Managing and treating prurigo nodularis

Learn about treatments for PN and how to talk to your dermatologist about finding control.

When it comes to managing your PN, your doctor or dermatologist is the best person to talk to

Often, living with PN can be frustrating. Especially if you’re struggling to find a way to manage your condition, or you’re seeing little improvement with your current approach.^1–3This can make appointments with your doctor or dermatologist a bit harder to navigate. When it feels like nothing is helping, it’s not easy to be positive – but it’s important to know that things are changing.³

For a long time, little has been known about PN, limiting the ways that doctors and dermatologists have been able to manage it.³ But clinical research is continually advancing our understanding of the condition, meaning we now know more about PN than ever before.^4,5

Your doctor or dermatologist is the best person to speak to about your PN. So, if you haven’t visited them in a while, or have questions, now may be a good time to book an appointment and discuss which management approach could work for you.

Taking control of your PN

A management plan for dealing with PN generally includes medication and skincare to reduce itch and related scratching.^5,6 It can also be used to help prevent further scarring, as scars can result from repeated scratching.^5,7 Depending on severity, a doctor or dermatologist may prescribe a range of treatments for your PN.

So, what types of treatments are out there?

Some treatments are applied to the skin. These are known as topical treatments.⁶ Procedures and surgical treatments can also be used for individual lesions. This may include intralesional injections and cryotherapy.⁶ Systemic treatments may also be used for the treatment of PN.^6,8 This includes biologics, which are given as an injection, and immunosuppressants, which are given orally.⁸ The different types of systemic treatments work within the immune system or nervous system in different ways.⁸

If you want to learn more about potential treatments for your PN, speak to your doctor or dermatologist.

Learning what self-care means for your PN

You might be wondering how self-care could help you with your PN. It turns out there are several measures you can take at home that may make it easier to stop scratching.^8,9

These include:^8,9

Wearing long-sleeved clothes and gloves
Wearing clothes made from cotton rather than synthetic fibres
Keeping your fingernails short
Staying as cool as possible. For example, by laying a cold cloth on the affected skin and keeping the room temperature down

It’s important to remember that these measures may not be targeting the underlying inflammation that could be at the root of your PN.¹⁰ They are simply there to support the management plan recommended by your doctor or dermatologist, and help make living with your symptoms a little easier.

DIY* remedies don’t always work

Many people living with PN try to manage their condition with home remedies or by removing foods from their diet that they suspect may be triggers.² However, there’s little evidence to suggest that these measures are effective in managing the condition or in addressing its underlying causes.

Remember, you don’t have to deal with your PN alone. The best way to find the right management approach for you is to speak to your doctor or dermatologist.

*Do It Yourself

Talking to your doctor or dermatologist

As someone living with PN, you may find doctor or dermatologist appointments tough. Recognising and sharing your symptoms with your doctor or dermatologist can be particularly stressful, especially if you’ve had difficulties in the past.

But now that we know more about PN than ever before, you may be able to have a more productive discussion with your doctor or dermatologist, as they’ll be able to update you on the latest developments. So, keep checking in with them to help make sure your current management approach is right for you.

If you don’t know where to start, here are a few steps you can take to help make the most out of your appointment.

Take photos of your skin in natural light to show to your doctor or dermatologist

Keep a log of your signs and symptoms, and how they are affecting you

Record the wider impact that PN may be having on your life, such as your mental health, sleep, social or work life

Note down any questions you want to ask your doctor or dermatologist before the appointment

Being honest and open with your doctor or dermatologist will help you get the very best out of your appointment.

Try not to hold back any details on how your PN may be affecting you. This could be what helps your doctor or dermatologist determine the right management approach for you.

The effect of prurigo nodularis goes beyond the skin^2,10,14

Causes of prurigo nodularis

Although prurigo nodularis affects the skin, its causes may be related to other factors. See what underlying factors may be significant

Living with prurigo nodularis

If prurigo nodularis affects your mental health, you can get help and support from your treating doctor.

Learn more

Symptoms

Prurigo nodularis is characterized by severe itching, lumps, swelling, and other lesions on the skin.⁸

Pereira MP et al. J Eur Acad Dermatol Venereol 2020; 34: 2373–2383.
Pereira MP et al. Acta Derm Venereol 2021; 101 : adv00403.
Aggarwal P et al. Clin Exp Dermatol 2021; 46(7): 1277–1284.
Mack MR and Kim BS. Trends Immunol 2018; 39(12):980-991.
Zeidler C et al. Dermatol Clin 2018; 36: 189-197.
American Academy of Dermatology Association. Prurigo nodularis: Diagnosis and treatment. Available at: https://www.aad.org/public/diseases/a-z/prurigo-nodularis-treatment. Accessed March 2023.
Pereira MP et al. J Eur Acad Dermatol Venereol 2018; 32: 1059–1065.
National Organization for Rare Diseases. Prurigo Nodularis. Available at: https://rarediseases.org/rare-diseases/prurigo-nodularis/. Accessed March 2023.
DermNet NZ. Nodular prurigo. Available at: https://dermnetnz.org/topics/nodular-prurigo. Accessed March 2023.
Williams KA et al. J Am Acad Dermatol 2020; 83(6): 1567–1575.