Epidermal Nerve Fiber Density Test




Article by Dr. Misako McLeod, DPM

Epidermal Nerve Fiber Density Test (EDNFD) may be recommended to assess the number of nerve fibers in your skin. This is a quantitative test that allows Dr. McLeod to evaluate the degree of peripheral neuropathy. Some patients may have only a small amount of nerve fiber damage and therefore you will see small nerve fibers. However, other patients may have severe neuropathy and you may see only a few nerve fibers or none at all.

Dr. McLeod will often place the patient on Metanx, a prescription grade vitamin supplement that regrows the nerves over time. Metanx is taken twice a day with meals and specially designed to regrow the nerves in the feet. Patient often start feeling a difference right away, but for other patient’s whose nerve damage is more severe, it may take several months to feel the effects.




Dr. McLeod will often re-biopsy the patient at about 6 months to assess the degree of nerve regrowth and the response to the Metanx.

If patient suffer from painful neuropathy with burning, tingling, and painful numbness, Dr. McLeod will often prescribe medication such as Lyrica or Neurontin to control the symptoms, and place patients on MicroVas treatments to help stimulate blood flow to the nerves to help them grow.


EDNFD test


The combination of treatments often help to alleviate pain, regrow the nerves, and restore sensation. Sensation in the foot is essential to prevent skin breakdown, ulcerations, and other lower extremity issues that are associated with peripheral neuropathy.


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