Patient's Query
Hello doctor,
I am struggling with prurigo nodularis, and the itching is getting worse no matter what I try. I have been using steroid creams, but they do not seem to help. My skin now has scars, and I am getting self-conscious. I heard about some new treatments like monoclonal antibodies.
Is that for my case too?
What triggers should I watch for to prevent it from flaring again?
Can stress make it worse or affect healing?
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern.
Yes, monoclonal antibody therapies, particularly Dupilumab and more recently Nemolizumab, have shown promising results for people with moderate to severe prurigo nodularis. These treatments work by targeting specific inflammatory pathways involved in the itch-scratch cycle. They are especially considered in cases where conventional treatments fail or when the condition is significantly impacting quality of life, as seems to be your case. These medications must be prescribed by a specialist, usually a dermatologist or immunologist, and may require prior authorization.
As for triggers, scratching is both a symptom and a cause. Every time the skin is scratched, it worsens the inflammation and reinforces the cycle. Here are some tips to reduce flare-ups:
Manage stress, as it is a known aggravator of chronic skin conditions like prurigo nodularis. Mind-body techniques such as mindfulness, deep breathing, and cognitive behavioral therapy can help reduce stress-related flares.
Avoid harsh soaps, hot showers, and scented skin care products, which may irritate already sensitive skin.
Keep your skin well hydrated with thick emollients such as petroleum jelly or Ceramide creams.
Use non-sedating antihistamines during the day and sedating antihistamines at night, if needed, to reduce the urge to scratch.
The scars and nodules can understandably affect your self-image, but healing is possible, especially when the itching is brought under control. With the right management plan, many patients see significant improvements over time.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
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Answered byDr. Aissa Youcef Mouffoki
Medically reviewed byiCliniq medical review team
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