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How does protopic work on vitiligo?

7 August 2009 8 Comments

protopic,vitiligo,vitiligo cover,nathalie pelletierI 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.

resource: http://www.vitiligosociety.org.uk/treatments/protopic.html

8 Comments »

  • sf said:

    Hi Nathalie,
    Thanks for the sharing your research with us! Very informative! I’m just curious as to what your dermatologist said about Protopic when he/she prescribed it to you. Are you personally noticing any advantages when using the ointment? Any side effects? How’s the repigmentation process by the way?

  • Nathalie Pelletier (author) said:

    hi sf,
    actually, i asked him for the protopic and he agreed that it could help…i think it has. so far, there have been no side effects, but i do have to be careful to not apply it the night before a treatment because the skin will be to photosensitive.
    the woman who normally does my treatment has been out for 6 weeks because she had a baby. when she returned last week, she couldnt believe how much pigmentation had occurred while she was away.
    it’s so difficult to see results on yourself since you see your skin everyday, but her words made me take notice of the large amounts of new pigmentation. ;)

  • tash said:

    we have just got back from seeing the dermatologist. my 13 yr old son has vitiligo as well as type 1 diabetes. (i know, what a bummer!!) we have been given protopic 0.1 and will let you know what happens!

  • acnelady said:

    Vitiligo has no permament cure, it can only be controlled by some medications.

  • sf said:

    Hi Tash,
    Hope the Protopic treatment works! I read younger people have better response to topical creams. Keep us posted!

  • CJ said:

    Hi I need help I’m 31 yrs of age and I have 2 white spots on my face the derm gave me some protopic cream, but I don’t see a change
    it makes me feel so insecure at times, I have tried make up to cover – it doesn’t work my skin is a dark completion . I have a dr appts approaching I;m going to ask her about the Vit, cream lotion .
    any suggestion ?

  • Jamie said:

    I have just started using Protopic for a small patch of vitiligo I’ve had for about 25 years. I was prescribed it by the dermatologist almost a year ago, but after I read all the warnings and possible health risks related to this medication, I held off using it until now. The dermatologist told me to ignore the FDA warnings, and that made me worried so I did some researching and decided after reading about the possible links to cancers, to use it only as a last resort. Well now it’s the last resort and I’m cautiously testing it out for a short time. I usually treat my body fairly good, I eat mostly organic food, and stay away from environmental toxins as much as I can, and using something like this goes against my better judgement, but I like most other people suffering from vitiligo, I’m getting desperate to rid myself of this condition and will try almost anything promising results. As far as results go, I’ve been using it as recommended on the box for over 3 weeks now with no apparent noticeable change yet. I really don’t want to have to use this medication for very long, especially since the warnings on the box say it’s not intended for long term exposure, and that the risks of cancer come from long term exposure. The cream itself is made of a toxic mineral oil base that itself would be harmful to use log term. Most of the research done on it with vitiligo though tell you to use the cream for at least 3 months. I think that’s crazy since it goes against the warnings of the drug company. I hope I see some positive results soon. I would be very disappointed, and angry at myself for exposing my body to something so toxic for nothing. Has anyone out there seen any results from Protopic after just a few weeks or have you had to wait months?

  • S.J said:

    Dear Sir/Madam,
    My wife is suffering from vitiligo. Her comments is given below.
    “I am a 41 years old woman, suffering from vitiligo on my face, neck, hand and foot for many years. As well my mother and younger sister are suffering the same complication.
    I have heard about Protopic and searched the Internet for the subject and found many comments. In my country dermatologists say that combined usage of protopic and UVB is useful for very small big spots where there are many spots in a certain location not for small and sparse spots.
    Would you please tell me how should I use Protopic with some information about method and interval of use, or other instructions, how should i start it. Does it work with no UVB.
    I would be appreciated for your kind reply.

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