Where Are Dermatology's Next Competitive Battles Taking Shape?

By Michelle Mariaprabhu, Junior Business Analyst; Karim Belkhou, Consultant; and Paola Pinto, Consultant, Lifescience Dynamics

Plaque psoriasis (PsO) and atopic dermatitis (AD) have been key drivers of growth in the dermatology landscape, supported by strong investments in the development and commercialization of highly effective targeted therapies. However, as these indications become increasingly competitive, companies face growing challenges in differentiating new assets against already established treatment options. In PsO, multiple IL-17 and IL-23 inhibitors, as well as a rise in oral therapies, have transformed the landscape, while Dupixent has established a strong position in AD, coupled with an expanding range of accessible biologic and oral therapies. Though validated mechanisms in PsO and AD have been established, incomplete treatment responses, sustained symptoms, and recurrence of disease following discontinuation of treatment continue to showcase gaps in current available therapies. These gaps are shaping next generation clinical discovery in dermatology, with companies looking to expand into alternate inflammatory pathways to provide a more targeted approach to achieving disease control.

With numerous effective treatments now available for PsO and AD, the spotlight is shifting toward treating smaller dermatological areas, including hidradenitis suppurativa (HS) and non-segmental vitiligo (NSV), where significant unmet needs remain. At the European Academy of Dermatology and Venereology (EADV) 2026 Congress in Vienna, Austria, emerging clinical data and discussions with industry representatives highlighted the growing focus on underserved dermatological indications. The contrast between the wide range of available therapies for PsO and AD, and the limited treatment options for patients with conditions such as HS, further reinforces the opportunities to address unmet patient needs. Growing pipeline activity in these therapeutic areas reflects efforts to build on established immunology portfolios while exploring novel therapeutic approaches, offering opportunities to address treatment gaps and establish a presence in less mature markets.

Hidradenitis Suppurativa Emerges As A New Frontier In Dermatology

Treatment options for HS have historically remained limited, with patients often relying on antibiotics, immunosuppressants, and surgery to manage their symptoms. Despite the significant physical and emotional burden of HS, treatment advances have lagged behind those in more established dermatological conditions, leaving considerable room for improvement in patient care.

The introduction of biologics has begun to reshape the HS treatment landscape. While AbbVie's Humira was previously the only approved biologic, Novartis's Cosentyx (anti-IL-17A) and UCB's Bimzelx (anti-IL-17A/F) have expanded treatment options and established IL-17 inhibition as an important therapeutic approach. At EADV 2026, UCB presented three-year Bimzelx data from its BE HEARD EXT trial, highlighting the potential benefits of earlier intervention with Bimzelx in HS. 67.3% of biologic-naïve patients achieved complete clearance of draining tunnels, compared with 47.7% of biologic-experienced patients. These findings, alongside growing emphasis on reaching higher Hidradenitis Suppurativa Clinical Response (HiSCR) thresholds, such as HiSCR75 and HiSCR90, reflect the industry's increasing focus on achieving deeper and more sustained disease control.

Pipeline developments also demonstrate growing interest in different mechanisms of action, particularly with IL-1α and IL-1β beyond established IL-17 inhibition. Previous research in HS lesions have identified elevated IL-1 signaling, with higher IL-1β levels observed in HS lesions compared to healthy skin. Additionally, further evidence demonstrated increased gene expression in both IL-17A and IL-1β, supporting the development of investigation into both pathways in HS.

MoonLake Immunotherapeutics' sonelokimab (a nanobody targeting IL-17A/F) and Incyte's oral JAK1 inhibitor (povorcitinib) demonstrates industry efforts to broaden the HS treatment landscape. AbbVie's development of lutikizumab, targeting IL-1α/IL-1β, and Avalo Therapeutics’ abdakibart, an IL-1β inhibitor, signal the growing interest in IL-1 inhibition in HS, exploring inflammatory pathways beyond currently established biologic targets. At EADV 2026, results from the Phase 2 LOTUS trial of abdakibart showed that the trial met its primary endpoint and demonstrated HiSCR75 response rates at Week 16 of 42.9% with 300 mg every four weeks and 42.2% with 150 mg every two weeks vs. 25.6% with placebo.

As competition grows, earlier treatment responses, sustained disease control, improvements in draining tunnels, and the potential to limit tissue damage will become necessary in differentiating emerging therapies. Additional research identifying disease-specific biomarkers, including increased neutrophil activity, IL-1β signaling, and additional markers of tissue remodeling could provide more color on disease activity, and further inform therapeutic developments. Leveraging biomarker specific data alongside clinical HS endpoints could provide further clarity on driving drug development and its potential in deeper disease control.

Redefining The Treatment Landscape For Non-Segmental Vitiligo

Treatment options for NSV have remained minimal, with patients largely relying on topical corticosteroids, calcineurin inhibitors, and phototherapy. Despite being a chronic autoimmune condition associated with significant psychological distress and reduced quality of life, vitiligo continues to be seen as a cosmetic concern rather than a medical condition, contributing to reimbursement challenges and barriers to treatment access.

The approval of Incyte's Opzelura marked an important step forward, introducing the first approved targeted therapy for repigmentation in NSV. However, topical treatments can be less practical for patients with extensive disease involvement, creating the need for systemic alternatives. The recent approval of AbbVie’s Rinvoq by the European Commission marks further progress in addressing this gap, as the first systemic treatment available for NSV. At EADV 2026, long-term data from the Phase 3 Viti-Up studies showed maintained improvements in facial repigmentation through Week 76, with 55.1% and 47.4% of patients from Viti-Up-1 and Viti-Up-2, respectively, achieving greater than 75% reduction from baseline in Facial Vitiligo Area Scoring Index (F-VASI75). Current investigational therapies in the developmental pipeline, including Incyte's povorcitinib, could offer additional treatment options for patients who may not be adequately served by topical approaches.

Beyond JAK inhibition, IL-15-targeted therapies are also gaining attention for their potential to address a key challenge in NSV treatment by maintaining repigmentation over time, as seen through Teva’s TEV-53408 (anti-IL-15), which demonstrated early efficacy signals, with 42% of patients achieving F-VASI50 at Week 24 in its Phase 1b trial.

Preclinical evidence shows sustained repigmentation following IL-15 inhibition in mouse models, supporting the potential approach of targeting pathways involved in the persistence of skin-resident memory T cells to help reduce disease recurrence following treatment. As new therapies advance, the focus will increasingly shift toward achieving durable repigmentation, while addressing reimbursement barriers that continue to limit patient access.

Competitive Opportunities Beyond Hidradenitis Suppurativa And Vitiligo

Prurigo nodularis (PN) and alopecia areata (AA) offer further examples of how companies are expanding their dermatology portfolios, although opportunities for differentiation vary across indications.

In PN, Sanofi and Regeneron's Dupixent and Galderma's Nemluvio (nemolizumab) have established a growing biologics market, raising the bar for therapies entering development. Galderma presented additional long-term evidence from the OLYMPIA trial, demonstrating improvements in sleep, itch, and quality of life across Week 148 with Nemluvio treatment. As additional treatments advance, companies will need to demonstrate advantages beyond durability of itch relief to compete with currently available options. 

In AA, oral JAK inhibitors, including Eli Lilly's Olumiant, Pfizer's Litfulo, Sun Pharma's Leqselvi, and AbbVie’s recently approved Rinvoq, have expanded treatment options for severe disease. At EADV, Q32 Bio presented Phase 2a SIGNAL-AA data for bempikibart (IL-7Rα) with 40% of evaluable patients achieving at least 80% scalp hair coverage at Week 36. Importantly, all 12 patients with hair growth who entered the off-treatment follow-up period maintained their response for 16 weeks without treatment. While further evidence is needed, these findings highlight how newer mechanisms could compete with established JAK inhibitors by offering different approaches to long-term disease control. Together, PN and AA demonstrate how opportunities in smaller dermatology indications increasingly depend on identifying gaps that existing treatments have yet to address.

Where Dermatology Goes Next

EADV 2026 highlighted how leaders in dermatology are looking to maintain their leadership in diseases such as PsO and AD while expanding their portfolios into smaller therapeutic areas, where treatment pathways and competitive positions are still developing. These indications offer opportunities to diversify their growth drivers and establish an early presence in emerging markets, although the crowded pipelines will make it difficult to stand out.

Looking beyond EADV, the clinical and regulatory progress of emerging HS therapies, including MoonLake’s sonelokimab, Incyte’s povorcitinib, and AbbVie’s lutikizumab, will be important to watch as companies look to compete with established biologics. In NSV, further development of oral JAK inhibitors and IL-15-targeted therapies could help address limitations of existing topical treatments, particularly for patients with more extensive disease. In PN and AA, longer-term efficacy and safety data will be important in determining how newer therapies compare with available options.

Beyond clinical outcomes, companies will also need to consider how disease awareness, earlier diagnosis, and reimbursement barriers affect patient access and treatment uptake. As these markets develop, companies that can demonstrate clear benefits over existing therapies while addressing these challenges will be better positioned to establish a strong presence alongside their existing PsO and AD portfolios.

About The Authors

Michelle Mariaprabhu is a junior business analyst with Lifescience Dynamics with experience covering competitive intelligence projects across indications including lung cancer, autoimmune diseases, focused on dermatology, and rare disease. Before joining Lifescience Dynamics, Michelle completed her MHSc in medical genomics at the University of Toronto, where her studies spanned immunology; women’s health; oncology; and genomics, including the application of single-cell RNA sequencing to investigate tailored treatment approaches for triple-negative breast cancer; and research examining anti-CRISPR phage mechanisms in CRISPR-Cas immunity. Her previous roles at McMaster University and Toronto Metropolitan University further broadened her experience in health outcomes and population health research.

Karim Belkhou is a consultant with Lifescience Dynamics with over 5 years of experience in competitive intelligence and strategic analysis. He brings a diverse background across clinical practice, regulatory strategy, and market analysis. He has developed deep therapeutic expertise in neurology, immunology, and oncology, along with a strong understanding of generic market dynamics across the EU-5 and Gulf regions. Before joining Lifescience Dynamics, Karim led business development for a global regulatory strategy and communication firm where he supported pharmaceutical and biotech clients through high-stakes regulatory milestones, including FDA advisory committees, EMA CHMP submissions, and late-stage data communication strategies. Earlier in his career, he worked as a clinical pharmacist at Imperial College Healthcare NHS Trust in London during the COVID-19 pandemic and contributed to several clinical research and product-launch initiatives in Canada and the U.K.

Paola Pinto is a Consultant at Lifescience Dynamics, specializing in pharmaceutical insights and strategy, with a focused expertise and interest in autoimmune diseases, including rheumatology, dermatology and gastroenterology. Experienced in partnering with global pharmaceutical clients throughout the drug development pipeline, from candidate selection to life cycle management, she is keen to understand and deliver insights on the dynamic treatment landscapes across therapeutic areas, including the emergence of novel modalities such as cell therapies. Before joining Lifescience Dynamics, Paola completed a Ph.D. in molecular biology and biochemistry at the University of Vienna.