I have a dx for SFN but didn’t have a punch biopsy. My pain management doctor talked me out of it as he felt it would become another place I’d have pain after. For example when I had frozen shoulder for a year after my shoulder burned and it never had before. I take Kratom for the burning and for me it’s been very good. I was able to get me off the narcotics with it. At night I use aspercreme with lidocaine or Salinas Lipocaine plus. I recently found something that works even better and to me makes no sense: Benadryl itch stopping Gel. I don’t itch and I don’t have poison ivy but it allows me to use covers and even makes me sleepy. Go figure! Btw I am in Florida too.