Atopic dermatitis, vitiligo and alopecia areata are difficult skin diseases to successfully treat. On-the-skin creams, cortisone and non-cortisones alike, work well for limited disease but have little impact on people with a lot of involvement. I also offer light therapy, oral cyclosporine, and Dupixent. The truth is some medicines will help some of the people some of the time. I love cyclosporine because it works within 7d and can make these patients, miserable with their disease, into human beings again. However, many people do not want to take by-mouth or injected medicines for any number of reasons.
A new class of medicines called JAK inhibitors has shown promise in the treatment of these diseases. The oral form, as with everything else in life, carries some side-effect and complications. Overall they are safe. I have had good success using compounded JAK inhibitor creams. However , these creams are expensive and don’t last very long.
Opzelura (ruxolitinib) cream is the first commercially available JAK Inhibitor on the market and will become available October 8. I look forward to using this in my patients and hope that it helps clear these difficult diseases.