Table I.

Recommended treatments for lichen simplex chronicus based on disease severity

Mild disease	Moderate disease	Severe disease
Emollients	Gabapentinoids (gabapentin)	Nemolizumab
Topical calcineurin inhibitors	Antidepressants (SSRI, TCAs i.e. imipramine)	Dupilumab
High-potency topical steroids	For night-time itch: Mirtazapine, sedating antihistamines	Janus kinase inhibitors (i.e. tofacitinib)
Combination of topical steroids and salicylates	Topical acetaminophen	Transcutaneous electrical nerve stimulation
Menthol	Cyclosporine	Focused ultrasound (in vulvar areas)
Pramoxine	Methotrexate
Topical doxepin	Narrow-band ultraviolet B
Topical aspirin with dichloromethane
Topical ketamine/amitriptyline/lidocaine

SSRI: selective serotonin uptake inhibitors; TCA: tricyclic antidepressants.