Topical calcineurin inhibitors are a common treatment for vitiligo. These treatments include the topical medications tacrolimus (Protopic) and pimecrolimus (Elidel). They are often combined with phototherapy in treatment protocols.
A recent analysis of 56 clinical studies of calcineurin inhibitors, either as monotherapy or in combination with phototherapy, confirms the usefulness of these medications.
According to the report, for topical calcineurin inhibitors monotherapy, an at least mild response was achieved in 55.0% of patients, an at least moderate response in 38.5%, and a marked response in 18.1% after median treatment duration of 3 months. Face and neck lesions responded strongly, with at least mild response in 73.1% and a marked response in 35.4%. Results in treating vitiligo with a topical calcineurin inhibitor plus phototherapy were even better: an at least mild response to topical calcineurin inhibitors plus phototherapy was achieved in 89.5% of patients, and a marked response was achieved in 47.5%.
At SOMA Skin & Laser, we often prescribe topical calcineurin inhibitors along with excimer phototherapy or home narrow-band UVB treatment. It is our experience as well that results are very favorable, especially on the head and neck. Extremities are generally resistant to treatment.
JAMA Dermatol. 2019 May 29