This article will cover what causes prurigo, symptoms, diagnosis, and available treatments.
Prurigo Causes
The exact cause of prurigo is unknown, but it is associated with nerve cell and immune system dysfunction. The skin of people with prurigo tends to have more immune cells and dense nerve fibers causing itchiness than people without prurigo. Prurigo can occur independently or alongside other skin conditions.
Mild Prurigo Symptoms
Skin itching may begin up to six months before prurigo nodules (itchy bumps) appear on the skin. The discomfort associated with this condition leads to scratching and creates skin changes which may increase the risk of infection. Other symptoms of prurigo include:
Mental health conditions Reduced liver and kidney function Skin conditions that cause itching, such as eczema HIV Certain infections, like hepatitis Type 2 diabetes Thyroid disorders Certain cancers
Burning or stinging Skin changes, like discoloration or scarring from scratching
Mild prurigo can disrupt daily functioning. The American Academy of Dermatology says the following are all possible effects of having prurigo.
Sleeping troubles (due to itching or discomfort)Missed days from school or work Feelings of shame, sadnessLimiting social activitiesChanging life plans (like retiring early)
Diagnosing Prurigo
Diagnosing prurigo involves an examination by a healthcare provider or skin specialist like a dermatologist. This exam can include a visual assessment of the size, color, and spread of skin nodules or skin biopsy, allowing your healthcare provider to look closely at the nodules under a microscope.
It can be helpful to your healthcare provider to know when symptoms began and what types of treatment you have tried. Consider keeping a journal of symptoms to discuss with your healthcare provider.
If a skin biopsy confirms prurigo, you can expect follow-up tests to determine the possible cause. Tests may include:
Complete blood cell count (CBC) for assessing overall health status, infection, and how well the immune system is functioning Comprehensive metabolic panel (CMP) that includes liver and kidney function tests Thyroid hormone panel for diagnosing systemic diseases Stool sample to test for parasites HIV testing, if deemed necessary
Treatment
Even mild cases of prurigo require clinical treatment since it’s unlikely to go away on its own. Treatment will depend upon the underlying cause. For example, if you have prurigo due to a bacterial infection, treatment will focus on resolving the infection.
Dupixent (dupilumab) is the first and only Food and Drug Administration (FDA) approved medication for the treatment of adults with prurigo nodularis. In addition, there are options used off-label to treat other skin and immune system disorders that your healthcare provider may recommend, including:
Elidel (pimecrolimus) Protopic (tacrolimus) Dovonex (calcipotriol)
Anti-itch cream can be applied to the skin to reduce the urge to scratch. Topical medications may include corticosteroid creams. In some cases, corticosteroids may be injected directly into the skin.
Your healthcare provider might recommend alternative treatments such as cryosurgery or light therapy (phototherapy).
Behavioral adjustments are another option that can help reduce skin dryness and scratching. Treatments include:
Keeping fingernails trimmedWearing long sleeves Covering fingers with glovesBandaging bumpsCleaning skin with gentle cleansersKeeping skin moisturizedAvoiding warm environments to reduce sweating
Summary
Mild prurigo is a chronic skin condition that causes itchiness, and skin bumps called nodules. Causes are associated with nerve cell and immune system dysfunction. Diagnosis will depend upon the results of an examination and skin biopsy. Treatment varies depending on the underlying cause but may include medications or behavioral changes to help reduce the itchiness and ability to scratch.
A Word From Verywell
Skin conditions can be mentally and physically troubling. The itching and the skin bumps may feel out of control or unmanageable to cope with. Following a self-care plan can improve how well a treatment works and how well you feel. If you’re experiencing embarrassment, shame, frustration, anger, or feeling like hiding yourself from others, you may want to consider reaching out to a mental health professional. They can help you process these feelings and develop coping strategies.
