In his early work as Prurient, Fernow worked primarily with a microphone and amplifier, and sometimes drums. He eventually began utilizing more electronics, and currently works primarily with laptop and synthesizers. On some releases he has been joined by Ben Barnett, Richard Dunn (FFH), John Wiese, Jeff Plummer (Immaculate:Grotesque, Shallow Waters), Kris Lapke (Alberich, MCMS), Sickness, Wolf Eyes, Macronympha, Philip Best, Sutcliffe Jugend, The Hototogisu, Carlos Giffoni, Wilt, Grunt, Nicole 12, and Emily Salvatierra. Fernow was born in Wisconsin, lived in New York, and then moved to Los Angeles, where he now runs the labels Hospital Productions and Bed Of Nails. Fernow has also performed in various bands, such as Football Rabbit, Vegas Martyrs, Taylor Bow, Ash Pool (in which he also sings), and formerly as part of Cold Cave.
Fernow has also recorded music under a variety of aliases, including Vatican Shadow, Rainforest Spiritual Enslavement, Exploring Jezebel, River Magic, Winter Soldier, Window Cleaning By Ian, December Magic, Vegas Martyrs, and Tortured Hooker.