Prurigo nodularis (PN) is a chronic skin disease that causes skin nodules and intense itching. Although scientists know that PN is systemic (affects the entire body) and linked to the immune system, the condition is not well understood. For this reason, it’s important to track your PN symptoms over time.

Tracking symptoms is crucial to understanding how your PN changes and discovering any triggers that make it worse. This information can help you to better communicate with your health care team to find effective treatments.

This article will cover how to track your prurigo nodularis symptoms, what to note as you identify your PN flares and triggers, and what works to manage symptoms. Keep this information organized and share it with your dermatologist, who can help you look for trends and triggers. It may take some trial and error to find the tracking strategy that works best for you.

Choosing a Tracking Method

Before you begin, you must decide on a way to keep track of your symptoms and triggers. These days, there are plenty of options to help you gauge the progress of your chronic conditions.

Traditional Journal or Planner

If you want to keep your journaling low-tech, consider a physical planner. This might be a blank journal for more open-ended tracking, or a planner with a calendar inside to keep you accountable day by day. If you go for this physical option, make sure to keep several colored pens or pencils handy for color-coding your journal. Writing freehand gives you flexibility and creativity to track your symptoms and other factors. Consider how you’ll keep this health journal private.

Spreadsheet

If you use spreadsheets to organize other aspects of your life, consider an online or desktop spreadsheet to keep track of your PN. You might have rows for each day or week and columns for each symptom or health factor you’re tracking. You may decide to color cells red for severe symptoms and green for mild symptoms. This will make it easy to keep track of your health data over time. If you’re a wiz with spreadsheets, you can even use the data to make graphs of these changes.

Health Tracking Apps

Many apps are available on your mobile phone, tablet, or smartwatch to keep track of your health and symptoms. There are dozens of applications that come with various templates, so you can track your symptoms on the go and with minimal thought. These apps may also send you reminders to make sure you stay on top of your journaling. Note that most apps are not specific to prurigo nodularis, but some made for skin conditions such as eczema or psoriasis may be adapted to work for PN.

Whichever method you use, make sure to update your information on a regular basis. Take five minutes each night before bed to track all relevant details from the day. Every piece of information is valuable for your long-term symptom management.

Getting the Most Out of Your Tracking Strategy

Once you’ve settled on how you want to track your symptoms, you can follow these tips to make the most out of the process.

1. Detail Your Symptoms

Prurigo nodularis looks different for everyone. It can show up as just a handful of itchy bumps or as hundreds of large, thickened nodules. Take careful notes when you first start tracking these details:

• Location and size of the nodules on your body
• Severity of your itching
• Location of the itch — Is it only the bumps or all of your skin?
• Feelings of burning or stinging
• Hardness or thickness of the affected skin
• The number of dark marks and scars left by healed nodules

It’s important to record these details regularly. Note when new nodules appear and how long they last. If you’re keeping a digital journal, you can add images to document these changes. Try recording the severity of itching daily on a scale of 1 to 10, so you can get a sense of how it improves or worsens.

By tracking this information on a regular basis, ideally every day, you and your dermatologist can get a better picture of how your PN changes over time. This will provide insights as you discuss PN treatment options.

2. Record Lifestyle and Environmental Factors

Including information about your lifestyle and environment is key to understanding potential triggers that worsen symptoms or beneficial changes that could help. You may start with noting the factors below, and then narrow them down over time to the ones that seem to influence your health the most.

Sleep

Sleep affects your whole body, including your skin. Many people report that PN worsens sleep quality because itching keeps them awake. Try noting how long and how well you slept each night. If you have a few days when you’re able to get more sleep, you may notice your PN symptoms improve.

Diet

For some, PN can be connected to allergies and food sensitivities. There may be a link to foods rich in fat and PN symptoms. Make sure to note if you make changes to what you eat, eat more or less of something, or try a new diet.

Weather

Weather can have an effect on your skin. For instance, humid heat accelerates acne growth, whereas dry cold exacerbates eczema. PN is thought to be worsened by sweat and heat. How does your climate affect your skin? Tracking this information may make these triggers clear. Based on what you find, you may choose to invest in a humidifier or dehumidifier and find better ways to control the temperature of your indoor spaces.

Other Chronic Conditions

PN is sometimes linked to other chronic conditions, including skin conditions like atopic dermatitis, eczema, and psoriasis. For some people, it’s associated with diabetes, chronic kidney disease, or hepatitis C. Make sure to note the severity of symptoms and any changes in treatment of other chronic conditions to see if there is a correlation. This will allow you to relate your PN to your overall health.

3. Track PN Treatment and Skin Care

How you treat your prurigo and care for your skin in general is likely to influence your symptoms. Keeping track of any improvement over time can help you and your doctor understand which treatments are working and which are not.

Treatment of Prurigo Nodularis

Currently, there is no PN treatment approved by the U.S. Food and Drug Administration (FDA). Your dermatologist may prescribe a combination of corticosteroids, antihistamines, ultraviolet phototherapy, cryotherapy, and other drugs and procedures to control PN symptoms. Several medications currently used for atopic dermatitis are being investigated for PN.

Note whenever you try these treatments, so you can begin to see which ones are most effective. Also note any side effects you have experienced from these treatment options.

Skin Care Products and Routine

Personal care products and over-the-counter skin remedies could have either negative or positive effects on your skin. Note any changes in lotion, soap, perfume, and over-the-counter ointment to find patterns in what seems to help or hurt your PN symptoms.

4. Note Stressful Events and Mood

Many chronic inflammatory conditions, including PN, have flares linked to stress levels and overall mental health.

Stress Levels

PN is thought to be worsened by stress. Track your overall stress levels and any major stressful events in your journal to discover how stress affects your symptoms. You could rate stress levels 1 through 10, use a color code, or add an emoji face to keep track of stress.

Mood and Mental Health

For complex reasons that are not entirely clear, people with prurigo have a higher risk of living with mood disorders such as depression and anxiety, ADHD, and mental health problems including eating disorders. Be sure to include information in your journal if you experience any of these:

• Panic attacks
• New or worsening depression
• Any changes in medication you take for your mood or mental health
• Any therapy you use to improve mood or stress, such as psychotherapy or counseling, meditation, or deep breathing

Noting patterns around stress, mood, and flares of PN symptoms may help you find associations. Share any mental health symptoms or concerns with your doctor. It’s just as important to get treatment for mental health as for skin symptoms to improve your overall quality of life.

Read more about links between prurigo nodularis, depression, and anxiety.

Sharing What You Learn With Your Doctor

Detailed records about how your symptoms have changed over time and any associations between lifestyle factors, treatments, and your mental health provide important information for your dermatologist. With the help of your PN journal, you and your doctor can work together to tailor your treatment plan and improve your quality of life.

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.

Do you track your PN symptoms? What else in your life seems important to track? Share your experiences in a comment below or on your Activities page.