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Protopic

Protopic (also known as tacrolimus) ointment is a treatment that has mainly been used for eczema.  Recently, protopic has also been used in clinical studies for the treatment of vitiligo.  It is made from a rare soil bacterium found only in Japan. 

Protopic appears to have unique qualities in suppressing the immune response in vitiligo patches.  It has a similar effect to steroid treatment, but without the side effects.  Protopic ointment has proved quite effective on the faces of some people who have vitiligo, when the loss of pigment is relatively recent and still active.  Like steroid creams, unfortunately protopic does not work for everyone.

Protopic is available in two strengths, the milder ointment (.03% strength) being usually for children.  Protopic can be prescribed by GPs for vitiligo, although it is not licensed.  Often a dermatologist may recommend it but ask the GP to actually prescribe it. 

The treatment usually involves applying the ointment twice a day.  Many doctors are also recommending that their vitiligo patients expose themselves to natural sunlight several times a week for 15 – 30 minutes. The usual procedure is to use protopic for six to eight weeks and then start it again after a break.

Current research is looking at the effectiveness of using protopic with Narrow Band UVB light treatment.  In some studies, this combination has shown enhanced pigmentation but further work is needed to establish safety standards for this treatment.

 

Elidel

Elidel (also known as pimecrolimus) is a similar product to protopic, but it is in a cream form.

The advantages and disadvantages of protopic and elidel

  • It is an alternative to steroid creams and can also be done at home.
  • It does not have the potential side effects of steroid creams. 
  • Protopic does not seem to be readily absorbed into the bloodstream, so the treatment is quite localised.
  • It takes a long time for results to show (usually three to six months).
  • Even when white patches have re-pigmented, they may relapse later.