Comparison of Tacrolimus versus Bimatoprost in Patients with Vitiligo: A Randomised Controlled Trial

Background:While not constituting a life-threatening ailment, vitiligo can greatly affect one's quality of life, particularly if it manifests on the face or hands.Feelings of shame can lead to diminished self-esteem.The predominant adverse effects of "topical calcineurin inhibitors, like tacrolimus," are cutaneous burning, pruritus, and redness.Hence, it is imperative to develop novel, more effective, and safer therapies.This study aimed "to compare the efficacy and safety of bimatoprost 0.03% solution and tacrolimus 0.1% ointment in repigmentation of localized vitiligo."Methods: 25 patients in Group I (Bimatoprost) received bimatoprost 0.03 % solution twice daily and 25 patients in Group II (Tacrolimus) received Tacrolimus 0.1% ointment twice daily for 3 months.Comparisons of continuous data such as VSA, age, and disease duration were performed using unpaired t-tests.Other outcome measures and baseline parameters such as repigmentation grade were expressed as percentages and ratios and compared using chi-square test.Results: Most of patients in Group I (Bimatoprost) and Group II (Tacrolimus) achieved grade I-II pigmentation at 3 months of pharmacotherapy.There were 2 cases with 76-100% pigmentation in Bimatoprost group as compared to Tacrolimus group.There was significantly less area with vitiligo in bimatoprost group (3.91 0.69) as compared to tacrolimus group (4.08 0.57) at three months of pharmacotherapy (p=0.03).There was higher incidence of skin infection in Group II (Tacrolimus).Also, incidence of pruritus, dryness and burning sensation was higher in Group II (Tacrolimus). Conclusion:Bimatoprost is a viable alternative for treating vitiligo in cases when traditional steroid-sparing medications are unavailable.