How effective is narrowband UVB phototherapy for prurigo nodularis?

Prurigo nodularis is driven by an itch–scratch cycle that can keep firm, itchy bumps active. Carefully dosed ultraviolet treatment may calm skin inflammation and reduce the urge to scratch. As itching eases, existing nodules can gradually become less raised and new trauma may decrease. It does not remove every trigger, and thick or long-standing lesions may respond slowly.

A dermatologist assesses skin type, the extent of disease, medicines, and any history of light sensitivity before choosing a starting dose. Progress is judged by itch, sleep, scratching, and the feel of nodules, not by a single dramatic change.

Attend each planned phototherapy visit and tell the clinic about redness, burning, blistering, new medicines, or a reaction after a session. Use the prescribed moisturiser and follow the agreed itch-control plan; scratching can reopen treated skin and maintain the cycle. Protect untreated skin and eyes exactly as directed, and do not add tanning or home ultraviolet exposure.

Keep a simple note of itch intensity, sleep disruption, and which nodules change. This gives your dermatologist useful information when deciding whether to adjust the dose, continue, or combine treatment with another approach.

Contact the phototherapy team promptly for severe or persistent redness, painful swelling, blisters, or a new rash after treatment. Seek urgent help for facial swelling, breathing difficulty, fever with rapidly worsening skin, or a spreading painful infection. Arrange a dermatology review if nodules bleed repeatedly, develop pus, or itch remains disruptive despite the plan.

Ask which areas will be treated, how itch and nodule thickness will be monitored, what reaction is expected after a session, and how your medicines or light sensitivity affect the plan.