Angela, my Prolotherapy M.D., Dr. K. Dean Reeves, said that skin ennervation is a factor which can be wiped out with topical pain relief. He uses a Capsaicin-based pain channel blocker. This can even be used afterwards to stop any looping skin pain cycles. Dr. Reeves can be contacted online, and suggests getting a Prolotherapy referral at the American Association of Orthopaedic Medicine/AAOM.