Topical Ruxolitinib Cream Rapidly Repigments Vitiligo Lesions, Study Finds

A three-month course of twice-daily ruxolitinib cream significantly repigmented vitiligo lesions in adults, improving both skin appearance and quality of life while showing a strong safety profile, according to data published recently in the International Journal of Dermatology.

Though the study did not directly mention the brand name of the cream, the ruxolitinib cream evaluated in this study corresponds to Opzelura (ruxolitinib), a topical Janus kinase (JAK) inhibitor approved for inflammatory skin conditions including vitiligo and atopic dermatitis. Applied twice daily, Opzelura works by altering immune pathways in the skin, helping to repigment lesions while maintaining its safety.

Vitiligo is a chronic skin condition marked by the loss of pigment due to the destruction of melanocytes, the cells responsible for skin color. Successful treatment requires both suppressing autoimmune activity and stimulating melanocyte regeneration, yet some therapies, such as narrowband UVB phototherapy and topical corticosteroids or calcineurin inhibitors, typically provide only short-term benefit, with relapse rates of around 40% within a year, according to the study.

Recent research has explored the use of ruxolitinib in recent clinical trials and it’s been found that twice-daily application of the cream can safely repigment vitiligo lesions. To evaluate its real-world effectiveness, the Journal of Dermatology study of 50 adults with non-segmental vitiligo looked at lesion improvement, facial involvement and quality-of-life outcomes after three months of treatment.

Published on September 1, 2025, Italian researchers, including lead author Mattia Cristallo of the Department of Precision and Regenerative Medicine and Ionian Area, Regional Reference Center for Allergic and Immunological Diseases at the University of Bari Aldo Moro, Bari, Italy, investigated ruxolitinib cream for vitiligo because conventional treatments often provide only short-term benefit, with many patients relapsing within a year.

By targeting the variables that destroy pigment cells, ruxolitinib offers a potential way to achieve more durable repigmentation and improve quality of life for patients who have struggled with existing therapies.

In a single-center retrospective observational study at the Bari Polyclinic, researchers analyzed 50 adults with non-segmental vitiligo affecting 0.5 to 10% of their body surface area, including the face. All patients underwent screening to rule out other autoimmune conditions for JAK-inhibitor use.

Participants applied ruxolitinib cream twice daily for three months. Effectiveness was measured using the Facial and Total Vitiligo Area Scoring Index (F-VASI and T-VASI), as well as the Vitiligo Noticeability Scale and quality-of-life assessments. The study aimed to examine the real-world impact of ruxolitinib cream, building on clinical trials that suggested rapid and safe repigmentation of vitiligo lesions.

It was revealed that twice-daily application of ruxolitinib over three months led to significant improvements in skin pigmentation. Median facial vitiligo scores (F-VASI) dropped from 1.0 to 0.34, with 40% of patients achieving at least 75% repigmentation. Total body vitiligo scores (T-VASI) also improved, with over 40% of patients seeing at least 50% lesion reduction.

Some patients reported improvements on the Vitiligo Noticeability Scale, and overall quality of life increased, including reductions in alexithymic traits, which reflect difficulty identifying and expressing emotions. The treatment was well-tolerated, with no severe adverse events reported. These results confirm prior clinical trial findings, highlighting that ruxolitinib cream can rapidly and safely repigment lesions in patients who had limited success with conventional therapies.

Based on the design and results of the study, the study’s strengths include real-world data on 50 adults with non-segmental vitiligo, consistent measures of lesion improvement using F-VASI and T-VASI and confirmation of ruxolitinib cream’s safety and rapid effectiveness.

Limitations include its single-center, retrospective design, small sample size and short three-month follow-up period.

The authors suggest that larger, longer-term studies are needed to confirm both the efficacy and safety of topical ruxolitinib and to better understand its impact on quality of life and psychological outcomes in vitiligo patients.