Prurigo nodularis is a skin condition that causes severe itchiness. Eczema can be an initial trigger for prurigo nodularis, and a person can have both conditions at the same time.

Both prurigo nodularis and eczema are chronic skin conditions that can cause intense itchiness. Doctors can usually diagnose both with a physical exam. Treatment typically focuses on reducing itchiness and scratching to allow the skin to heal.

This article explains what prurigo nodularis is, including its symptoms, causes, treatment options, and how it relates to eczema.

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Prurigo nodularis is a chronic skin condition that causes multiple, itchy bumps on the skin. Estimates suggest that as many as 72 people in every 100,000 adults may get prurigo nodularis each year in the United States.

It is common for prurigo nodularis to co-occur with other skin conditions, such as atopic dermatitis, a common type of eczema.

A 2022 retrospective analysis found that over half of the included study population had both prurigo nodularis and atopic dermatitis, with atopic dermatitis being the most common comorbidity.

Prurigo nodularis causes multiple bumps on the skin that:

  • range from half a centimeter (cm) to 2 cm in width
  • are very itchy
  • may be flesh-colored, red, pink, brown, or black

People may also notice a thickening of skin in affected areas. Itchiness may come and go or may be continuous. It usually takes 6 weeks or longer of itching or picking at the skin before the bumps appear.

Scratching can transform these small bumps into raised, dome-shaped nodules and may eventually lead to scarring. These skin bumps can affect any part of the body but often do not appear on hard-to-reach body parts.

If a person has eczema and prurigo nodularis, they may also experience eczema symptoms, such as patches of inflamed, itchy skin.

Learn more about eczema symptoms.

Researchers do not know the exact cause of prurigo nodularis. However, symptoms typically occur in response to persistent scratching.

The following groups may have a higher risk of developing prurigo nodularis:

  • African Americans
  • people ages 51 to 65 years
  • females
  • people with other conditions, such as atopic dermatitis, kidney failure, or psychiatric conditions

Factors such as stress, heat, or tight clothing may worsen symptoms of prurigo nodularis.

In some cases, eczema may trigger prurigo nodularis. Genetic and environmental factors play a role in the development of eczema. However, these causes may vary depending on the type of eczema a person has.

When treating prurigo nodularis, doctors will emphasize the need for a person to stop scratching the skin, which can worsen symptoms. Potential treatment options include:

If a person also has eczema, a doctor may prescribe or recommend treatments for eczema. This may include avoiding triggers and adjusting skin care routines.

Doctors will typically suggest general care tips alongside any medical treatments. This may include:

  • reducing stress, which may involve:
  • using gentle cleansers
  • moisturizing the skin regularly
  • keeping nails short
  • wearing protective clothes, such as gloves or long sleeves
  • covering affected skin with bandages
  • staying in a cool and comfortable environment, if possible
  • using lotions containing camphor or menthol

It is also important for people to avoid scratching their skin, as this can worsen symptoms.

Living with prurigo nodularis and eczema

Managing itchy skin is also a key part of living with eczema. Scratching skin affected by eczema can lead to increased itchiness and worsening symptoms.

The National Eczema Association suggests the following additional tips that may help a person with eczema and prurigo nodularis:

  • soaking affected skin in an oatmeal bath
  • using a cold compress on itchy areas
  • avoiding triggers, such as stress or topical irritants
  • patting or pinching the skin instead of itching
  • wearing soft, breathable clothing
  • avoiding letting bare skin touch rough surfaces

Scratching prurigo nodularis lesions can lead to secondary infections. Signs of infection may include:

Anyone with prurigo nodularis and the above symptoms should speak with a doctor. Doctors may prescribe topical or oral antibiotics to treat an infection.

People with prurigo nodularis may also experience emotional distress and mental health complications. A 2022 study suggests that anxiety disorders are the most common psychiatric comorbidity.

It is important for people to consider speaking with a healthcare professional if they experience symptoms of anxiety or depression.

People should speak with a healthcare professional if they experience signs of prurigo nodularis, such as extremely itchy skin that develops into bumps.

Prurigo nodularis can appear similar to other skin conditions, such as keloids, or can occur alongside other conditions. Consulting a doctor can help a person receive an accurate diagnosis and begin treatment to help them manage their symptoms.

People should also speak with a healthcare professional if they have prurigo nodularis and any complications, such as signs of infection. They may also wish to consider contacting a doctor if they are experiencing mental health conditions.

Is prurigo serious?

Although prurigo nodularis is a chronic condition, it is typically benign. Complications may include mental health conditions and skin infections due to scratching.

Underlying conditions, such as eczema, can trigger prurigo nodularis, but symptoms may persist even after a person treats the underlying trigger. Doctors can work with affected people to help them manage ongoing symptoms, such as chronic itchiness.

What cream is good for prurigo?

Doctors may recommend topical corticosteroids and menthol solutions or lotions for prurigo nodularis. People should also use gentle cleansers and apply emollients regularly to keep the skin clean and hydrated.

How do doctors treat prurigo mitis?

Prurigo mitis is another name for prurigo simplex. Doctors may use the tern prurigo simplex when a person has no underlying condition, such as eczema, alongside their symptoms.

Initial treatment may involve topical steroids and antihistamines. If these do not help, a doctor may prescribe phototherapy or systemic medications, such as immunosuppressants.

Prurigo nodularis is a chronic skin condition that causes extreme itchiness. Scratching can cause bumps on the skin, and continued scratching may lead to complications such as infection.

Other skin conditions, including eczema, can trigger prurigo nodularis or occur alongside it. The presence of eczema symptoms may guide a doctor’s decisions when creating a treatment plan.

People should speak with a doctor if they have symptoms of prurigo nodularis that they are having difficulty managing. If someone has prurigo nodularis, they should also contact a doctor if they have any signs of infection, such as a fever.