Off-Label Uses of Topical Ruxolitinib
Abstract
Ruxolitinib cream has demonstrated significant promise in both approved and off-label dermatological indications. Its localized action, rapid symptom relief, and favourable safety profile make it an attractive alternative to systemic treatments. However, current evidence is limited by small sample sizes, short follow-up periods, and unoptimized dosing protocols. Addressing these gaps through larger-scale, long-term research will be critical to understanding its full potential as a safe and effective therapy for diverse inflammatory and autoimmune skin diseases.
References
Hoy, Sheridan M. 2023. “Ruxolitinib Cream 1.5%: A Review in Mild to Moderate Atopic Dermatitis.” American Journal of Clinical Dermatology 24 (1): 143–51.
Tavoletti, G., G. Avallone, C. Conforti, G. Roccuzzo, C. A. Maronese, M. A. Mattioli, P. Quaglino, et al. 2023. “Topical Ruxolitinib: A New Treatment for Vitiligo.” Journal of the European Academy of Dermatology and Venereology : JEADV 37 (11): 2222–30.
Gong, Xiaohua, Xuejun Chen, Michael E. Kuligowski, Xing Liu, Xiang Liu, Evan Cimino, Ryan McGee, and Swamy Yeleswaram. 2021. “Pharmacokinetics of Ruxolitinib in Patients with Atopic Dermatitis Treated With Ruxolitinib Cream: Data from Phase II and III Studies.” American Journal of Clinical Dermatology 22 (4): 555–66.
Hosking, Anna-Marie, Margit Juhasz, and Natasha Atanaskova Mesinkovska. 2018. “Topical Janus Kinase Inhibitors: A Review of Applications in Dermatology.” Journal of the American Academy of Dermatology 79 (3): 535–44.
Solimani F, Meier K, Ghoreschi K. Emerging Topical and Systemic JAK Inhibitors in Dermatology. Front Immunol. 2019;10:2847. Published 2019 Dec 3. doi:10.3389/ fimmu.2019.02847
Böll SL, Seyed Jafari SM, Conrad C, Schlapbach C. Topical Ruxolitinib and Delgocitinib Versus Systemic JAK Inhibitors: A Comparative Safety Review. Int J Mol Sci. 2025 Oct 30;26(21):10592. doi: 10.3390/ijms262110592. PMID: 41226626; PMCID: PMC12607478.
Carmona-Rocha E, Rusiñol L, Puig L. New and Emerging Oral/Topical Small-Molecule Treatments for Psoriasis. Pharmaceutics. 2024;16(2):239. Published 2024 Feb 6.
Punwani N, Scherle P, Flores R, Shi J, Liang J, Yeleswaram S, et al. . Preliminary Clinical Activity of a Topical JAK1/2 Inhibitor in the Treatment of Psoriasis. J Am Acad Dermatol. 2012;67(4):658-664. doi:10.1016/j. jaad.2011.12.018
Craiglow BG, Tavares D, King BA. Topical ruxolitinib for the treatment of alopecia areata. JAMA Dermatol. 2016;152(4):490–492. doi:10.1001/ jamadermatol.2015.4445
Bayart CB, DeNiro KL, Brichta L, Craiglow BG, Sidbury R. Topical Janus Kinase Inhibitors for the Treatment of Pediatric Alopecia Areata. J Am Acad Dermatol. 2017;77(1):167-170. doi:10.1016/j.jaad.2017.03.024
Gordon SC, Abudu M, Zancanaro P, Ko JM, Rosmarin D. Rebound effect associated with JAK inhibitor use in the treatment of alopecia areata. J Eur Acad Dermatol Venereol. 2019;33(4):e156-e157. doi:10.1111/jdv.15383
Deeb M, Beach RA. A Case of Topical Ruxolitinib Treatment Failure in Alopecia Areata. J Cutan Med Surg. 2017;21(6):562-563. doi:10.1177/1203475417716363
Olsen EA, Kornacki D, Sun K, Hordinsky MK. Ruxolitinib cream for the treatment of patients with alopecia areata: a 2-part, double-blind, randomized, vehicle-controlled phase 2 study. J Am Acad Dermatol. 2020;82(2):412-419. doi:10.1016/j.jaad.2019.10.016
Pope E, Kowalski E, Tausk F. Topical ruxolitinib in the treatment of refractory facial seborrheic dermatitis. JAAD Case Rep. 2022;24:59-60. Published 2022 Apr 23. doi:10.1016/j.jdcr.2022.04.003
Desai D, Nohria A, Lo Sicco K, Shapiro J. The use of topical ruxolitinib 1.5% cream in frontal fibrosing alopecia: a case report. JAAD Case Rep. 2024;50:141-143. Published 2024 May 4. doi:10.1016/j.jdcr.2024.04.03
Brumfiel CM, Patel MH, Severson KJ, Zhang N, Li X, Quillen JK, et al. Ruxolitinib cream in the treatment of cutaneous lichen planus: a prospective, open-label study. J Invest Dermatol. 2022;142(8):2109-2116.e4. doi:10.1016/j. jid.2022.01.015
Nugent S, Coromilas AJ, English JC 3rd, Rosenbach M. Improvement of necrobiosis lipoidica with topical ruxolitinib cream after prior nonresponse to compounded topical tofacitinib cream. JAAD Case Rep. 2022;29:25-26. Published 2022 Aug 27. doi:10.1016/j. jdcr.2022.08.028
Kashetsky N, Turchin I. Utilization of Topical Ruxolitinib in Dermatology: A Review. Skin Skin Therapy Lett. 2023;28(3):8-13.