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What Causes Facial Swelling, Sensitive Spots On Head, Fatigue And Ear Infection?

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Posted on Mon, 22 Dec 2014
Question: Hello, My 81 year-old mother has facial swelling, and sensitive spots on her head (within her hairline) that have come and gone for the last 2 weeks, or so. The sensitive spots (at first she described them as "bumps" to me, but upon further questioning, she said they're not really bumps, but rather just "sensitive spots") are warm to the touch, and are not always in the same spots. They move around: sometimes they're more on the left side, and then sometimes they're more on the right side. My mother is tired and sleeps a lot more. She does sound a little plugged up, but it is not VERY noticeable. Some background is that she has a "bad" left ear due to severe infections during childhood and has had a couple surgeries to remove her middle ear(?). Her left ear had been feeling full and uncomfortable for the last week - after the swelling and sensitive spots started. She does see an ENT 1-2 times per year, and upon my insistence, saw an ENT resident 2 days ago where I believe all they did was clean out her ear. There was no apparent infection, and they did not give her any meds. She did not address her facial swelling or sensitive head spots with them. She does not plan to see a doctor until next Thursday (in 6 days), when she plans to piggy-back onto my dad's appointment with their internist. What could cause the facial swelling and head bumps? Sinus infections? Should she be seen earlier? She is in otherwise good health.
Thank you!
doctor
Answered by Dr. Rahul Tawde (1 hour later)
Brief Answer:
Evaluation for dermatitis needed

Detailed Answer:
Hi, thanks for posting your concern in the HCM.
After reading the symptoms you mentioned, the first name that popped up in my mind was Seborrheic dermatitis.
As the ENT doctor has checked her only two days back and there was no infection, significant enough to be treated with antibiotic, my understanding is there cannot be a so severe infection that happened to be just present at the time of check up and has caused facial swelling and scalp pain in two days without any history of fever.
Rather, your saying that there was some wax in the ear canal which needed to be cleaned is far more significant. All these symptoms, facial swelling, incresead ear wax, migrating scalp tenderness are features of allergic or seborrheic dermatitis (the later seems to be more specific a term and more likely to have happened).
Now, I can recommend you some basic treatment for the same. But, you should be examined by your local dermatologist first to get a final diagnosis and treatment specific for the same.
My recommendations are-
Shampooing / leathering hair for long
You need to use 2% Ketokonazole or Nizoral shampoo or 8x shampoo everyday
You also need to use 2% Nizoral cream over face once daily.
Oral medicines may be needed depending upon the clinical findings.
If you find this answer helpful, please close the thread and rate my answer.
Regards.
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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What Causes Facial Swelling, Sensitive Spots On Head, Fatigue And Ear Infection?

Brief Answer: Evaluation for dermatitis needed Detailed Answer: Hi, thanks for posting your concern in the HCM. After reading the symptoms you mentioned, the first name that popped up in my mind was Seborrheic dermatitis. As the ENT doctor has checked her only two days back and there was no infection, significant enough to be treated with antibiotic, my understanding is there cannot be a so severe infection that happened to be just present at the time of check up and has caused facial swelling and scalp pain in two days without any history of fever. Rather, your saying that there was some wax in the ear canal which needed to be cleaned is far more significant. All these symptoms, facial swelling, incresead ear wax, migrating scalp tenderness are features of allergic or seborrheic dermatitis (the later seems to be more specific a term and more likely to have happened). Now, I can recommend you some basic treatment for the same. But, you should be examined by your local dermatologist first to get a final diagnosis and treatment specific for the same. My recommendations are- Shampooing / leathering hair for long You need to use 2% Ketokonazole or Nizoral shampoo or 8x shampoo everyday You also need to use 2% Nizoral cream over face once daily. Oral medicines may be needed depending upon the clinical findings. If you find this answer helpful, please close the thread and rate my answer. Regards.