Ruxolitinib Cream

How it works

It inhibits JAK1 and JAK2 within the skin, blocking cytokine signalling that drives inflammation in eczema and the melanocyte-directed immune response in vitiligo, supporting repigmentation.

Prescribing in practice

• Although systemic absorption from the cream is low, oral JAK inhibitors carry class warnings for serious infection, thrombosis and malignancy, so limit treated body-surface area and duration as directed and avoid in serious active infection.
• Apply a thin layer to affected areas only and avoid the eyes and mucous membranes; in vitiligo, repigmentation develops slowly over months.
• Avoid concurrent use with other immunosuppressive biologics or potent immunosuppressants unless specialist-advised.

Monitoring

Monitoring is mainly clinical, reviewing skin response, extent of application and any signs of infection, with reassessment if there is no benefit after an adequate trial.

Counselling the patient

• Apply a thin layer only to the affected skin and do not exceed the area advised.
• In vitiligo, colour returns gradually over many months, so persistence is important.
• Report any signs of infection and keep the cream away from your eyes.

Evidence & guidelines

Topical ruxolitinib's efficacy was demonstrated in the TRuE-AD trials for atopic dermatitis and the TRuE-V trials for non-segmental vitiligo.