Consumer’s Guide to Severe Eczema and JAK Inhibitors

Everything you need to know about the newest treatment for this skin condition.

Medically Reviewed

I f you’re living with severe eczema, you know that when the condition flares up, you need a medication that can calm the itchy, painful rash — and you need it immediately.

Oral and topical steroids can quickly reduce itching by helping to ease the condition’s underlying inflammation — but they can’t be used for extended periods due to potential side effects. In the past, that has left people who have severe eczema with relatively few options for successfully and safely treating their condition over the long term.

Thankfully, though, this is starting to change, as new prescription medications have recently become available, says the National Eczema Association (NEA). In 2017, the Food and Drug Administration (FDA) cleared the first biologic for severe eczema and followed that up in 2022 with the approval of a new class of drugs called Janus kinase (JAK) inhibitors.

Before you ask your doctor about JAK inhibitors, you’ll need to do your homework — and make sure these drugs are right for you. Find out more about how this new treatment can potentially help you better manage your symptoms day to day.

How Severe Eczema Is Treated

Your dermatologist will likely recommend trying other treatment options before starting you on a JAK inhibitor, says Marisa Garshick, MD, an assistant clinical professor of dermatology at Weill Cornell Medical Center and a dermatologist at MDCS Dermatology in New York City.

These may include:

Topical or oral steroids are frequently prescribed to treat the dry, itchy skin associated with eczema. But long-term use of these drugs, considered immunosuppressants, isn’t recommended, due to significant side effects ranging from skin thinning and stretch marks to weight gain, high blood pressure, and gastrointestinal (GI) problems.

Immunosuppressants such as azathioprine, cyclosporine, methotrexate, and mycophenolate mofetil are systemic drugs. As their name suggests, they’re designed to suppress the immune system in order to control the symptoms of eczema.

It’s believed that an overreacting immune system causes the inflammation behind symptoms such as itching, irritation, and skin problems, according to the NEA.

These immunosuppressants can also cause long-term side effects, including increased risk of infection, nausea and vomiting, and increased risk of certain types of cancers. As a result, they are generally recommended for short-term use to get eczema under control. If the treatment is effective, your dermatologist may gradually reduce your dose and then recommend switching to topical medications for long-term management.

Light therapy, also called phototherapy, which involves standing in front of a light-emitting machine to control symptoms, but also comes with side effects such as sunburn and an increased risk of skin cancer as well as premature skin aging.

How JAK Inhibitors Work for Severe Eczema

JAK inhibitors work by targeting JAK enzymes, which transmit signals from the immune system throughout the body via the JAK-STAT (signal transducer and activators of transcription) pathway and cause eczema-related inflammation, according to the NEA.

Research suggests that JAK enzymes play a role in driving the abnormal immune responses behind several complex autoimmune conditions, including eczema, by stimulating the production of inflammatory proteins called cytokines. JAK inhibitors are designed to disrupt the overactive JAK pathways seen in eczema and to limit the cytokines that cause inflammation, in turn curbing its symptoms.

Although four JAK inhibitors have been evaluated for use in eczema, only three — upadacitinib (sold under the brand name Rinvoq), ruxolitinib (sold under the brand name Opzelura), and abrocitinib (sold under the brand name Cibinqo) — have received FDA approval for the condition. Another JAK inhibitor, baricitinib, is currently in clinical trials and has been approved to treat other conditions.


What are you most curious to learn about JAK inhibitors?

9 Essential Facts About JAK Inhibitors for Eczema

Is It Time to Try a JAK Inhibitor?

Understand where JAK inhibitors might fit into your treatment journey.

7 FAQs About Treating Severe Eczema With JAK Inhibitors, Answered

Are JAK Inhibitors Right for My Eczema?

Wondering if a JAK inhibitor is right for you? Take these factors into consideration:

Next Steps: Making Treatment Decisions


You’ve learned a lot about treatment options for atopic dermatitis. So what’s next?

Take some time to absorb all of this info and talk with your dermatologist to determine the best approach for you. Here are some things to consider.



Before your next appointment, think about your current treatment plan and how well it’s controlling your symptoms.

  1. Are you satisfied with your current treatment?
  2. Have your eczema symptoms improved as well as you had hoped?
  3. Are you downplaying your symptoms to your doctor?
  4. Are your symptoms interfering with your quality of life (sleep or self-image, for example)?
  5. Are you able to follow your treatment regimen as prescribed?
  6. Have you tried other treatments to see if they help you manage your symptoms?
cg-JAK-Inhibitors-for-Eczema-doctor discusion

Doctor Discussion

If you’re having trouble finding a treatment plan that works for you, you might want to talk to your dermatologist. Here are a few conversation starters that you can use at your next appointment.

  1. Do you think it’s possible for me to gain better control of my atopic dermatitis?
  2. What else can I do to better manage my symptoms?
  3. How often should I be using my treatments?
  4. What should I do during flares?
  5. What should my maintenance plan look like?
  6. What can I do to maximize the effectiveness of my medication?
  7. Are there certain fabrics or products I should avoid?
  8. What should I do if I don’t see an improvement in my symptoms?
  9. Am I a good candidate for a JAK inhibitor?
  10. How often should I come in for checkups?