I received a comment on a previous post in which I wrote about protopic being added to my excimer xtrac laser treatments. The writer asked how it works on vitiligo; upon reading the question I laughed at myself because I had no idea. Why on earth had I not researched protopic a bit more before using it?
So, here it is…more info than you may need about protopic 😉
What stuck out to me in this info:
1. no evidence of skin cancer has been associated with use of these agents in humans
2. it supresses the immune reponse associated with vitiligo
3. it’s not a steroid
4. works for some, but not all, cases of vitiligo
5. it’s not absorbed into the bloodstream or body
What is Protopic
Both protopic and elidel have been reported in the US to be associated with development of skin cancers in animals. This was with larger quantities of calcineurin inhibitor creams and there is no evidence that this finding has been associated with use of these agents in humans. Most dermatologists (even in the US) consider both elidel and protopic to be very safe in human use provided there is regular medical supervision.
Protopic (Tacrolimus) is a treatment that has mainly been used for atopic dermatitis (eczema). It is made from a rare soil bacterium found only on the island of Honshu in Japan which appears to have unique qualities in suppressing immune response. Over the last few years it has been used in clinical studies for the treatment of vitiligo.
Most experts believe that vitiligo is the result of the , mistakenly generating anti-bodies to the sufferer’s pigment cells, which attack and kill or weaken such cells. Protopic works to down-regulate (suppress) the immune response in a local area of skin, where the vitiligo is located; it has a similar effect to steroid treatment, but without the side-effects. The ointment is showing very good success in many (but not all) people who are using it.
Protopic can be prescribed by GPs for vitiligo, although it is not licensed for this condition. Often a dermatologist may recommend it but ask the GP to actually prescribe it.
The most common advice for patients by doctors is to apply the ointment twice a day with many doctors also recommending that their vitiligo patients expose themselves to natural sunlight a few times a week for 15 – 30 minutes. What is most reassuring to many users is that Protopic does not seem to be readily absorbed into the bloodstream or body, therefore keeping the treatment fairly localised. The product itself is available in two strengths .03% strength (usually for children) and also 1%.
One thing that should be remembered is that whilst Protopic is showing good results for many it can still take time for others to see any improvement. A period of three to six months is not unusual to see initial results and 100% repigimentation is still difficult, especially on certain parts of the body, such as the hands. Best results have been observed on the face. Even so once an area has re-pigmented it may be subject to a future relapse; some patients have reported long-lasting results whereas others have experienced a relapse.
There are some investigations into testing Narrow Band UVB Light Treatment in combination with Protopic and this combination has shown enhanced repigmentation in some studies. Further studies are required to determine the safe parameters for this combination.