Delivery 7–10 daysVTAMA (tapinarof) cream 1%
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Description
💊 Prescription first-in-class topical aryl hydrocarbon receptor (AhR) modulating agent for plaque psoriasis in adults and atopic dermatitis in adults and children down to 2 years of age.
▪︎ Tapinarof 1% cream, 60 g tube
▪︎ Manufacturer: Organon
▪︎ FDA approval: May 2022 (psoriasis), December 2024 (atopic dermatitis)
🔬 How it works: tapinarof is a synthetic analogue of a stilbene made by Photorhabdus bacteria living in symbiosis with nematodes. Activating AhR in skin cells upregulates the barrier proteins filaggrin and loricrin while damping interleukin-17 in psoriasis and interleukins 4 and 13 in eczema — it restores the skin's own programme rather than shutting inflammation down wholesale. Because it is not a steroid it causes no skin atrophy, so there is no cap on duration, treated area or body site: the face and skin folds included. 📊 Evidence: PSOARING 1 and 2 (NEJM 2021) — clear or almost clear skin at week 12 in 35.4% and 40.2% versus 6.0% and 6.3% on vehicle; PSOARING 3 (JAAD 2022) — 40.9% completely clear, with a mean off-therapy remittive interval of 130 days; ADORING 1 and 2 (JAAD 2024) — week-8 response in 45.4% and 46.4% versus 13.9% and 18.0%; ADORING 3 (JAAD 2025) — 51.9% completely clear over 48 weeks.
⚠️ Prescription-only. Applied once daily, treat-to-clear then pause rather than continuously. The common adverse event is folliculitis — 22.7% over a year in psoriasis, 12.1% in atopic dermatitis — usually mild. No head-to-head trials against potent steroids or dupilumab exist.
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