Prurigo Nodularis: Causes, Treatment Options, Foods to Avoid & More

What Triggers It or Makes It Worse?

Certain health issues can make you more likely to get PN. These include:

• Atopic dermatitis (eczema), which already makes your skin itchy
• Kidney or liver disease, which can dry out the skin
• HIV and other infections that weaken your immune system
• Stress or anxiety, which can trigger the urge to scratch

Can Your Environment Affect It?

Yes, definitely. Things around you can act as triggers.

For example:

• Hot or dry weather
• Harsh soaps or fragrances
• Tight or scratchy clothing
• Poor sleep, which worsens nighttime itching

Even small changes in your routine or environment can make the itching worse. That’s why it’s important to track what sets it off for you.

Where Does It Show Up?

This condition can appear anywhere on your body. However, it usually affects places like:

• Your arms
• Your legs
• Your scalp
• Your shoulders
• Your upper back
• Your abdomen

Is It a Long-Term Condition?

Yes, PN is chronic. That means it doesn’t just go away quickly. It can last a long time. Sometimes, it may get better and then come back again.

Who Is Most at Risk?

Anyone can get PN. But some people are more likely to develop it, including:

• African Americans
• Adults between the ages of 40 and 69
• Women

What Can Increase the Risk?

Some skin conditions raise your chances of getting PN. These include:

• Eczema (atopic dermatitis)
• Psoriasis
• Lichen planus
• Bullous pemphigoid
• Cutaneous T-cell lymphoma

How Common Is It?

PN affects about 72 out of every 100,000 people in the U.S. But experts believe it’s more common than that. Why? Because it often appears with other skin problems and might be missed during diagnosis.

How Is Prurigo Nodularis Treated?

The main goal of treatment is to stop the itch-scratch cycle. That means:

• Relieving the constant itching
• Treating any underlying health issues that may be causing or worsening the itch

Sometimes, it’s difficult to pinpoint the exact cause of Prurigo Nodularis (PN). You might need to explore a few options to find what works best for you.

Types of Treatments for Prurigo Nodularis

Treating this skin condition usually takes a mix of prurigo nodularis treatment methods to ease the itch, heal the skin, and stop it from coming back.

Topical Treatments (Applied to Skin)

These help reduce itch and calm the skin:

Steroid Creams

• These reduce inflammation and itching by calming the skin’s immune response.
• They’re often used to shrink nodules and prevent further irritation.

Calcineurin Inhibitors

• These creams help control the immune system in the skin without using steroids.
• They’re useful for long-term treatment, especially on sensitive areas like the face.

Coal Tar Creams

• Coal tar slows skin cell growth and reduces itching and scaling.
• It’s an old but effective remedy for chronic skin conditions.

Vitamin D3 Ointments

• These regulate skin cell production and help flatten the raised bumps.
• They also reduce inflammation and support skin healing.

Menthol

• Menthol creates a cooling sensation that distracts from the itching.
• It’s soothing and offers temporary relief from constant scratching.

Injections

For tough nodules, your doctor might use:

• Corticosteroid injections
  These are injected directly into the bumps to shrink them and reduce inflammation.

Systemic Medications (Work Throughout the Body)

These are often taken by mouth and help with itch and sleep:

• Antihistamines – Help reduce itching and allow better sleep
• Certain antidepressants – Medications like paroxetine and amitriptyline may reduce the urge to scratch and help the skin heal

Other Therapies That May Help

Cryotherapy

Cryotherapy uses extremely cold temperatures, usually liquid nitrogen, to freeze and destroy abnormal skin tissue.

• It’s applied directly to the nodules using a cotton swab or a spray.
• This process helps shrink the bumps, reduce inflammation, and relieve itching.
• The area may blister or scab afterward, but it usually heals within a few weeks.

Phototherapy

Phototherapy involves exposing the affected skin to ultraviolet (UV) light under controlled medical settings.

• It’s often used when topical treatments don’t work.
• UVB light slows down the skin’s overactive immune response and reduces itching.
• You usually need multiple sessions each week to see results.
• It’s generally safe but requires regular follow-up.

PUVA (Psoralen + UVA light)

PUVA combines a light-sensitizing medication (psoralen) with ultraviolet A (UVA) light treatment.

• Psoralen is taken by mouth or applied to the skin before light exposure.
• The UVA light then activates the medication, helping to calm inflammation, stop itching, and shrink nodules.
• This therapy is usually used when other light treatments fail.
• You’ll need to wear eye protection and limit sun exposure after treatment.

Pulsed Dye Laser (PDL)

Pulsed dye laser therapy uses a focused beam of light to target blood vessels under the skin.

• It helps reduce redness, itchiness, and bump size by destroying small blood vessels that feed inflamed tissue.
• It’s non-invasive and typically causes minimal pain or downtime.
• Several sessions may be needed for best results.

Excimer Laser

This laser emits a high-intensity, targeted UVB light to treat small areas of affected skin.

• It’s often used when other treatments don’t work or when the nodules are hard to reach.
• It helps reduce itching, inflammation, and skin thickening.
• Unlike traditional phototherapy, it doesn’t expose surrounding healthy skin to UV light.

Foods to Avoid with Prurigo Nodularis

Here are some common foods that may trigger inflammation and worsen itching in people with PN:

• Fried Food – Increases inflammation and can worsen itching.
• Processed Foods – Often contain additives that may trigger flare-ups.
• Dairy Products – May contribute to skin inflammation in sensitive individuals.
• Red Meat – High in saturated fats that can inflame the skin.
• Refined Carbohydrates – Can spike blood sugar and lead to increased skin irritation.
• Sugary Foods – Promote inflammation and may aggravate symptoms.