How effective is steroid injection into the skin for prurigo nodularis?

A clinician places corticosteroid medicine directly into selected nodules. This concentrates treatment in thick, inflamed areas and may make a nodule flatter, softer, and less itchy over time. It does not remove the underlying itch-scratch cycle by itself, and it cannot prevent every future lesion. Several nodules may need separate attention, while very thin or delicate skin may not be suitable for injection.

A dermatology assessment helps confirm that the bumps fit prurigo nodularis and identifies infection, open skin, or another cause of itch before treatment. Follow the aftercare instructions, avoid scratching or rubbing the injected sites, and continue any prescribed moisturiser or itch-control treatment. Ask which nodules are being targeted and when improvement should be assessed. Possible local effects include temporary tenderness, a small depression, or lightening or thinning of the skin; tell the clinician if you have noticed poor wound healing or previous steroid reactions.

Contact the treating clinic if an injected area becomes increasingly painful, hot, swollen, drains fluid, or develops spreading redness. Seek prompt medical assessment for fever or rapidly worsening skin changes. Arrange review if the itch remains severe, nodules continue multiplying, or a lesion bleeds or changes in a way that does not fit your usual pattern, because the diagnosis and treatment plan may need reassessment.

Which nodules are suitable for injection? What improvement should I look for, and when? How will you protect nearby skin from thinning or colour change? What other measures will help break the itch-scratch cycle?