Pimecrolimus

Is it effective against hair loss?

To date, there have been a few studies that have tested the effects of Pimecrolimus on alopecia areata with controversial results: some demonstrate that it is effective while others do not.

We also have studies that claim it is effective for seborrheic dermatitis, which is the source of seborrheic alopecia, as well as for psoriasis and eczema, which can also cause hair loss. 

Pimecrolimus may treat alopecia areata

Alopecia areata is a form of hair loss characterized by chronic inflammation caused by an autoimmune problem. It has many subtypes which can range from a simple circular patch to complete loss of hair over the whole body.

On the left: patchy alopecia areata; On the right: ophiasis pattern alopecia areata

Pimecrolimus is an immunosuppressant that has been tested in several studies for its potential in treating alopecia areata. As mentioned earlier, some studies claim its effectiveness, while others argue the opposite.

Here are a few of these studies:

2020 study : 1% Pimecrolimus cream for alopecia Areata

In a 2020 study conducted by Terzi and Tursen involving 20 patients, it was found that 1% pimecrolimus cream proved to be ineffective in treating alopecia areata.

The patients applied the cream twice daily for a duration of 6 months. At the conclusion of the study, the results revealed that only one individual experienced complete hair regrowth, one person showed some improvement in hair growth, and three others demonstrated minor growth. The remaining 15 patients showed no noticeable changes.

The overall conclusion drawn from this study is that the pimecrolimus cream did not yield significant benefits for alopecia areata in the majority of cases. Only 20% of the participants observed some degree of improvement, which could potentially have occurred naturally.

2011 study : 1% Pimecrolimus vs 0.05% clobetasol propionate for alopecia Areata

In this 2011 study conducted by Haydar et al, researchers compared clobetasol 0.05% propionate (corticosteroid) and pimecrolimus 1% cream for treating alopecia areata in 100 patients.

After 12 weeks, both treatments showed similar effectiveness, but pimecrolimus had fewer side effects.

Here is a before and after photo of a patient who used pimecrolimus 1% cream for 12 weeks :

(source)

In conclusion, this study and several others demonstrate that topical pimecrolimus is an effective treatment for alopecia areata. However, there are also studies that affirms that it does not work very well (like the one from 2020 above).

Pimecrolimus may reduce seborrheic dermatisis and seborrheic alopecia

According to a 2022 systemic review, which analyzed five studies, the use of Pimecrolimus 1% cream has been found to be effective in reducing facial seborrheic dermatitis. Even though it’s a case of seborrheic dermatitis on the face, it’s generally similar to what one finds on the scalp.

Seborrheic dermatitis is a common skin condition that causes flaky, dry, white to yellowish scales on oily areas of the skin. It commonly affects the scalp, causing red, itchy, and greasy flaking that can lead to seborrheic alopecia – a form of hair loss due to inflammation from seborrheic dermatitis.

Pimecrolimus may treat Psoriasis

According to a 2013 review, studies deonstrate that oral and topical Pimecrolimus can help to reduce and treat psoriasis, a skin condition that can appear of the scalp and cause hair loss in some cases.

To explain it in simple terms, psoriasis causes skin cells to grow too quickly, resulting in red, thick, scaly patches on the skin. It is an immune disorder where the immune system attacks healthy skin cells by mistake. Psoriasis can be itchy and uncomfortable.

Here is an example of psoriasis :

Pimecrolimus may treat Eczema

There are several studies that demonstrates the effectiveness of topical 1% Pimecrolimus in relieving atopic dermatitis, which is commonly known as eczema. However, it seems that Pimecrolimus is not the best option in the treatment of eczema because more effective treatment exists.

In a 2017 study, Sigurgeirsson et al. conclude that Pimecrolimus could be used as a first-line treatment for mild to moderate eczema in children because it’s a very safe medication.

Eczema is a skin condition that causes itchy, red, dry patches on the skin. It happens when the skin barrier that keeps moisture in and irritants out does not work properly. This allows moisture to escape and irritants to enter, which leads to itchiness and inflammation.

The skin of people with eczema is very sensitive and easily irritated. Eczema often runs in families and can flare up due to environmental triggers like stress, weather changes, or certain fabrics touching the skin. With eczema, the immune system overreacts to these irritants, causing more inflammation. Applying moisturizers and avoiding flare triggers are important ways to manage eczema symptoms and prevent the very itchy, painful rashes from occurring.

Closing thoughts and verdict

I believe that Pimecrolimus could be a potential option for treating various types of hair loss and conditions, such as alopecia areata, seborrheic alopecia, psoriasis, and eczema.

As with all medications, it may not be effective for everyone. Since it is generally not considered a first-line treatment, I would recommend exploring other more effective treatments before considering Pimecrolimus for any of the conditions I mentioned earlier.

For instance, there may be cases of alopecia areata where Pimecrolimus proves to be effective when other treatments that are supposed to be more efficient have not yielded results.

Precautions & side effects

Side Effects:

• Burning or stinging sensation at the application site
• Itching or redness
• Headache
• Flu-like symptoms
• Skin infection (rare)

Precautions:

• Use Pimecrolimus only as prescribed by a healthcare professional.
• Avoid contact with eyes, mouth, and mucous membranes. Rinse thoroughly if contact occurs.
• Do not use on broken or infected skin.
• Limit sun exposure and use sunscreen when using Pimecrolimus, as it may increase sensitivity to sunlight.
• Inform your doctor of any known allergies or skin conditions before starting Pimecrolimus.
• Consult your doctor if you are pregnant, planning to become pregnant, or breastfeeding before using this medication.
• Do not use Pimecrolimus if you have a weakened immune system or are taking medications that suppress the immune system, without consulting your healthcare provider.