Protopic is a topical ointment that can be used off-label to treat vitiligo. It comes in two different strengths, and can be applied directly to affected areas of skin.
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Protopic belongs to a group of medications called topical calcineurin inhibitors (TCI). They are classed as ‘immunomodulating agents’. The active ingredient in Protopic is tacrolimus monohydrate (tacrolimus). The ointment is one of two TCIs, the other being pimecrolimus cream, which is sold as the brand Elidel.
Vitiligo is an autoimmune disease that causes your immune system to destroy melanocytes, cells in your skin that are responsible for melanin production. Melanin gives your skin its pigment, along with your hair and eyes. Because of this lack of melanin, pale patches develop on different parts of the body of vitiligo sufferers. These light areas of skin can occur anywhere on the body, but typically show up on the face, hands, neck and in the creases of your skin.
How does Protopic work?
TCIs like Protopic treat vitiligo by suppressing your immune system, so it no longer destroys melanocytes. Without this destruction of melanocytes, melanin is produced, which can help change the colour of your affected areas of skin.
It might take months before your skin pigment changes to the extent you want it to, but using tacrolimus twice a day has been proven to help treat vitiligo.
What doses of Protopic are there?
Protopic ointment is available in two strengths: 0.03% and 0.1%. A clinician will advise you about which strength they think will work best for your condition.
For eczema, the ointment is typically applied twice a day — once in the morning, and again in the evening. This might be the dosage routine you’re advised to stick to while trying to change your skin pigment, but it might differ person-to-person.
In a 2009 study that looked at using tacrolimus to treat facial vitiligo, a twice daily application proved to be an effective treatment routine.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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How to use Protopic
Apply a thin layer of Protopic to any areas of skin affected by vitiligo. The ointment can be used on all parts of the body, including your face, neck, and any areas where your joints bend (flexures).
Try to avoid applying the ointment to any mucous membranes (such as the nose and mouth).
How long does Protopic take to work?
Because Protopic is used off-label to treat vitiligo, there aren’t a great deal of studies to say how long the ointment takes to affect skin pigmentation. It will likely vary person-to-person, as no two cases of vitiligo are the same.
Skin repigmentation can be a lengthy process, and it might be a while before you start to see changes. Changes in skin pigment are typically monitored after 6 months, so you might be advised to stick with Protopic for this long before you and a clinician decide whether the ointment is working.
What happens if I make a mistake while using Protopic?
Protopic has a better chance of working effectively if you stick to the dosage routine recommended by your clinician. If you forget to apply the ointment at your usual time, use it as soon as you remember. There’s no need to apply more ointment than normal to make up for a missed dose, as it might increase the chances of you getting side effects.
If you swallow some ointment accidentally, get urgent help at your nearest hospital.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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FAQ: Protopic
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
How is Protopic different from other vitiligo treatments?
Answer:
The most common method of treating vitiligo is with a topical corticosteroid. Using corticosteroids long-term can cause side effects, like skin atrophy and acne. Because of this, using them to manage vitiligo often needs the supervision of your GP.
Topical corticosteroids are often prescribed if you have non-segmental vitiligo, and usually if it affects less than 10% of your body. Non-segmental vitiligo is the most common type of vitiligo, and affects both sides of your body.
Protopic is a type of topical calcineurin inhibitor (TCI) and, like pimecrolimus, it suppresses the immune system from destroying the cells in your skin that produce melanin (melanocytes). Because the melanocytes aren’t being destroyed, melanin is produced, helping to repigment the skin.
Which dose of Protopic works best for vitiligo?
Answer:
The dose of Protopic you’ll be prescribed will depend on several factors, such as the size of the area of skin you’re trying to treat, and the skin pigment you’re trying to achieve by using the ointment.
A clinician will advise you about which dose they think you should start out using. If you’re prescribed the lower dose 0.03% ointment and you’re not seeing the results you want to, you can easily switch to the 0.1% version if our medical experts think it’s a safe decision.
Will I get any side effects while using Protopic?
Answer:
We can’t say for sure whether you’ll get any side effects while using Protopic. All medications can cause them, but people respond to treatments in different ways so you might not experience any.
The patient information leaflet (PIL) provided with your medication contains a list of all the possible side effects you might encounter. Increased skin sensitivity, tingling and redness are all listed as affecting more than 1 in 10 people who use the ointment.
If you feel like Protopic is causing acne, lentigo (brown spots that appear on your skin) or oedema (swelling) on the areas you’ve applied it to, stop using the ointment and contact a clinician. It might be that you need to try an alternative treatment.
Who should avoid using Protopic?
Answer:
A study that looked at using Protopic to treat atopical dermatitis showed that it was both safe and effective when used over a six month period. It was well tolerated by the children and adults in the trial, and any adverse effects like a burning sensation after application only lasted a short time. This means Protopic should generally be considered a safe treatment option.
Drinking alcohol while using the ointment can cause your face and skin to become flushed and feel hot, so might be best avoided.
If you’re pregnant or planning on having a baby, let a clinician know before you start using Protopic. They will advise you about any possible risks involved while using the ointment.
Why should you buy Protopic online from us?
Answer:
When it comes to managing sensitive conditions, we’re here to help. We provide care that’s specific to you, so the medications our clinicians recommend are based on your personal needs.
Once you’ve chosen a treatment for your vitiligo, you’ll get ongoing support from our medical experts. They’ll check in with you to see if you’re happy with your choice, and if it’s working the way you want it to.
If you need your medication often but don’t want the hassle of regular pharmacy trips, our subscription plans take care of re-ordering so you don’t have to.
Safety and Efficacy of Tacrolimus Ointment 0.1% (ProtopicTM) in Atopic Dermatitis: A Canadian Open-Label Multicenter Study. Journal of Cutaneous Medicine and Surgery, vol. 8, no. 4, Aug. 2004, pp. 213–219.
Effectiveness and Safety of Topical Tacrolimus Monotherapy for Repigmentation in Vitiligo: A Comprehensive Literature Review. Anais Brasileiros de Dermatologia, vol. 91, no. 2, Apr. 2016, pp. 187–195.
Response of Vitiligo to Once- vs. Twice-Daily Topical Tacrolimus: A Controlled Prospective, Randomized, Observer-Blinded Trial. Journal of the European Academy of Dermatology and Venereology: JEADV, vol. 23, no. 8, 1 Aug. 2009, pp. 951–953.
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
