JAK 1–3 & TYK2 Inhibitors in Dermatology
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This table is not intended to replace medical judgment.
Generic Name (Brand Name) and MOA | FDA-Approved Indications (Approved Age) | Derm Dosing | Suggested Monitoring*§ | Clinical Considerations |
|---|---|---|---|---|
| Systemic | ||||
Upadacitinib (Rinvoq)†
JAK-1 Inhibitor | Derm: Atopic dermatitis (≥12 yrs) Other: Ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, nonradiographic axial spondyloarthritis, Crohn’s disease | 15 mg PO QD starting dose
Consider increasing to 30 mg PO QD if inadequate response
(see Clinical Considerations) | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP, lipids at 4-12 weeks and repeat annually, TB annually | • Approved for adolescents ≥12 years and weighing at least 40 kg
• Do not increase dose if patient >65 years old or with severe renal impairment
• Do not use in severe hepatic impairment |
Abrocitinib (Cibinqo)†
JAK-1 Inhibitor | Derm: Atopic dermatitis (≥12 yrs) Other: None | 100 mg PO QD starting dose
Consider increase to 200 mg QD in non-responders after 12 weeks of use
(see Clinical Considerations) | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP, lipids at 4-12 weeks and repeat annually, TB annually | • Moderate renal impairment: 50 mg PO QD or 100 mg PO QD for patients who are not responding to 50 mg
• Do not use in ESRD or hepatic disease
• Do not use with antiplatelet therapies except for low-dose aspirin (≤81 mg daily) during the first 3 months of treatment |
Baricitinib (Olumiant)†
JAK-1/2 Inhibitor | Derm: Severe alopecia areata (≥18 yrs) Other: Rheumatoid arthritis, COVID-19 in hospitalized adults | 2 mg QD, consider increase to 4 mg QD if inadequate response
(see Clinical Considerations) | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP, lipids at 4-12 weeks and repeat annually, TB annually | • Not recommended in patients with severe renal impairment
• Reduce dose to 2 mg QD when adequate response is achieved
• For patients with nearly complete or complete scalp hair loss, with or without substantial eyelash or eyebrow hair loss, consider treating with 4 mg QD |
Ritlecitinib (Litfulo)†
JAK-3 and TEC Kinase Inhibitor | Derm: Severe alopecia areata (≥12 yrs) Other: None | 50 mg PO QD | Initial: TB, CBC w/diff., CMP, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/diff., CMP at 4-12 weeks and repeat annually, TB annually | • Efficacy and AE profiles similar between adolescent and adults
• Do not use in patients with severe hepatic impairment |
Tofacitinib (Xeljanz)†
JAK-1/3 Inhibitor | Derm: Psoriatic arthritis (≥18 yrs) Other: Rheumatoid arthritis, ankylosing spondylitis, ulcerative colitis, polyarticular course juvenile idiopathic arthritis | 5 mg PO BID (PsA dose) | Initial: TB, CBC w/diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: TB annually, CBC w/diff. at 4-8 weeks then q 3 months, LFTs at q 3-6 months, lipids at 4-8 weeks and repeat annually | • Consider QD dosing in moderate/severe renal impairment or moderate hepatic impairment |
Deuruxolitinib (Leqselvi)†
JAK 1/2 Inhibitor | Derm: Severe alopecia areata (≥18 yrs) Other: None | 8 mg PO BID | Initial: CYP2C9 genotype test, TB, CBC w/ diff., CMP, lipids, viral hepatitis screening, pregnancy, HIV, vaccinations Follow up: CBC w/ diff., CMP, lipids at 4-12 weeks, TB annually | • No dose adjustment is recommended for patients with moderate renal impairment or mild-moderate hepatic impairment
• Not recommended for use in patients with severe renal or hepatic impairment
• Contraindicated for use in patients who are CYP2C9 poor metabolizers or using moderate or strong CYP2C9 inhibitors
• If a dose is missed, skip the missed dose and resume dosing at the next scheduled dose |
Deucravacitinib (Sotyktu)
TYK2 Inhibitor | Derm: Psoriasis (≥18 yrs) Other: Psoriatic arthritis (≥18 yrs) | 6 mg PO QD | Initial: LFTs and viral hepatitis screening in patients with known or suspected liver disease, TB, pregnancy, HIV, vaccinations Follow up: LFTs in patients with known or suspected liver disease at ~3 months | • No boxed warning
• No dose adjustment is recommended in patients with mild, moderate, or severe renal impairment or in patients with ESRD on dialysis or in patients with mild/moderate hepatic impairment
• Not recommended for use in patients w/ severe hepatic impairment |
| Topical | ||||
Ruxolitinib (Opzelura)†
JAK-1/2 Inhibitor | Derm: Atopic dermatitis (≥2 yrs), vitiligo (≥12 yrs) Other: None | Apply 1.5% cream BID | No routine lab monitoring required | • For atopic dermatitis, can treat up to 20% BSA; for vitiligo, up to 10% BSA (per PI) • For atopic dermatitis: 60 g per week or <100 g per 2 weeks
ages 12 and older; <60 g per 2 weeks 2-11 yrs of age
• For vitiligo: 60 g per week or <100 g per 2 weeks ≥12 yrs of
age |
Delgocitinib cream 2% (Anzupgo)
JAK1/2/3/TYK2 Inhibitor | Derm: Chronic hand eczema (≥18 yrs) Other: None | Apply BID to skin of affected areas only on the hands and wrist, not exceeding 30 g per 2 weeks or 60 g per month | No routine lab monitoring required | • No boxed warning
• For use in adults who have had an inadequate response to, or for whom topical corticosteroids are not advisable |
AE = Adverse event; ALC = Absolute lymphocyte count; ANC = Absolute neutrophil count; BID = Twice daily; BSA = Body surface area; CBC = Complete blood count; CMP = Comprehensive metabolic panel; ESRD = End-stage renal disease; Hgb = Hemoglobin; HIV = Human immunodeficiency virus; JAK = Janus kinase; LFT = Liver function test; Mg = Milligrams; MOA = Mechanism of action; PI = Prescribing information; PLT = Platelets; PO = By mouth; PsA = Psoriatic arthritis; QD=once daily; TB = Tuberculosis; TYK2 = Tyrosine kinase 2
*As evidence is not sufficient to fully assess the safety of JAK inhibitors in pregnancy and lactation, it is not recommended for use in women who are pregnant or nursing; vaccinations should be done before starting a JAK inhibitor; perform pre-treatment HIV testing in high-risk populations. Specifically check ALC, ANC, PLT and Hgb at initiation and subsequent monitoring as per individual PIs.
§Hypoglycemia, including severe hypoglycemia, has been reported in patients with diabetes receiving JAK inhibitors. Consider increased blood glucose monitoring as clinically indicated.
†Boxed Warning: serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis. See full PI for additional information.
v6 - August 2026. © 2026 - April W. Armstrong, MD, MPH, James Q. Del Rosso, DO, Mark Lebwohl, MD, and Nicholas Brownstone, MD.
DISCLAIMER: The dosages and other information seen in this chart were primarily obtained from the respective FDA-approved package inserts. This chart is for reference only and not to be substituted for clinical judgment. The authors are not responsible for treatment decisions or outcomes based on the information in this chart. Please check for drug interactions.