Topical Ruxolitinib for the Treatment of Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory skin disease characterized by painful nodules, abscesses, sinus tracts, and scarring, with significant impact on quality of life. Although biologics have expanded treatment options for moderate to severe disease, there are currently no approved therapies specifically indicated for mild HS. Emerging evidence implicates dysregulation of the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway in HS pathophysiology, suggesting JAK inhibition as a promising therapeutic strategy. This review summarizes current evidence on JAK inhibition in HS, with a focus on topical ruxolitinib. Early clinical trials in patients with mild to moderate HS have demonstrated encouraging efficacy, including significant improvements in Hidradenitis Suppurativa Clinical Response (HiSCR) rates and histologic reductions in epidermal and dermal inflammation, alongside a favorable safety profile. Existing data support topical ruxolitinib as a promising, targeted, and potentially safer treatment option for early-stage HS.