What skin side effects can Rinvoq (upadacitinib) cause?
Rinvoq (upadacitinib) can cause several skin-related effects. Reported skin problems include:
- Rash and itching (pruritus)
- Hives (urticaria)
- Severe allergic skin reactions (rare)
- Skin infections that may show up or worsen during treatment, such as herpes zoster (shingles) and other infections (risk is increased with immunosuppressing medicines like Rinvoq)
Because skin symptoms can signal either a drug reaction or an infection, new or worsening rashes should be assessed promptly by a clinician—especially if there are blisters, fever, pain, or rapidly spreading redness.
Are rashes and itching common with Rinvoq?
Rashes and itching are among the skin effects that can occur during Rinvoq treatment. In general, any new rash that appears after starting Rinvoq, or that gets worse while on treatment, warrants medical review to rule out:
- A hypersensitivity reaction to the medication
- An infection-related rash (including shingles)
- Worsening of an underlying inflammatory skin condition
How can you tell a drug rash from shingles?
Shingles (herpes zoster) can present as skin pain or burning followed by a rash with clusters of blisters, often on one side of the body and in a band-like pattern. A medication-related allergic rash can vary in appearance (including hives) and may come with itching rather than pain.
Get urgent care if you develop:
- Painful blisters or a one-sided rash
- Fever or feeling unwell
- Eye-area rash (any rash near the eye)
What skin infection risks should patients know?
Rinvoq is an immunomodulating drug, so infections are a key concern. Skin-related infections can occur, and shingles is specifically important because it can start with skin symptoms before the full rash appears. People with prior shingles risk, older age, or other immune-suppressing therapies may be at higher risk.
Clinicians typically advise monitoring for signs of infection and seeking care quickly when symptoms start.
When should you contact a doctor right away?
Contact your prescriber promptly (or seek urgent care) for skin symptoms that include:
- Blistering rash, peeling skin, or sores in the mouth/genitals
- Rash with fever, facial swelling, trouble breathing, or widespread hives
- Painful, one-sided rash that could be shingles
- Rapidly spreading redness or pus/drainage
Does Rinvoq cause eczema/psoriasis to worsen or change skin patterns?
Rinvoq can affect the immune pathways involved in inflammatory diseases, so it may change existing skin symptoms in either direction depending on the person and the underlying condition being treated. If you notice a new or worsening pattern of rash while on Rinvoq, it should be assessed so clinicians can determine whether it’s:
- A flare of the underlying disease
- A side effect of the medicine
- A coincident infection
If you tell me which skin symptom you mean (rash type, where it is, whether there are blisters, and when it started relative to Rinvoq), I can help you think through the most likely causes and what to ask your doctor.