Monoclonal Antibodies and JAK Inhibitors Show Real Progress for Photosensitive Skin Disorders

Emerging targeted therapies may improve symptoms and quality of life for people living with chronic sunlight-triggered skin conditions.

A new systematic review suggests that monoclonal antibodies and JAK inhibitors may offer meaningful symptom relief and improved sunlight tolerance for several photosensitive skin disorders, including chronic actinic dermatitis, actinic prurigo, solar urticaria, photoaggravated eczema, photoaggravated psoriasis, and polymorphic light eruption. Although these treatments are not formally approved for these conditions, evidence from 32 studies indicates consistent clinical improvements.

Study Details

Idiopathic photosensitive skin disorders include a group of conditions in which the skin reacts abnormally to sunlight or artificial ultraviolet light. These disorders often lead to intense itching, burning, hives, eczema flares, or blistering after even short sun exposure. Standard treatments such as topical steroids, sunscreens, and phototherapy provide incomplete relief for many patients.

Researchers conducted a systematic review to evaluate how modern targeted therapies might help. The review focused on monoclonal antibodies such as dupilumab, omalizumab, adalimumab, and ustekinumab, as well as JAK inhibitors such as tofacitinib, baricitinib, and upadacitinib. These medications are widely used in inflammatory skin and autoimmune diseases, making them promising candidates for photodermatoses that are driven by immune overactivity.

Methodology

The review analyzed 32 studies published from 1960 to 2025. Most were case reports or small case series, with a few retrospective studies and systematic reviews. Across all studies, a total of 96 patients were treated with either a monoclonal antibody or a JAK inhibitor. Researchers evaluated how each therapy affected symptoms, skin lesions, patient reported quality of life, and tolerance to sunlight. Because treatment approaches and outcome measures varied, the review emphasized overall trends rather than pooled statistical outcomes.

Key Findings

• Dupilumab showed consistent benefit in chronic actinic dermatitis across 10 studies. Patients experienced reduced redness, fewer papules, less itching, and increased sunlight tolerance within 8 to 16 weeks.
• Improvement was also seen in actinic prurigo and photoaggravated eczema within 4 weeks of treatment.
• Omalizumab was effective for solar urticaria in eight studies and polymorphic light eruption in one study, often producing complete remission within 1 to 3 months.
• Adalimumab followed by ustekinumab led to full clearance in severe photoaggravated psoriasis.
• Tofacitinib produced rapid responses in chronic actinic dermatitis, with burning sensations easing quickly and full remission generally seen within 2 months.
• In a study of polymorphic light eruption, tofacitinib cleared itching within days and resolved lesions within 1 to 4 weeks.
• Baricitinib and upadacitinib also helped chronic actinic dermatitis. Patients regained sunlight tolerance within 9 to 12 months on baricitinib, while upadacitinib produced lesion clearance within 4 weeks and maintained remission for 8 months.

Implications for Practice

For patients, these findings suggest that targeted immune therapies may help when standard treatments fall short. Many people with photosensitive skin disorders experience significant disruption to daily life due to strict light avoidance, chronic itching, and frequent flares. The improvements seen with these medications may offer new hope for restoring comfort and confidence outdoors.

For clinicians, this evidence indicates a potential role for monoclonal antibodies and JAK inhibitors in carefully selected patients with severe or refractory disease. Dupilumab and omalizumab stand out for their repeatable benefits across multiple reports. JAK inhibitors offer promising rapid control in some cases, although long-term safety considerations remain important. Because these therapies are not formally approved for these conditions, shared decision making and close monitoring are essential. Larger controlled trials are needed to establish dosing, safety, durability of response, and comparative effectiveness.