What You Should Know About Vtama Side Effects

Starting a new medication always comes with questions — especially about side effects. If your doctor has prescribed Vtama (Tapinarof) cream for plaque psoriasis or atopic dermatitis, here's what the clinical data shows about what you might experience and when you should reach out to your doctor.

What Is Vtama?

Vtama is a first-in-class topical cream that contains Tapinarof 1%. It works by activating the aryl hydrocarbon receptor (AhR) in your skin, which helps reduce inflammation and support your skin barrier. It's FDA-approved for plaque psoriasis in adults and atopic dermatitis in adults and children ages 2 and older.

Unlike topical steroids, Vtama is not a corticosteroid, so it doesn't carry the same risks of skin thinning with long-term use. You can learn more about how Vtama works in our detailed guide.

Common Side Effects

The following side effects were reported in clinical trials and are listed in Vtama's FDA-approved labeling:

• Folliculitis — Small red bumps around hair follicles. This is the most commonly reported side effect. It usually looks like tiny pimples and often resolves on its own.
• Nasopharyngitis — Pain or swelling in the nose and throat, similar to a common cold.
• Contact dermatitis — Skin rash, irritation, peeling, burning, or stinging at the application site.
• Headache
• Pruritus (itching) — Some itching at or near the application site.
• Influenza — Flu-like symptoms were reported in some trial participants.
• Upper respiratory tract infection

Most of these side effects are mild to moderate and tend to improve as your body adjusts to the medication over the first few weeks.

What's Normal in the First Few Weeks

It's common to experience some folliculitis or mild irritation when you first start Vtama. This doesn't necessarily mean the medication isn't working or that you need to stop. Many patients find these effects lessen after 2–4 weeks of consistent use.

Serious Side Effects

Serious side effects with Vtama are uncommon, but they can happen:

• Severe contact dermatitis — If you develop intense redness, blistering, swelling, or pain at the application site that goes beyond mild irritation, contact your doctor.
• Severe folliculitis — In rare cases, folliculitis can become significant enough that your doctor may recommend stopping Vtama.

Vtama does not carry a boxed warning (the FDA's most serious warning level). It also does not carry the same risks as topical corticosteroids, such as skin atrophy (thinning), striae (stretch marks), or hypothalamic-pituitary-adrenal (HPA) axis suppression.

Specific Populations

Pregnancy and Breastfeeding

There is no adequate data on Vtama use during pregnancy. The prescribing information recommends using it only if the potential benefit justifies the potential risk. There is also no data on whether Tapinarof passes into breast milk. Talk to your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

Children

Vtama is approved for atopic dermatitis in children ages 2 and older. It has not been studied in children under 2 years old and is not approved for pediatric psoriasis. Side effects in children were similar to those seen in adults.

Older Adults

Clinical trials showed no overall differences in safety or effectiveness in patients 65 and older compared to younger adults.

How to Manage Common Side Effects

Here are some practical tips for dealing with Vtama's most common side effects:

• For folliculitis: Keep the area clean and avoid tight clothing over treated areas. If the bumps are bothersome, ask your doctor about using a gentle cleanser. Don't pick or squeeze the bumps.
• For contact dermatitis or irritation: Apply a thin layer as directed — using more won't help and may increase irritation. If burning or stinging is significant, try applying Vtama to dry skin (wait at least 20 minutes after bathing).
• For itching: A fragrance-free moisturizer applied before or after Vtama (check with your doctor on timing) can help manage dryness and itch.
• For headache: Over-the-counter pain relievers like Acetaminophen or Ibuprofen are generally fine, but check with your pharmacist about any potential interactions.

When to Call Your Doctor

Contact your doctor if you experience:

• Severe redness, blistering, or swelling at the application site
• Folliculitis that worsens or doesn't improve after 2–4 weeks
• Signs of skin infection (increasing warmth, pus, spreading redness)
• Any reaction that feels beyond normal irritation
• Allergic reaction symptoms (hives, difficulty breathing, swelling of face/lips/tongue)

Final Thoughts

Most people who use Vtama tolerate it well. The most common side effects — folliculitis and mild skin irritation — are usually manageable and tend to improve with continued use. Serious reactions are rare.

If you're weighing whether to start Vtama, talk to your dermatologist about what to expect. And when you're ready to fill your prescription, Medfinder can help you find a pharmacy with Vtama in stock.