Topical vitiligo treatments, such as steroid creams and tacrolimus, are commonly prescribed to help manage vitiligo. Doctors commonly prescribe topical vitiligo treatments, such as steroid creams and tacrolimus, for short periods, usually up to two months, with longer use only under close supervision.

These treatments do not cure vitiligo or guarantee that the condition will not progress. However, they may help reduce inflammation, ease discomfort and, in some cases, encourage repigmentation.

These medicines form part of topical vitiligo treatments used for localised areas of depigmentation. Doctors have traditionally used Protopic, also known as tacrolimus, to treat eczema. More recently, researchers have studied it as a treatment option for vitiligo. Elidel, also known as pimecrolimus, is a similar product to protopic, but it is in a cream form.

Using Protopic as a vitiligo 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.

Protopic is made from a rare soil bacterium found only in Japan. It appears to have unique qualities in suppressing the immune response in vitiligo patches. It also has a similar effect to steroid treatments, but without the side effects.

Studies show that Protopic can be effective on the face for some people with vitiligo, particularly when pigment loss is recent and still active. Like steroid creams, unfortunately protopic does not work for everyone.

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.

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

Topical vitiligo treatments can suit some people better than others, depending on location and disease activity. The advantages and disadvantages of Protopic and Elidel include:

The NHS most commonly offers steroid creams, also known as corticosteroids, to treat vitiligo. Steroid creams help reduce inflammation and may slow the progression of vitiligo in some people. They include such brand names as Betnovate, Cutivate, Dermovate and Synalar.

Vitiligo is considered to be an ‘autoimmune’ condition, in which the immune system attacks the body’s own tissues. Steroid creams can stop this happening and therefore stop the progress of vitiligo. They are classified as:

The doctor will generally prescribe the least potent cream that will treat the condition. Treatment probably involves having a trial period of using the cream of up to two months. This is to make sure that there are no side effects.

The usual procedure is to use the cream for six to eight weeks and then start the cream again after a break. It may be used for longer under close supervision.

The cream or ointment must be applied to the white patches of your skin thinly. It is important that you follow the instructions you have been given carefully. You also need to continue with the treatment for some time (at least three months) before any results are likely to be seen.

The advantages and disadvantages of steroid creams

You may also find these pages helpful:

You may find additional evidence‑based information about topical vitiligo treatments from the following organisations, NHS guidance on vitiligo treatments & British Association of Dermatologists information on topical treatment.