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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Indent On Head. Runny Nose, Congestion And Sinus Headaches. Taking Allergy Shots Once A Week. Should I Be Concerned?

Hi. I am a 22 year old female. I just recently noticed a vertical indentation from the very top of my head down maybe an inch of my crown. It doesn't really hurt, but because I have been touching it a lot and allowing family members to feel it, it seems a little soar or sensitive now. I just got my hair dyed last week where I sat under a heater for a while. I have not had any injuries, but I have always had crazy allergies. I wake up nearly every morning with a runny nose, congestion, and sometimes a sinus headache. I use to get allergy shots once a week for a while, but that was years ago. I have also lost about 10 lbs, I have been trying to eat healthier and exercise. But this past week or 2 I have been eating junk food. What is this seemingly sudden indentation on my head? Should I be concerned?
Thu, 21 Nov 2013
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General & Family Physician,  's  Response
hello Dear!
thank you for asking. I read your query and i want you to know that if the indent on your head is not preceeded by some trauma or fall then it is probably innocuous and it will go away. If it doesn't in a week you can see Nearby Gp to assess this bump and sort out the etiology for you. If it hurts simple acetaminophen or topical NSAIDs will be enough.

Now your main Concern. Allergic rhinitis with allied morbidities

you need 3 phases for management

1)Avoidance:
Avoiding exposure to allergens such as pollen, dust mites, and mold to a minimum and all other environmental control measures.

2)Medication therapy

a-Second-generation antihistamines
Cetirizine (Zyrtec) Levocetirizine (Xyzal) Cetirizine and pseudoephedrine (Zyrtec-D) Fexofenadine/pseudoephedrine (Allegra-D)
Loratadine/pseudoephedrine (Claritin-D 24 Hour, Claritin-D 12 Hour)

b-Leukotriene receptor antagonists
Montelukast (Singulair)

c-First-generation antihistamines
Chlorpheniramine (Chlor-Trimeton) Diphenhydramine (Benadryl, Benylin) Hydroxyzine (Atarax, Vistaril, Vistazine)

d-Decongestants
Pseudoephedrine (Sudafed)

e-Nasal corticosteroids
Mometasone (Nasonex) Beclomethasone (Beconase AQ, QNASL) Budesonide inhaled (Rhinocort Aqua) Fluticasone (Flonase) Ciclesonide (Omnaris) Fluticasone furoate (Veramyst) Triamcinolone (Nasacort AQ)

f-Intranasal antihistamines
Azelastine (Astelin) Olopatadine intranasal (Patanase)

g-Intranasal cromolyns
Cromolyn sodium (Nasalcrom)

h-Intranasal anticholinergic agents
Ipratropium (Atrovent Nasal Spray 0.03%)

3) immunotherapies
if the above two precautions could not modify your condition then i am afraid you would need a step up. that is immunotherapy

There are sublingual and subcutaneous immunotherapies SLIT SCIT. you can discuss the possibility with your doctor.

4) see the Otorhinolaryngologist for ruling out surgivcally treatbale causes or complications of allrgic rhinitis like deviated nasal septum, chronic sinusitis polyps or turbiectomies for relief.

I hope i was of some help

regards
Dr S Khan
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Indent On Head. Runny Nose, Congestion And Sinus Headaches. Taking Allergy Shots Once A Week. Should I Be Concerned?

hello Dear! thank you for asking. I read your query and i want you to know that if the indent on your head is not preceeded by some trauma or fall then it is probably innocuous and it will go away. If it doesn t in a week you can see Nearby Gp to assess this bump and sort out the etiology for you. If it hurts simple acetaminophen or topical NSAIDs will be enough. Now your main Concern. Allergic rhinitis with allied morbidities you need 3 phases for management 1)Avoidance: Avoiding exposure to allergens such as pollen, dust mites, and mold to a minimum and all other environmental control measures. 2)Medication therapy a-Second-generation antihistamines Cetirizine (Zyrtec) Levocetirizine (Xyzal) Cetirizine and pseudoephedrine (Zyrtec-D) Fexofenadine/pseudoephedrine (Allegra-D) Loratadine/pseudoephedrine (Claritin-D 24 Hour, Claritin-D 12 Hour) b-Leukotriene receptor antagonists Montelukast (Singulair) c-First-generation antihistamines Chlorpheniramine (Chlor-Trimeton) Diphenhydramine (Benadryl, Benylin) Hydroxyzine (Atarax, Vistaril, Vistazine) d-Decongestants Pseudoephedrine (Sudafed) e-Nasal corticosteroids Mometasone (Nasonex) Beclomethasone (Beconase AQ, QNASL) Budesonide inhaled (Rhinocort Aqua) Fluticasone (Flonase) Ciclesonide (Omnaris) Fluticasone furoate (Veramyst) Triamcinolone (Nasacort AQ) f-Intranasal antihistamines Azelastine (Astelin) Olopatadine intranasal (Patanase) g-Intranasal cromolyns Cromolyn sodium (Nasalcrom) h-Intranasal anticholinergic agents Ipratropium (Atrovent Nasal Spray 0.03%) 3) immunotherapies if the above two precautions could not modify your condition then i am afraid you would need a step up. that is immunotherapy There are sublingual and subcutaneous immunotherapies SLIT SCIT. you can discuss the possibility with your doctor. 4) see the Otorhinolaryngologist for ruling out surgivcally treatbale causes or complications of allrgic rhinitis like deviated nasal septum, chronic sinusitis polyps or turbiectomies for relief. I hope i was of some help regards Dr S Khan