Comparative study on the therapeutic efficacy of topical bimatoprost (0.03%) ophthalmic solution and tacrolimus (0.1%) ointment in stable vitiligo.

Background: Vitiligo is a chronic autoimmune skin disorder characterized by loss of melanocytes, leading to depigmented patches. Though not physically harmful, its appearance causes significant psychological distress, especially in darker-skinned individuals. Topical therapies like tacrolimus, calcineurin inhibitor, are first-line treatment for localized, stable vitiligo. However, bimatoprost, a prostaglandin analog known for its melanogenic properties, is emerging as a potential alternative. The current study was done to compare efficacy and safety of topical bimatoprost 0.03% solution versus tacrolimus 0.1% ointment in management of stable vitiligo. Material & Methods: A randomized comparative study was conducted over 24 months in Department of Dermatology at Era’s Lucknow Medical College. Fifty clinically stable vitiligo patients (aged >18 years, <5% BSA involvement) were randomized into two groups: Group A received topical bimatoprost 0.03%, and Group B received topical tacrolimus 0.1%, both applied twice daily over lesions. Treatment was continued for 12 weeks, with follow-up every 4 weeks. Efficacy was assessed using the Vitiligo Area Scoring Index (VASI), Subjective score and Photographic documentation. Any side effects were documented at each follow-up. Results: Both groups showed clinical improvement, with Group A demonstrating faster onset of repigmentation, particularly in facial lesions. Bimatoprost was well-tolerated with minimal side effects such as local hypertrichosis, while tacrolimus was associated with mild burning in some cases. Conclusion: Topical bimatoprost 0.03% is a safe and effective alternative to tacrolimus 0.1% ointment in treating stable vitiligo, especially for cosmetically sensitive areas. Therefore, it can be considered as a treatment option in stable vitiligo.