You have hundreds of small, oval- or bean-shaped lymph nodes (also known as lymph glands) throughout your body. Your lymph nodes, along with lymph vessels, are part of your immune system. Lymph nodes contain immune cells that help defend against disease.

Your lymph system filters fluid to remove harmful substances from your body. When the lymph system is working, fluids get drained away.

Normally, your lymph nodes are small and firm. When they’re healthy, you shouldn’t even notice them. A buildup of fluid can cause them to swell. Swollen lymph nodes may feel tender to the touch or even painful.

The preauricular lymph nodes are the ones located just in front of your ears. They drain lymph fluid from the eyes, cheeks, and the scalp near your temples.

Generally, lymph nodes swell in only one area of the body at a time (localized lymphadenopathy). The problem, such as an infection, can usually be found nearby.

But there are certain conditions, such as viral illnesses, that cause swollen lymph nodes in multiple areas of the body (generalized lymphadenopathy).

Continue reading to learn a few of the causes of swollen preauricular lymph nodes and when you should see a doctor.

Whenever there’s an infection, injury, or cancer, lymph nodes spring into action to fight it off. In the process, they can become enlarged.

If you have swollen lymph nodes, it’s because something is wrong. Usually, the problem is located in close proximity to the affected lymph nodes. Following are some reasons you might have swollen or painful preauricular lymph nodes.

Ear infection

An ear infection can cause lymph nodes in front of or behind the ears to swell. You might also have ear pain and fever. Ears can become infected when fluid builds up in them. This can happen when you have allergies, a sinus infection, or the common cold.

Eye infection

Parinaud oculoglandular syndrome is a type of conjunctivitis (pink eye) that can cause preauricular lymph nodes to swell. There are many things that can cause this condition, the most common one being cat scratch fever. Cat scratch fever is acquired from bacteria when a cat scratches or bites you. You can also get it when a cat licks an open wound. Other symptoms may include:

  • mucus discharge from the eyes
  • puffiness around the eyes
  • swelling of the eyelids
  • corneal ulcer
  • low grade fever and pain

Some of the less common causes of Parinaud oculoglandular syndrome are:

Tooth infection

A tooth abscess is a buildup of pus due to a bacterial infection. Nearby lymph nodes can swell as they try to fight off this infection. Other symptoms are:

  • mouth pain
  • jaw pain
  • swollen gums
  • foul-smelling breath

Skin or scalp infection

Infections of the skin and scalp can spread to the preauricular lymph nodes. Infection of the lymph nodes (lymphadenitis) may be accompanied by fever. You might also develop an abscess, and the skin over the lymph nodes may become red and warm.

Rubella (German measles)

One symptom of rubella is that you might have swollen lymph nodes behind the neck or ears. But rubella can cause swollen lymph nodes in other parts of the body, in addition to the preauricular nodes. Some other symptoms of rubella are:

  • rash that begins on the face and spreads down
  • fever
  • headache
  • runny nose
  • painful joints

Other conditions

While swollen lymph nodes are not among the main symptoms, these other conditions can sometimes cause generalized lymphadenopathy:

Lymphoma is a type of cancer that begins in the lymphatic system, including the lymph nodes, spleen, thymus, and bone marrow. There are many different types, including Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Besides swelling of the lymph nodes, other signs and symptoms are:

  • fatigue
  • fever, night sweats
  • shortness of breath
  • weight loss

Leukemia is cancer of the blood-forming tissue. That includes the lymphatic system. There are several different types of leukemia. Some are very aggressive (acute) and some tend to progress more slowly (chronic). In addition to swollen lymph nodes, leukemia can cause:

  • bleeding or bruising easily
  • enlarged liver or spleen
  • fatigue, weakness
  • fever
  • frequent infections
  • weight loss

A biopsy of the affected lymph node can help diagnosis the cancer.

Also, any type of cancer can spread into the lymph system and cause swollen or painful lymph nodes. That’s why when you’re diagnosed with cancer, nearby lymph nodes are usually examined.

Swollen or tender lymph nodes are a symptom, not a disease. Treatment depends on the cause for swelling of the preauricular lymph nodes. Generally speaking, lymph nodes tend to return to normal size once the underlying condition is treated.

Ear, eye, skin, and scalp infections can generally be treated with antibiotics. Any conditions that cause these infections should also be treated.

For an abscessed tooth, you may need a root canal to clear the infection. This would be followed by having a crown placed over the tooth. Alternatively, you can have the tooth drained by cutting into the gum tissue. This would be followed by a course of antibiotics. In some cases, the only remedy may be to have the tooth extracted.

There’s no standard treatment for rubella. Antibiotics are ineffective, but without complications, it should get better on its own. This disease can be prevented with the measles, mumps, rubella (MMR) vaccine.

The treatment for cancer can be complex. It may involve some combination of chemotherapy, radiation therapy, and biological and targeted drugs.

Treatment for lymphoma and leukemia depend on the specific type and stage of cancer. Other considerations are your age, overall health, and personal preferences. In some cases, stem cell transplant (also called bone marrow transplant) is an option for lymphoma and leukemia.

Most of the time, swollen lymph nodes don’t signal a dangerous health problem. They should return to normal within a short period as the underlying condition clears up. But because they can occasionally be symptomatic of a serious condition, do see your doctor if:

  • you also have a persistent fever or unexplained weight loss
  • there’s no apparent reason for the swelling
  • swelling continues for more than two weeks
  • lymph nodes feel hard or rubbery
  • lymph nodes don’t move when you push on them
  • the skin over the lymph nodes is red or inflamed
  • you have a personal history of cancer
  • you have a family history of lymphoma or leukemia