Topical Bimatoprost May Be Viable Treatment Option for Nonsegmental Facial Vitiligo

Topical bimatoprost may be safe and effective for patients with nonsegmental facial vitiligo and is comparable to tacrolimus ointment, according to study research published in the Journal of Cosmetic Dermatology.

The randomized, single-blinded, intra-individual controlled preliminary study enrolled 16 patients, older than 15 years, with more than 2 vitiliginous patches on the face and less than 2% of their body surface area involved. A total of 10 patients (8 women; mean age, 45.5) with a median disease duration of 60 months (interquartile range, 24, 108) completed the protocol and were included in the analysis.

Patients received either topical 0.1% tacrolimus ointment or 0.01% bimatoprost ophthalmic solution, applied twice daily for 12 weeks. The study authors calculated the vitiligo surface area (VSA, cm²) and assessed the percentage of repigmentation. At baseline, the mean VSA was comparable in the 2 treatment groups. At week 12, the VSA had a statistically significant decrease in both groups (P < .05), although no statistically significant difference occurred in the groups.

Also at week 12, 20% of the patients in the bimatoprost group and 10% in the tacrolimus group achieved greater than50% repigmentation, and the overall grading score between the 2 groups was not different at a statistically significant level. Itching and burning were adverse events of bimatoprost, and no changes in intraocular pressure were observed in 2 patients with lid involvement.

Study limitations include the small sample size, and the treatment period may not have been long enough, as topical monotherapy requires a longer time to induce repigmentation, the investigators noted.

“The method of measuring vitiligo surface area used in this study was a quantitative measurement which is the most accurate technique, resulting in more reliable information,” stated the researchers. “In addition, both treatment modalities can decrease the disease activity, as shown by the reduction in Vitiligo Disease Activity score, although there was no statistically significant difference.” They continued, “Our study demonstrated that 0.01% topical bimatoprost solution as monotherapy was considered safe and effective as treatment of nonsegmental facial vitiligo with comparable results to 0.1% tacrolimus.” They suggested that 0.01% topical bimatoprost solution “may be an alternative choice for facial vitiligo when conventional steroid-sparing agents are not available.”

Reference

Kanokrungsee S, Pruettivorawongse D, Rajatanavin N. Clinical outcomes of topical bimatoprost for nonsegmental facial vitiligo: A preliminary study [published online August 3, 2020]. J Cosmet Dermatol. doi: https://doi.org/10.1111/jocd.13648