Your dermatologist is the best guide for managing PN

The goal of treatment for PN is to break the itch-scratch-itch cycle.1 This involves reducing inflammation, relieving itchiness, and minimizing the appearance of nodules. While living with PN can be frustrating, a silver lining is the array of treatment options available to help manage your symptoms and improve quality of life. By understanding more about PN, you can work with your dermatologist to devise a personalized treatment plan.1,2

Treatment typically relies on the use of topical or intralesional steroids. More severe or treatment-resistant cases often require phototherapy or systemic immunosuppressives.3

Topical treatment2-4

Topical corticosteroid creams and ointments are usually the first-line treatment for PN and helps reduce inflammation in the skin that causes itching and nodule formation. However, with long-term use, steroids can cause skin-thinning. Corticosteroids may also be given intralesionally.

Topical calcineurin inhibitors work by altering the immune system (e.g., tacrolimus and pimecrolimus). They have similar efficacy to topical corticosteroids but can be used long term without the associated side effects.

Other topical therapies include local anaesthetic creams, coal tar ointment and calcipotriol ointment.

Systemic treatment2-4

Oral medications may be used in combination with topical treatments.

Antihistamines can be taken to relieve itchiness.

Immunomodulators (e.g. methotrexate, thalidomide, azathioprine, tacrolimus and pimecrolimus) are usually reserved for more severe cases or treatment-resistant disease.

Other medications used to relieve the itch include antidepressants, gabapentinoids, opioid receptor antagonists and NK1 receptor antagonists.

Biologics are novel treatments that significantly alleviate itchiness in patients with prurigo nodularis.5

Other treatment options2-4

Phototherapy is commonly used to treat PN. Exposing affected areas of skin to specific wavelengths of ultraviolet light may help improve symptoms.

Cryosurgery is recommended when other treatments fail. Freezing reduces the itch and flattens the bumps.

Self-care tips6-8

Living with prurigo nodularis means making some lifestyle changes and incorporating healthier and positive habits to help manage your symptoms and improve quality of life.

Stop scratching

  • Keep your fingernails short to minimise damage from scratching.
  • Find ways to distract yourself until the urge to scratch passes. Do some light exercise or try relaxation techniques to keep your hands and mind occupied.
  • Cover bumps with by wearing pants, long sleeves, and socks for an added layer of protection between your nails and the bumps.
  • Consider wearing gloves or mittens while sleeping.

Soothe the itch

  • Apply calamine lotion or an anti-itch cream that contains camphor or menthol.
  • Choose loose, lightweight clothing made of natural fibres like cotton.
  • Moisturize your skin throughout the day with a fragrance-free moisturiser.
  • Use mild soaps and warm water while showering and avoid rubbing or scrubbing your excessively.
  • Keep rooms to a cool temperature. Heat and warmth can irritate your skin and make the itch feel more intense.

It is essential to understand that finding the right regimen that works for you will take time. Be patient and maintain open communication with your doctor or dermatologist to address any concerns regarding your treatment plan.8 Together, regaining confidence and comfort is within your grasp.

1. American Academy of Dermatology Association. Prurigo nodularis: Overview. Available at: Accessed August 2023.
2. American Academy of Dermatology Association. Prurigo nodularis: Diagnosis and treatment. Available at: Accessed August 2023.
3. Patient. Prurigo nodularis. Last updated: 17 January, 2022. Available at: Accessed July 2023.
4. Dermatology Times. Overview of prurigo nodularis for practicing dermatology clinicians. Available at: Accessed July 2023.
5. U.S. Food & Drug Administration. FDA approves first treatment for prurigo nodularis. Available at: Accessed July 2023.
6. Yale Medicine. Prurigo Nodularis. Available at: Accessed August 2023.
7. DermNet NZ. Nodular prurigo. Available at: Accessed: August 2023.
8. American Academy of Dermatology Association. Prurigo nodularis: Self-care. Available at: Accessed August 2023

The health information contained herein is provided for general educational purposes only. Your healthcare professional is the single best source of information regarding your health. Please consult your healthcare professional if you have any questions about your health or treatment.