Calcineurin Inhibitors in the Treatment of Alopecia Areata

Abstract

Topical calcineurin inhibitors (TCI) are a relatively new class of drugs used in dermatology. There are
two drug forms available – tacrolimus 0.03% or 0.1% ointment and 1.0% pimecrolimus cream. The
drugs act by inhibiting synthesis of proinflammatory cytokines. The only approved indication for using
TCI is treatment of atopic dermatitis. The TCI may be used as an alternative therapy to corticosteroids.
Tacrolimus is used to treat moderate-to-severe atopic dermatitis, pimecrolimus – mild-to-moderate
atopic dermatitis. Topical calcineurin inhibitors do not cause skin atrophy and the drug absorption
through the skin is minimal. The TCI have been well-studied, their efficacy was evaluated in a number
of vast, long-term studies. The anti-inflammatory potency of tacrolimus ointment is similar to a
corticosteroid with moderate activity, while the latter is clearly more active than pimecrolimus cream.
Topical calcineurin inhibitors significantly relieve pruritus in atopic eczema.