Topical Tacrolimus, Clobetasol, and Minoxidil for Primary Cicatricial Alopecias: A Retrospective Analysis of Clinical Outcomes and Safety
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction: Primary cicatricial alopecias (PCAs) cause permanent hair loss and psychosocial distress. Management involves anti-inflammatory and hair growth-promoting therapies. A combination of tacrolimus, clobetasol, and minoxidil (TCM) may offer synergistic benefits by targeting distinct inflammatory pathways while increasing background hair density for improved camouflage. This study evaluates the safety and efficacy of TCM use in PCA patients. Methods: We conducted a retrospective chart review of PCA patients aged 18+ years treated with TCM between January 1, 2009, and May 31, 2025. Outcomes included inflammatory activity on trichoscopy, scalp symptoms, provider- and patient-reported disease status, and objective hair measurements. Descriptive statistics were performed using SAS v9.4. Results: Eighty-two patients (80.5% female, mean age 61.5) were included, most commonly with frontal fibrosing alopecia or lichen planopilaris. TCM was typically prescribed as a compounded solution used 1-2 times/day for an average of 24.5 months. Adverse effects included worsened itch/burning (6.1%), hypertrichosis (4.9%), scalp irritation/dryness (4.8%), and atrophy (3.7%); most (62.2%) experienced no adverse effects. Provider-assessed inflammation and disease status improved or stabilized in 69.5% and 76.9%, respectively. Objective hair measurements also improved. Conclusions: TCM is well tolerated and, used alone or in conjunction with other therapies, appears to be effective. Improvements were seen in provider-reported outcomes and objective hair measurements.
Source: Skin Appendage Disorders
DOI: 10.1159/000548130
Authors: Anna L. Brinks, Caitlin A. Kearney, Carli D. Needle, Akshay Pulavarty, Archie Spindler, Derek Maas, Loren D. Krueger, Kristen I. Lo Sicco, Jerry Shapiro
Institutions: New York University, Emory University
Language: English
Topic: Hair Growth and Disorders
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4413788665