I think I have worms in my head
May 14, 2011 1:30 PM   Subscribe

I think my scalp is infested with nematodes. What do I do?

I know I sound like a crazy person, but this is freaking me out. I have a raised itchy and slightly painful bump on my scalp, about an inch across. I plucked a hair out, and it looked vaguely fuzzy. I thought I might have a fungus, so looked at it under a microsope at 50x. There are long tendriley things coming out of it and I swear they are moving. My first thought is that the air currents were making them move about (I don't have a cover slip), but I actually saw one emerge from the side of the hair root. This is disgusting.

I know. Occams razor, this is probably some totally normal comensurate critter that lives in everybody's hair follicles, or it's some artifact that I am misinterpreting. But I am freaking out, because it looks a hell of a lot like pelodera strongyloides, and now I think I have nematodes living in my scalp. I have an appointment with a dermatologist for Friday, but I am freaking out, and want to see a doctor ASAP.

1. Should I see a dermatologist or an infectious diseases specialist? Both are near my house and open at 8am on Monday.

2. How do I calm down and get on with it when I think I have things living in my head?
posted by anonymous to Health & Fitness (22 answers total) 8 users marked this as a favorite
Pluck out another hair. Does it also look vaguely fuzzy? Does it also have long tendrilly things coming out of it that appear to move under a microscope? OK, then take this hair and dip it in rubbing alcohol. Wait until it dries. Now look at it again. Still moving? Probably not a nematode.

Go see your dermatologist as soon as possible, regardless. Either way, you still have an itchy, painful bump on your scalp.
posted by phunniemee at 1:42 PM on May 14, 2011 [3 favorites]

I would see a dermatologist, if for no other reasons than (1) your peace of mind and (2) your scalp is bothering you. No opinion on nematodes.
posted by J. Wilson at 2:14 PM on May 14, 2011 [1 favorite]

so looked at it under a microsope at 50x.

Agree with see a dermatologist, which you're doing--but unless the dermatologist has some special powers you might just call around until you get one who can see you Monday AM if your insurance won't be too much of a problem. It sounds like it would be worth the money for the comfort factor.

But also -- the microscope -- this seems like a practice that can't not freak a person out. There are few objects in my house that would stand up to scrutiny under a microscope and I couldn't guess which ones they are -- just looking around, it all seems like it would be pretty gross. Seriously. Gross. I'm sure we're crawling with lifeforms.

Even if you did have some weird thing what you're describing is really teensy, not visible to the naked eye, and as you point out, we all have freaky critters living in our eyebrows. Worst case scenario is they give you a shampoo (from what I could gather via a quick search.)

Remember: if you can't see it, it doesn't exist. Take that, science.

And for the love of God, stop looking at it.
posted by A Terrible Llama at 2:41 PM on May 14, 2011 [25 favorites]

Seems pretty unlikely unless you were in some sort of situation where you were exposed to a likely vector (ever since I slept on that damp pile of straw in the barn...)

Having dealt with lice in my day I know how hard it can be to deal with the crawlies, and that's what it boils down to. Because pragmatically even if you are right this isn't really a big deal and having it go on for another week isn't much of an issue. But if you can't stand it by the end of Sunday, do what you gotta do, it's not going to be the end of the world either way.

You most likely do not have nematodes in your scalp.
posted by nanojath at 2:42 PM on May 14, 2011 [1 favorite]

Googling that nematode, the page I read said to change the animal's exposure to larvae, e.g., by changing the straw bedding, then the infestation would go away on its own. Wash your sheets and call it a day?
posted by salvia at 2:47 PM on May 14, 2011

Wash your hair, pour alcohol on your bump. Wash your sheets. Relax. We have so many creepy crawlies living on and in us, it is probably nothing. Now if it were large and protruding from your abdomen, a la, Alien, I would worry a bit.
posted by fifilaru at 2:53 PM on May 14, 2011 [3 favorites]

Have you been to Central America lately? Could be botfly larvae [caution: video not for the faint of heart or weak of stomach].
posted by dersins at 3:07 PM on May 14, 2011 [2 favorites]

Don't freak out the OP.

There have been a handful of documented cases of humans being infected with pelodera strongyloides, iirc. I don't know you but based on that fact alone I'd wager a not insubstantial amount that you have anxiety rather than pelodera strongyloides.

I know. Occams razor

This goes beyond Occam's razor, I think. If you're concerned, by all means see a dermatologist since you have a really itchy scalp. But looking at your own hair under a microscope and deciding you have a pelodera strongyloides infestation is verging on shrink territory.
posted by Justinian at 3:28 PM on May 14, 2011 [7 favorites]

What you are doing to yourself falls under the category of delusory parasitosis. Or you are bordering on it. Stop. Calm down. Take a deep breath. You do not want to become one of these people. I am an entomologist, and I have dealt with people suffering from this disorder several times. They become so convinced that they are infested with mites/beetles/worms/whatever that they are beyond help. It is very sad, and it sounds like you haven't fallen off the deep end yet. Once they fall off of that end, there is very little anyone can do to help them. Please, stay calm, don't obsess about it, don't worst case scenario it to death, and stay rational. Go to your dermatologist with the bump on your head, which is just an itchy bump.
posted by bolognius maximus at 3:42 PM on May 14, 2011 [15 favorites]

Mod note: From the OP:
When the hair root dries nothing moves. The moving stopped a few minutes after the hair was plucked. I haven't tried rubbing alcohol, but I did attempt to stain one of the hair roots with an herbal tincture I have lying around, just 'cause it's what I have handy, and I thought the alcohol might dissolve a little of the sebum when I was looking for fungi. I didn't see anything moving, but I saw the clear outlines of some fat, torpedo shaped wormey things which look like demodexmites. But it's not unusual to have mites - they might be contributing to the itchyness, but I'm not freaking out about them. I am freaking out about the wrigly things that emerged from the freshly plucked hair.
posted by mathowie (staff) at 4:47 PM on May 14, 2011

Don't know if it'll help or not, but when I had ringworm on my neck I washed my hair and beard with Nizoral shampoo. It's a pretty strong antifungal, from what I recall.
posted by swashedbuckles at 5:25 PM on May 14, 2011

IANAD, but I've used a microscope or two in my day. Consider that your experiment doesn't have a control. Ideally, you would look at some "normal" samples and also some samples from skin known to be afflicted with pelodera, looking under the same scope, and then decide which better matched your sample. It is dangerously easy to draw whatever conclusions you want from very limited data. Have a dermatologist look at you - they've seen thousands of scalps, of all types.

Also, as per Terrible Llama, everything looks creepy under the scope. You could easily have just been seeing fraying tendrils of hair and dead strips of skin -- and you're seeing a 2D-ish slice of a 3D image, which can make it even harder to see what's going on.

To answer your second question: sometimes thinking of the worst case scenario can be helpful. Here, the absolute worst case scenario is that you have some nematodes on your scalp. I don't know exactly what they would give you but there are a variety of anti-helminthitic drugs out there and they work well. The same is true for fungal infections. It would hardly be the end of the world.

So, see a dermatologist as soon as you can, but in the meantime: it's probably nothing. And even if you do have an infection, it's unlikely to be anything more than a temporary inconvenience.
posted by en forme de poire at 5:46 PM on May 14, 2011 [1 favorite]

Mod note: From the OP:
1. The things stopped moving after a few minutes. Plucked a new hair - things moved and emerged from the hair root, then stopped after a few minutes. This seems congrous with the hypothesis that they are living critters that are drying out, but for all I know they are angels playing red-light green-light.

2. dersins's comment especially helped put things in perspective. Oh thank god it's not a botfly! (The darn things I found are tiny, about 1/6 the diameter of a human hair. ) I did hike through rain forest and marsh lands in Central America twice in the past year, most recently about two months ago. I have also been in the Rocky Mountains and the Eastern US for what that's worth. I haven't been sleeping on any hay though, and my animal contact is pretty minimal, although I did have mice in my house. But I will be counting my blessings that I do not have a botfly!
posted by jessamyn (staff) at 6:07 PM on May 14, 2011

You need to stop inspecting your own hair under a microscope. I know it seems like a good idea at the time, but it is really just a way to feed your own anxiety. It's not healthy.
posted by Justinian at 7:33 PM on May 14, 2011

Reread bolognius maximus' comment. And stop doing anything until your appointment with the dermatologist. It's not going to hurt you or kill you in that short a time, and talking to the doc will likely put your mind to rest.
posted by Miko at 7:37 PM on May 14, 2011

First, you have your own microscope!? That's too cool. I am now a little envious.

Second, I agree with the first commenter, phunnimee. Check a hair sample from a non-itchy area. Then STOP because you are only going to freak yourself out even more. There is not much you can do about it at the moment. so have a good stiff drink or the equivalent, and try to think about other things.
posted by annsunny at 8:19 PM on May 14, 2011

Is there anyone you know who you can ask for a hair sample that you can compare against your own? I'd do that and see if everyone is "infected" or if it's just you.
posted by Mrs Roy G Biv at 9:30 PM on May 14, 2011

A lot of minor things clear up by themselves without going to a doctor. A very few could become serious enough that they can't be treated, or will cause major problems.

Your bump might just be a bump. Do you want to be the person who lives their life stress free or the person who looks into everything just in case of the unlikely worst case scenario?

I don't know all the details of the bump, but from what you said I personally wouldn't go to a doctor or a dermatologist, just see if it goes away.
posted by Not Supplied at 2:51 AM on May 15, 2011

Call your doctor back on Monday and say "I am really freaking out I need an appointment earlier than Friday." Doctors always have spots where they can squeeze in emergencies.
posted by radioamy at 7:03 AM on May 15, 2011

I have seborrheic dermatitis and the bump you're describing sounds like ones that I get from time to time on my scalp. They are usually cleared up by shampooing with coal tar or salicylic acid-based products. Again, the dermatologist will have all kinds of helpful info.
posted by gsh at 11:00 AM on May 15, 2011

Have you read about Morgellons? That's what your question made me think of.
posted by crabintheocean at 2:11 AM on May 18, 2011

I wish there was an update feature for anonymous posts!
posted by otherwordlyglow at 8:39 AM on June 1, 2011 [2 favorites]

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