After week 16, all participants could enter an extension phase and apply ruxolitinib as needed. Response rates stayed high through week 32, though that phase had no comparison group.

Melinda Gooderham, MD, a dermatologist in Peterborough, Ontario, Canada, medical director at SKiN Centre for Dermatology and senior author of the study, framed the significance in a statement: "This phase 2 study is important because it moves the HS treatment conversation earlier in the disease course. For patients with Hurley I/II disease without draining tunnels, ruxolitinib cream showed reductions in inflammatory lesions, fewer flares, sustained benefit, and a reassuring safety profile. This study supports further investigation of topical JAK inhibition as a targeted, nonantibiotic approach for milder HS, and phase 3 trials are ongoing."

Safety profile

The cream was generally well tolerated in the small trial. Reported side effects included upper respiratory infections and application-site reactions. No major cardiovascular events occurred. A study of 69 people cannot rule out uncommon risks.

Why the mechanism matters

Current topical options for early HS — antibiotic creams, resorcinol, antiseptic washes — have limited research behind them. None directly target the immune signals driving the inflammation.

Ruxolitinib works differently. As a JAK inhibitor, it blocks inflammatory signaling. It also avoids the bacterial-resistance concerns that come with topical antibiotics.

The cream is not approved for HS, and phase 3 trials are underway. For the industry, the data point to a potential first-in-class topical entry in a segment where biologics currently dominate — and a commercial extension for Opzelura beyond its approved indications.