Prurigo nodularis (PN) can be challenging to treat because people with the disease may respond to treatments differently. Due to the intensity of the itch, people with PN may try several different treatments without receiving much relief. Some people may try all current treatments available without receiving complete relief. For most people, a combination of several treatments may need to be tried to find out what will work best.

The most commonly used treatments for PN are:

• Corticosteroid creams that are applied to the nodules (topical) and covered with special bandages that are air- and water-tight
• Corticosteroid injections into the nodules
• Ointments with menthol or phenol to cool and soothe itchy skin
• Capsaicin cream
• Oral corticosteroids
• Oral antihistamines
• Selective serotonin reuptake inhibitors (SSRIs)

If these treatments are not effective, other procedures may be used. These include cryotherapy, which uses very cold temperatures to try to reduce the size of the nodules, or laser therapy. Some people have used photochemotherapy, which combines the use of a medication that increases the skin’s sensitivity to ultraviolet (UV) rays with special light therapy. In some cases, immunosuppressants have been used to treat PN. If the lesions become infected, antibiotics or antibiotic ointment may be prescribed.

All treatments are typically used in combination with habit reversal therapy, which aims to reduce the frequency of scratching the skin. This can be helpful in slowing down or stopping the cycle of itching and scratching that is associated with PN. Some people wear gloves while they sleep to reduce scratching.