Key takeaways:
Vtama (tapinarof) is a topical treatment for plaque psoriasis and atopic dermatitis (eczema). The most common side effects are folliculitis (inflamed hair follicles) and cold or flu symptoms. Itchy skin and headache can also occur.
A good skincare routine can help reduce skin irritation and itching from Vtama. You can also talk to your dermatologist or pharmacist about an over-the-counter product to help if needed.
In rare cases, Vtama can cause contact dermatitis (an allergic skin reaction). If you think you may have contact dermatitis after using Vtama, contact your dermatologist before applying your next dose.
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Vtama (tapinarof) is a topical cream that’s FDA approved to treat adults living with plaque psoriasis. It’s also approved for atopic dermatitis (eczema) for adults and children ages 2 and older.
Vtama isn’t a steroid, and you can use it on sensitive areas, such as your face, neck, and groin. But side effects are still possible. Knowing what to expect can help you get the most from your medication and understand when to seek medical care.
Vtama side effects at a glance
Below is a list of Vtama side effects that can happen during treatment. Keep in mind that Vtama is generally tolerated well by most people. Most side effects were reported by fewer than 5% of people using Vtama in clinical studies.
More common Vtama side effects include:
Folliculitis (inflamed hair follicles)
Upper and lower respiratory infections
Contact dermatitis
Headache
Itchy skin
Less common Vtama side effects include:
Influenza
Asthma
Vomiting
Ear infection (more common in children under age 6)
Stomach pain
Pain in joints, hands, and feet
Keep in mind that this isn’t a comprehensive list. Reach out to your healthcare team about any side effects that occur while using Vtama, even if they aren’t listed here.
Let’s take a closer look at five Vtama side effects and how to manage them.
1. Inflamed hair follicles
The most common Vtama side effect is inflamed hair follicles where the cream is applied. Symptoms can include small red bumps or pimples around hair follicles, which may be sore or itchy. During initial clinical studies, most cases of folliculitis were considered mild or moderate and occurred within the first 30 days of starting Vtama.
If you develop folliculitis, keep the affected area clean and dry to help prevent irritation from getting worse. You’ll also want to avoid shaving or plucking the area. Applying a warm compress for 15 minutes several times a day can also help with redness, pain, and itching. Avoid tight clothing that can chafe or irritate the skin. While tempting, try not to scratch the affected areas, as this raises the risk of infection.
For most people, folliculitis usually gets better on its own with home care. But if it doesn’t improve or gets worse, contact your dermatologist. In some cases, they may have you temporarily stop Vtama until your symptoms resolve.
2. Cold and flu symptoms
Cold and flu-like symptoms are another possible Vtama side effect. Infections such as the common cold, sinus infections, and the flu were reported by people while using Vtama in clinical studies. You may feel under the weather and have symptoms such as a runny or stuffy nose, cough, or fatigue.
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Getting enough rest and staying hydrated may help combat fatigue. Over-the-counter (OTC) medications can help manage your symptoms, too. But if your symptoms persist, get worse, or become severe, contact your healthcare team. You may have an infection that requires further treatment.
3. Contact dermatitis
Another possible Vtama side effect is contact dermatitis. Contact dermatitis is an allergic skin reaction. Symptoms include redness, swelling, or a rash at the site of application. The rash is often itchy. Similar to folliculitis, contact dermatitis cases usually occur within the first 1 to 2 months of treatment. But it can also happen later on during treatment after repeated use.
If you notice worsening skin irritation or swelling while using Vtama, contact your dermatologist. They may have you temporarily stop applying it until your symptoms resolve. Home care remedies, such as a cold compress and an OTC oral antihistamine, can also help provide relief. If you continue to have this reaction after continued use, your dermatologist may recommend switching to a different medication.
4. Itchy skin
Itchy skin, whether it’s from folliculitis, contact dermatitis, or just general itchiness, can also be a Vtama side effect. As mentioned above, try to avoid scratching the itchy area since this can cause breaks in the skin and may lead to an infection.
To relieve itching, use gentle, unscented cleansers and avoid harsh soaps or detergents. The National Psoriasis Foundation has a list of recommended products for people living with psoriasis.
It’s also a good idea to moisturize regularly, typically several times per day. Good times to moisturize include right after applying Vtama and directly after taking a shower or bath. OTC antihistamines can also help relieve symptoms of itchiness, but talk to your prescriber or pharmacist before taking them.
If the itching is severe or doesn’t go away, contact your dermatologist. It’s possible you have contact dermatitis, discussed above, rather than just itchy skin.
5. Headache
Since Vtama is a cream, you may be surprised to learn that headache is also a possible side effect. A small percentage of people in clinical studies reported headaches, including migraines and tension headaches, while using Vtama.
If you get an occasional headache, check with your pharmacist. They may recommend an OTC pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). But some people may experience more persistent or painful headaches that make Vtama difficult to tolerate. In this case, reach out to your dermatologist for next steps.
Frequently asked questions
Vtama cream is FDA approved to treat plaque psoriasis for adults, as well as eczema for adults and children ages 2 and older. It can help reduce itching within the first week of treatment, and typically improves skin appearance within several weeks of daily use.
Vtama is an aryl hydrocarbon receptor (AhR) agonist. Experts aren’t exactly sure how Vtama works. But it seems to activate AhR, which in turn reduces skin inflammation and helps restore healthy proteins to the skin. Vtama may also help reduce immune system activity, which helps improve the symptoms of autoimmune skin disorders.
Yes, you can apply Vtama to your face if needed. In clinical studies, there was no difference in side effects with Vtama when it was applied to sensitive areas, such as the face and groin.
Vtama cream is FDA approved to treat plaque psoriasis for adults, as well as eczema for adults and children ages 2 and older. It can help reduce itching within the first week of treatment, and typically improves skin appearance within several weeks of daily use.
Vtama is an aryl hydrocarbon receptor (AhR) agonist. Experts aren’t exactly sure how Vtama works. But it seems to activate AhR, which in turn reduces skin inflammation and helps restore healthy proteins to the skin. Vtama may also help reduce immune system activity, which helps improve the symptoms of autoimmune skin disorders.
Yes, you can apply Vtama to your face if needed. In clinical studies, there was no difference in side effects with Vtama when it was applied to sensitive areas, such as the face and groin.
The bottom line
The most common Vtama (tapinarof) side effects are folliculitis (inflamed hair follicles) and cold or flu symptoms. Itchy skin and headaches are also possible. These side effects are usually mild and can be managed at home. Contact your dermatologist if they don’t go away or get worse.
In rare cases, Vtama may cause a more severe allergic skin reaction. If this happens, contact your dermatologist before you apply the next dose. Symptoms of an allergic skin reaction include moderate to severe redness, rash, and itching. In some cases, you may need to temporarily (or permanently) stop Vtama until your symptoms resolve.
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References
American Academy of Dermatology Association. (n.d.). Acne-like breakouts could be folliculitis.
Desai, S. R., et al. (2023). Tapinarof cream 1% once daily for the treatment of plaque psoriasis: Case photography of clinical outcomes from three phase 3 trials. Dermatology and Therapy.
Elder, A. J., et al. (2023). Tapinarof. StatPearls.
Lebwohl, M. J., et al. (2021). Phase 3 trials of tapinarof cream for plaque psoriasis. The New England Journal of Medicine.
National Eczema Association. (2025). Contact dermatitis.
National Psoriasis Foundation. (n.d.). Seal of recognition.
Organon. (2025). VTAMA- tapinarof cream [package insert].
Winters, R. D., et al. (2023). Folliculitis. StatPearls.
