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5 Natural Prurigo Nodularis Treatments and Their Effectiveness

Medically reviewed by Kevin Berman, M.D., Ph.D.
Posted on January 9, 2023

During a prurigo nodularis (PN) flare-up, the symptoms can seem unmanageable, leading many people with the condition to seek natural remedies. However, not all natural therapies are safe or beneficial. It’s important to try new treatments with caution because there’s always the chance you could have an allergy or other side effects.

If you’re living with this inflammatory skin disease, it’s a good idea to know which natural remedies you might consider adding to your existing treatment options. Here’s the research behind five common natural therapies for PN.

1. Baths

Prurigo nodularis often coincides with related skin conditions, like atopic dermatitis (eczema), and their management strategies may overlap. Doctors sometimes encourage people with eczema to bathe in lukewarm water for no more than 10 to 15 minutes, followed by a generous application of moisturizer to “soak and seal” the skin while it’s still moist. These same recommendations can also apply to PN.

Some people with skin conditions also add extra ingredients to their bathwater to promote skin health and break free from the itch-scratch cycle.

Examples of bathwater additions include:

  • Bath oils — Natural bath oils can help lubricate the skin, but be sure to avoid products with potentially irritating fragrances and other additives.
  • Baking soda — Baking soda is a classic remedy to help relieve itchy skin.
  • Bleach — Bleach baths are believed to reduce bacteria (Staphylococcus aureus) and infections in some skin conditions. To prepare a bleach bath, add a quarter cup of bleach for a half-full tub or half a cup of bleach for a full tub.
  • Oatmeal — Colloidal oatmeal added to a warm bath may help reduce itching and improve skin health.
  • Salt — Adding a cup of table salt to a full bath may reduce painful stinging associated with an inflammatory flare-up.
  • Vinegar — Like bleach, vinegar is used in baths to kill bacteria on the skin. Add one cup or up to a full pint.

Soaking in these solutions may be helpful for some but irritating for others, so always ask your doctor before trying one of these options. For instance, people with asthma or a sensitivity to fumes may want to avoid bleach baths.

Although there are no specific dermatology studies on bleach baths for PN, diluted exposure to bleach is considered safe, with proven antimicrobial effects that reduce inflammation and itchiness in other conditions, like atopic dermatitis. In the short term, bleach baths lower the need for topical corticosteroids and antibiotics.

There’s evidence that salt baths improve symptoms for some people with psoriasis. However, researchers have also noted individual cases in which salt caused side effects, including skin irritation, or had no impact.

If you’re experiencing a severe PN flare-up or have an infection, ask your dermatologist if baths are a good idea — and let them know if you plan to add something extra to the bathwater.

2. Cannabidiol

Many people use cannabis products as an alternative or complementary therapy to manage the symptoms of various skin, autoimmune, and other health conditions. Growing evidence points to the benefits of cannabis for reducing inflammation and infection and managing pain.

Although more research is needed, five studies have demonstrated reduced itch intensity after cannabinoid treatment. Because nerve fibers in the skin contain cannabinoid receptors, cannabis products may help reduce pruritus (itch) by blocking some of the excitatory effects (likelihood of activity) of histamine on these receptors — and affecting oil production.

An active cannabinoid compound that doesn’t produce the feeling of getting “high” is cannabidiol (CBD). According to the National Eczema Association, CBD lowers itch, inflammation, and pain. Some small studies have shown that using CBD eased itching and improved sleep for people with atopic dermatitis. In most states, you can purchase creams, lotions, and gels containing CBD legally without a prescription. Your dermatologist should be able to point you toward reputable products if they agree that CBD is worth trying for your PN.

3. Capsaicin

Capsaicin — the compound that makes chiles hot — has been proved to reduce skin inflammation. There’s strong evidence that people with certain skin conditions, including atopic dermatitis and psoriasis, can benefit from capsaicin’s pain relief and anti-itch effects.

Although there aren’t as many large studies on prurigo nodularis, a small 2001 study demonstrated impressive results with capsaicin cream. In this study, 33 people with PN applied capsaicin cream with a concentration of 0.25 percent to 0.3 percent four to six times per day. After 12 days of treatment, pruritus was eliminated in all participants, and skin lesions had begun to heal. When capsaicin was discontinued, about half the participants noticed their symptoms returning within two months. Researchers concluded that capsaicin treatment is likely safe and can improve quality of life for people with PN. However, further studies need to be done to confirm how and if capsaicin reduces itch.

4. Ayurveda

Ayurveda is a form of holistic medicine that started more than 3,000 years ago and continues to be widely practiced in countries like India and Nepal. Treatment is given by trained providers and includes internal purification, dietary changes, herbal remedies, massage, meditation, and yoga.

Although some case studies have suggested that Ayurvedic treatment helped improve PN, this alternative approach shouldn’t replace conventional treatment. Unlike India, the United States has no licensing or regulation of Ayurvedic practitioners. Additionally, Ayurvedic products are sold in the dietary supplement industry, which isn’t regulated the same way prescription medications are. Be sure to inform your dermatologist before experimenting with Ayurveda, especially if you plan to take supplements or herbal remedies.

5. Ultraviolet Light

Exposing the skin to ultraviolet (UV) rays increases vitamin D levels and may offer benefits for certain skin conditions, such as chronic itch, psoriasis, and vitiligo. That’s why dermatologists may recommend light therapy or phototherapy as an effective option for a range of skin diseases. Studies show that phototherapy (the use of artificial UV light) is generally considered safe and potentially helpful for people with prurigo nodularis. But how about tanning?

Artificial tanning beds are a known carcinogen (cause of cancer), as is spending too much time in the sun. Tanning beds and natural sunlight provide different types of UV light. Natural sunlight and artificial tanning beds emit mostly UVA rays. Phototherapy primarily uses UVB rays, which are associated with skin benefits that include easing intense itchiness.

Ultimately, tanning beneath sunlight or in an artificial tanning bed is risky — even if you don’t burn. UV exposure increases the chance of developing skin cancer and promotes skin aging. Although UV light may help with some PN symptoms, it’s best to have supervised light treatment in a controlled health care setting, where the amount of your exposure to light is monitored.

Talk With Others Who Understand

MyPrurigoTeam is the social network for people with prurigo nodularis and their loved ones. On MyPrurigoTeam, members come together to ask questions, give advice, and share their stories with others who understand life with PN.

Have you heard of any other natural remedies for PN? What treatments have you tried or thought about trying? Share your experiences in a comment below or on your Activities page.

Posted on January 9, 2023
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Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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