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Opzelura (ruxolitinib) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat nonsegmental vitiligo in adults and children 12 years and older.
These insights are based on 519 comments about Opzelura from MyVitiligoTeam members. These are the experiences of a small number of members and are not meant to be medical advice.
Opzelura is a topical prescription medicine. It works on tiny “signal switches” in the skin called Janus kinases (JAK1 and JAK2). These switches help control the body’s immune response. In vitiligo, the immune system attacks melanocytes (the cells that make skin pigment). By blocking these switches, Opzelura helps calm that immune response. Experts don’t yet know exactly how this leads to restored skin color.
Doctors may prescribe Opzelura for adults and children 12 years and older with nonsegmental vitiligo. The medicine is a cream applied as a thin layer to affected areas twice daily. It may be used on up to 10 percent of body surface area. Use is limited to no more than one 60 gram tube per week or one 100 gram tube every two weeks. Treatment may require more than 24 weeks; if repigmentation is not meaningful by 24 weeks, a doctor may reevaluate whether to continue.
These insights are based on 519 comments about Opzelura from MyVitiligoTeam members.MyVitiligoTeam members who’ve used Opzelura report that it helps many people regain skin color, especially on the face and areas with hair, though results take time and patience. The cost and insurance process can be challenging, but the side effects are usually mild. Most agree it’s an important step forward in vitiligo treatment even if it doesn’t work for everyone.
Some members have continued light therapy while on Opzelura. Early studies suggested that adding narrowband UVB phototherapy to ruxolitinib cream might enhance repigmentation in vitiligo. However, this finding comes from one small study, and larger, controlled studies are still needed to confirm any added benefit.
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In studies of people 12 years and older with nonsegmental vitiligo, the most common side effects were those listed below. Each of these happened in between 1 percent and 6 percent of people, with acne and itching being the most common.
Medicines in the JAK inhibitor class have important safety warnings. Serious infections (including tuberculosis and shingles), certain cancers (including skin cancer), heart problems (heart attack and stroke), blood clots, and death have been reported with JAK inhibitors used for inflammatory conditions. In a large study of an oral JAK medicine for rheumatoid arthritis in adults with heart risk factors, some of these risks were higher than with TNF‑blocker medicines. People who smoke now or used to smoke also had more risk. In Opzelura studies, some people developed blood clots.
Your doctor can help you weigh the risks and benefits. They may have you pause or stop treatment if serious problems occur.
Incyte, the manufacturer of Opzelura, offers the Opzelura On Trac patient support program. Eligible people with commercial insurance may pay less or no money with a copay savings card.
For those without insurance or who have government-funded insurance, the IncyteCARES Patient Assistance Program may be able to provide Opzelura at no cost. Learn more about lowering vitiligo treatment costs.
Before starting Opzelura, your doctor may check for tuberculosis. They will watch for signs of infection during treatment.
Skin checks are advised when using Opzelura. Try to limit exposure to sunlight and ultraviolet light. Wear protective clothing and a broad-spectrum sunscreen to reduce the risk of skin cancer.
Tell your doctor about all medicines and supplements you take. Some medicines can interact with Opzelura and raise the chance of side effects. Your doctor may tell you to avoid certain ones or adjust how you use Opzelura. Taking it at the same time as therapeutic biologics, other JAK inhibitors, or potent immunosuppressants (such as azathioprine or cyclosporine) is not recommended.
Also tell your care team if you have a current infection, get infections often, have been around someone with tuberculosis, smoke now or used to smoke, or have had a heart attack, stroke, or blood clots.
Opzelura is approved to treat nonsegmental vitiligo in adults and children 12 years and older. It’s also approved to treat mild to moderate atopic dermatitis in certain adults and children 2 years and older.
There is a pregnancy exposure registry for people who use Opzelura during pregnancy. Do not breastfeed during treatment and for about four weeks after the last dose. Be sure to discuss pregnancy plans with your doctor.
These answers are fact-checked by our editorial staff.
How effective is Opzelura for treating nonsegmental vitiligo?
In two studies of people 12 and older, about 30 percent of those using Opzelura had 75 percent or more return of facial color after 24 weeks. About 15 percent had 90 percent or more return of facial color. Researchers measured this with a score called the Facial Vitiligo Area Scoring Index (F-VASI), which estimates how much color has returned to the face. An F-VASI 75 result means at least 75 percent return compared with the start of treatment.
Where does Opzelura work best on the body?
Because melanocytes live in the base of hair follicles, Opzelura tends to work best in areas of the body that contain hair follicles. Our faces tend to have a lot of short, fine vellus hair (some call it “peach fuzz”), whereas our hands do not. As a result, Opzelura tends to work better on the face than the hands. Repigmentation requires some exposure to light (either natural or narrowband UVB phototherapy), so areas that are covered by clothing are less likely to respond as well.
How long does Opzelura take to work?
A MyVitiligoTeam survey of 93 adults with vitiligo who used Opzelura found that for many, it took between four months and a year before the level of repigmentation was greater than 50 percent. This is consistent with the clinical trial results and the messaging on the Opzelura website.
Doctors usually check progress around 24 weeks in the studies. Some people may need more than 24 weeks for meaningful repigmentation, and the studies followed people out to 52 weeks to see continued change. Your doctor may reevaluate your treatment plan if your repigmentation is not meaningful by 24 weeks.
On MyVitiligoTeam, people share their experiences with vitiligo, get advice, and find support from others who understand.
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