What are the treatment options for prurigo nodularis?

Prurigo nodularis causes firm, itchy nodules that can persist when scratching repeatedly injures the skin. A treatment plan addresses both the inflammation in the nodule and the itch-scratch cycle. The choice depends on the number and location of nodules, previous treatments, other skin conditions and general health.

A clinician may use an intralesional steroid injection for selected thicker nodules. Narrowband UVB phototherapy can treat broader areas under supervised sessions. Dupilumab is a targeted option for appropriate patients and requires a review of medical history and injection-related considerations.

Keep nails short, use bland moisturiser and reduce friction from rough clothing. Try not to scratch; covering accessible nodules at night may help interrupt unconscious rubbing. Report new eye symptoms, facial swelling or a reaction after an injection or medicine promptly.

Ask whether [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/), [Dupilumab Treatment](/treatments/medical-dermatology/dupilumab-therapy/) or [Narrowband UVB Phototherapy](/treatments/medical-dermatology/narrowband-uvb-phototherapy/) fits your pattern.

Arrange dermatology care when itchy nodules are multiplying, bleeding, disrupting sleep or leaving open areas. Seek prompt attention for spreading redness, warmth, pus, fever or rapidly increasing pain, which can indicate infection or another process needing treatment.

How extensive is my condition, and what should we use to break the itch-scratch cycle? Which nodules are suitable for injection? Would phototherapy or dupilumab fit my medical history, and what symptoms should I report during treatment?