Prurigo nodularis: Self-care

9 tips that can improve treatment for prurigo nodularis

Prurigo nodularis can be difficult to treat. Self-care plays an important role in helping you get the best results from treatment. Here’s the self-care advice that dermatologists give their patients who have prurigo nodularis.

1. Understand that treatment takes time, and you may need to try different treatments before you find the combination that works for you. Many patients become frustrated and give up too quickly because they don’t see results. Continue to follow your treatment plan. Tell your dermatologist if you have problems following the plan.

2. Try to stop scratching, rubbing, picking, and touching the skin with prurigo nodularis. Treatment cannot work if you keep scratching. Also, if you continue to scratch, rub, pick, or touch the skin with prurigo nodularis, new bumps can develop, and old ones may not clear.
   
   Dermatologists understand how difficult it can be to stop scratching. Here are a few self-care tips that can help:

   • Cover the bumps and patches. Covering bumps with clothing like pants, long sleeves, and socks adds a layer of protection between your nails and the bumps. If the area is intensely itchy or inflamed, dermatologists recommend that you bandage the area.
     
     If you are still scratching the bumps through your clothes or bandages, tell your dermatologist. A medicated tape may be an option for you. The medication reduces the itch, and the tape adds a protective layer between your nails and your skin.
   • Keep your nails short. Fingernails and toenails do less damage when they’re short.
   • Consider wearing lightweight gloves or mittens. If you can prevent overheating, try wearing gloves or mittens until you can stop scratching. You want to make sure that you don’t overheat, as that can cause your skin to itch.

3. Be prepared to calm the itch. Prurigo nodularis can cause uncontrollably itchy skin. Here’s what you can do instead of scratching.

   • Sudden itch? Apply calamine lotion or an anti-itch cream that contains camphor or menthol.
   • Skin becomes extra itchy at bedtime. Prurigo nodularis often itches when you’re relaxed or in bed. Taking a sedating (can cause drowsiness) antihistamine can relieve bedtime itch. Take this medication only as directed.
   • Soothe and soften your skin. Apply a fragrance-free emollient throughout the day.

   Dermatologists recommend gently applying a fragrance-free emollient several times a day

   An emollient can soften and soothe your skin, which may help relieve the itch.

   

4. Use gentle skin care products. Any skin care product — soap, cleanser, or emollient — that will touch skin with prurigo nodularis should be:

   • Made for sensitive skin
   • Fragrance-free
   Make sure the label says, “fragrance free” rather than “unscented”

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   Unscented means the product contains fragrance, but the fragrance has been covered up.

5. Be gentle with your skin and use warm water when bathing and showering. Rubbing or scrubbing your skin can make it itchier. To avoid this, gently apply your cleanser and other products that your dermatologist recommends.
   
   Skip the washcloths and buff puffs. You want to apply your skin care products gently with your fingertips. Then rinse well with lukewarm water.

6. Find out what triggers your itch and figure out how to avoid these triggers. Common triggers for itch are:

   • Stress
   • Heat
   • Sweating
   • Extreme humidity
   • Dryness
   • Personal care products
   • Clothing made of wool, polyester, or any rough-feeling fabric
   If you have trouble avoiding any of your triggers, tell your dermatologist. These are common triggers for many skin conditions. Your dermatologist can offer solutions that can help.

7. Look for signs of a skin infection. While the goal of treatment is to heal the skin, treatment takes time. It can also take time to stop scratching. During this time, you can develop a skin infection.
   
   If skin with prurigo nodularis develops any of the following signs of infection, call your dermatologist or primary care doctor right away:

   • Swelling
   • Discoloration
   • A warm (or hot) feeling
   • Pus leaking from open skin
   • Pain
   If you have an infection, you may also have a fever.

8. Keep your medical appointments. Patients who have prurigo nodularis often see a dermatologist, primary care doctor, and other health care providers. To get the best results from treatment, keep all medical appointments. Doing so will help:

   • Make sure you know what to do.
   • Know whether your treatment plan is working or needs to be changed.
   • Find an infection, which can be serious, early.
   • Spot a possible side effect early.

9. Learn the possible side effects of the medications in your treatment plan. A dermatologist tailors each treatment plan to a patient’s unique needs, which helps to reduce the risk of developing side effects. Still, it’s helpful to know what you should watch for. Your dermatologist or pharmacist can tell you.

These self-care tips can help you cope while you’re treating prurigo nodularis – and help the disease from flaring after it clears.

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References
Elmariah S, Kim B, et al. “Practical approaches for diagnosis and management of prurigo nodularis: United States expert panel consensus.” J Am Acad Dermatol. 2021;84(3):747-60.

Mullins TB, Sharma P, et al. “Prurigo nodularis.” In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing; 2021 Jan.

Silverberg JI. “Nummular eczema, lichen simplex chronicus, and prurigo nodularis.” In: Kang S, et al. Fitzpatrick’s Dermatology. (9th edition) McGraw Hill Education, United States of America, 2019:388-92.

Written by:
Paula Ludmann, MS

Reviewed by:
Shari Lipner, MD, PhD, FAAD
J. Klint Peebles, MD, FAAD
Caroline Robinson, MD, FAAD

Last updated: 9/14/21