-3 months and if the child suffers from fever, weight loss or night sweats.

Swollen lymph nodes behind ear or in your neck can be a symptom of Covid-19, as when the virus creates upper respiratory tract infections, the lymph nodes in the neck and in front of the ear are the first to respond to the virus. This type of lymph node swelling is usually not dangerous and will go away on its own. Rarely will they lead to infections or other complications.
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