8 dermatology developments from 2026 that experts say matter most | 2026 Fall Clinical Derm

Pills that rival biologics, weight-loss drugs paired with psoriasis treatment and a phase 3 win for a personalized mRNA melanoma vaccine were only some of the developments in dermatology of 2026 so far that were highlighted at the Fall Clinical Dermatology Conference today.

During a general session, experts in the space each reviewed what the past year brought to their area of practice. Here are eight takeaways.

1. Oral psoriasis drugs are closing the gap with biologics

This year has been one full of oral treatments in psoriasis, according to April Armstrong, M.D., M.P.H., chief of dermatology at UCLA Health.

To start, the FDA approved the once-daily targeted peptide Icotyde (icotrokinra) in March as the first oral interleukin-23 (IL-23) receptor antagonist. Mark Lebwohl, M.D., dean for clinical therapeutics at the Icahn School of Medicine at Mount Sinai, said it has the precision of an injectable antibody but reaches tissue more easily, and it requires no blood monitoring. In a trial in adolescents, he said, more than 70% of patients reached a 90% improvement on the Psoriasis Area and Severity Index (PASI 90) by week 16. Close to 90% reached it two months later.

Other approvals expanded who can be treated. For instance, Sotyktu (deucravacitinib) was approved for adults with active psoriatic arthritis (PsA) in March. In June, Skyrizi (risankizumab) was approved for children 6 and older with plaque psoriasis or PsA, and Zoryve (roflumilast) cream 0.3% was approved for plaque psoriasis in children as young as 2.

The experts revealed that more therapies are coming.

Armstrong pointed to two next-generation oral TYK2 inhibitors, zasocitinib and envudeucitinib, along with oral IL-17 drugs in development and IL-23 and IL-17 biologics that may be dosed every six months or once a year. Imsidolimab, an IL-36 receptor antibody for generalized pustular psoriasis, is under FDA review.

2. Head-to-head trials are giving clearer comparisons

Armstrong reviewed a run of head-to-head results with icotrokinra and zasocitinib, each outperforming deucravacitinib in plaque psoriasis, and zasocitinib and envudeucitinib outperforming Otezla (apremilast).

In PsA, Bimzelx (bimekizumab) beat risankizumab in the phase 3 BE BOLD trial. Results showed at week 16, 49.1% of patients on bimekizumab reached ACR50, meaning at least a 50% improvement in joint symptoms, compared with 38.4% on risankizumab.

3. Weight-loss drugs are joining psoriatic disease care

Lebwohl said his department now treats close to 200 patients with weight-loss drugs, most of them injectable.

The phase 3b TOGETHER-PsA trial tested tirzepatide with Taltz (ixekizumab) in 271 adults with active PsA and who were overweight or obese. With the combination, 33.5% reached ACR50, compared with 20.4% on ixekizumab alone. At week 36, 31.7% of combination patients hit both ACR50 and at least 10% weight loss, compared with 0.8% on ixekizumab alone. A companion trial, TOGETHER-PsO, studied the same pairing in plaque psoriasis.

Lebwohl said the approach has raised patient satisfaction, adding that follow-up visits are handled by a nurse practitioner, which has “been a good source of income for the department as well.”

4. Off-label and combination use is growing

Dermatologists are increasingly combining drugs and using them off-label, according to James Del Rosso, D.O., research director at JDR Dermatology Research in Las Vegas. Many package inserts limit pairing certain drug types, but he said those limits are not based on data, and it’s “all preemptive.”

Lebwohl said off-label JAK inhibitor use has helped patients with lichen planus, granuloma annulare and sarcoidosis. He said that despite the class's boxed warning, he has found the drugs fairly safe. He described adding icotrokinra to bimekizumab for a patient who had failed multiple biologics and said insurers did not push back.

In hidradenitis suppurativa (HS), Del Rosso said evidence is mounting that blocking both IL-17A and IL-17F, as bimekizumab does, adds benefit over blocking IL-17A alone with Cosentyx (secukinumab). He added that both drugs work and either may suit a given patient better.

5. Vitiligo finally has a severity definition

Seemal Desai, M.D., founder and medical director of Innovative Dermatology and a past president of the American Academy of Dermatology, helped lead an international consensus that defines severe and relapsing vitiligo for the first time. It found that by the skin area alone, less than 3% depigmentation is mild, 3% to 10% is moderate and more than 10% is severe. But active spread, confetti-like lesions, heavy psychological burden or high-impact sites such as the face can raise a patient's severity.

“Do not determine vitiligo disease severity based simply on body surface area,” Desai noted.

Oral treatment is also getting closer. For example, the United Arab Emirates approved Rinvoq (upadacitinib) for nonsegmental vitiligo in August, the first country to do so, and AbbVie filed for FDA approval in February. In addition, Litfulo (ritlecitinib) and povorcitinib both posted positive phase 3 results this year, and Opzelura (ruxolitinib) cream remains the leading topical option, Desai said.

6. Skin cancer care is getting more personalized

According to Darrell Rigel, M.D., M.S., clinical professor of dermatology at New York University, a 40-gene expression profile test for cutaneous squamous cell carcinoma can also flag which patients are likely to benefit from radiation after surgery. Patients in the test's highest-risk class benefited; those in lower classes did not.

On melanoma, Rigel pushed back on the idea that rising rates reflect overdiagnosis. “There’s no data that supports overdiagnosis,” he said, pointing to his group’s research suggesting rates are truly rising.

For patients with high-risk melanoma, he highlighted a personalized mRNA vaccine, intismeran autogene. Each vaccine is built from a sample of the patient’s own tumor and takes about six weeks to make, so patients start Keytruda (pembrolizumab) first and add the vaccine once it is ready, Rigel said. In the phase 3 INTerpath-001 trial, the combination improved recurrence-free survival compared with pembrolizumab alone in patients whose stage IIB to IV melanoma had been surgically removed. Merck and Moderna have not yet released detailed results.

7. A prescription acne gel moved over the counter

In May, the FDA approved Differin Epiduo Acne Gel, which combines adapalene 0.1% and benzoyl peroxide 2.5%, for over-the-counter use in people 12 and older. It’s the latest in a line of products to make that switch. The prescription version is approved down to age 9, so younger patients still need a prescription, according to Linda Stein Gold, M.D., division head of dermatology at Henry Ford Health.

Stein Gold also cited an analysis finding that the triple combination of clindamycin, adapalene and benzoyl peroxide is the most effective of the combination acne products. Another study found that adding Winlevi (clascoterone) cream to isotretinoin modestly improved results and reduced side effects.

8. Lower reimbursement is pushing practices toward aesthetics

Some of the experts pointed to falling reimbursement this year.

“They're cutting reimbursement, but we have opportunities for other things," Mark Nestor, M.D., Ph.D., director of the Center for Clinical and Cosmetic Research in Aventura, Florida, said. He pointed to aesthetics and regenerative dermatology, including collagen stimulators, microneedling and newer, lower-cost toxins.

Gary Goldenberg, M.D., an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai, urged caution on equipment costs, particularly for small practices weighing energy devices.

“You don't want to spend $200,000 only to realize it's going to take you years to pay off the device,” he said. Nestor agreed and said that older devices often deliver the best results.