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Why Am I Getting Pigmented Spots On My Skin After Using Protopic For Vitiligo?

Posted on Tue, 5 Mar 2024

Question: Hi
I have vitiligo since XXXXXXX 2016. I used Protopic 0.1 since then and The spots in the face repigmented except very small ones. The hands and feet are not cured at all and very small spots are appearing in the legs.
I am using excimer laser since end of 2017 but no improvement at all. Since I travel a lot I stop some times but when I comeback they start over.

My question is : I have an XXXXXXX friend who suggested the following medication because his brother used and his hands and feet are cured.
The medication:
1- Betamethasone Dipropioionate lotion USP
2- Diprovate ointment

I could not find them where I live but they are available in XXXXXXX
I need to know what you think about the these medications, are they safe and is true the work well.
Please let me know.
Thanks

Answered by Dr. Dr. Kakkar (49 minutes later)

Brief Answer:
Regarding vitiligo

Detailed Answer:
Hello. Thank you.
I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern.
Topical steroids are first line treatment options for vitiligo patches. Betamethasone dipropionate 0.05 % is a topical steroid that can be used for vitiligo patches. It can be used either alone or along with the other medications.

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Kakkar (7 hours later)

Thank you for the reply.

Please clarify please. Give detailed answer and reply to my questions below:

1- Shall I use both of the following:
- Betamethasone Dipropioionate lotion USP
- Diprovate ointment

2-Are they safe?

3-Will they work please faster/better than Protopic 0.1?

4- You said "It can be used either alone or along with the other medications. "
You mean the lotion with Diprovate or what other medications?

Please relpy in details.

Thanks

Answered by Dr. Dr. Kakkar (20 hours later)

Brief Answer:
Regarding vitiligo

Detailed Answer:
Hi.
Yes, you may use both betamethasone dipropionate 0.05 % ointment (diprovate ointment), night time as well as tacrolimus 0.1 % ointment (Protopic), twice daily, for vitiligo patches. Together they will work better than tacrolimus alone. They are safe and standard therapies for vitiligo

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (33 hours later)

Thanks for the reply but please try to answer all my questions.

What about the lotion? - Betamethasone Dipropioionate lotion USP

Every doctor I saw (3 doctors) says cortisone is bad avoid it and use only Protopic. But you recommend the cortisone. Please can you comment?

Thanks

Answered by Dr. Dr. Kakkar (27 hours later)

Brief Answer:
Regarding vitiligo

Detailed Answer:
Hello.
The lotion form of betamethasone dipropionate 0.05 % is fine but cream or ointment is usually preferred if you have just a few small patches. The lotion form is for wider area involvement because its easy spreadability.
Betamethasone dipropionate 0.05 % is a well known and standard topical therapy for vitiligo just like tacrolimus (Protopic). Kindly go through the following link- https://www.jaad.org/article/S0190-9622(07)02104-4/abstract.
You can find a lot of information about the use of topical steroids in vitiligo. Of course topical steroids can cause side effects like skin atrophy and here forever they must be use judiciously and understand supervision.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Prasad