What are the side effects of Tacrolimus, which was given to me for my hair fall?

Question

Hello doctor,

For the last six to seven weeks, I have had severe hair fall where strands of hair are falling out. As a result, I see hair everywhere, and when I rinse them, they are all over the sink (up to 40 to 50 strands). As a result, I have developed bald patches on my head. I saw a dermatologist today who told me this was some type of alopecia (I do not remember the second word). The doctor also prescribed me Tacrolimus 1 mg twice daily for three months, as my immune system was acting up He said no topicals are required. I surfed the internet about the medicine and saw that Tacrolimus has serious side effects and seems like a strong immunosuppressant. When he prescribed this, he told me that this medicine had no side effects. This seems to be given to people who have had transplants. Moreover, alopecia seems to be one of the side effects. Do the side effects of the medicine last while taking medicine or after discontinuing also? Should I worry about this condition? Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. With your description, it looks like it is alopecia areata, which is an autoimmune disorder. There are a few types of alopecia areata, like alopecia totalis, alopecia universalis, ophiasis, sisaipho, and diffuse alopecia areata, for which the treatment includes topical corticosteroids, topical Tacrolimus 0.1 %, intralesional injection of Triamcinolone (Triamcinolone acetonide), topical irritants- DPCP (Diphenylcyclopropenone), DNCB (Dinitrochlorobenzene), and Anthralin, oral corticosteroids mini-pulse therapy, oral Tacrolimus, and Cyclosporine, PUVA (psoralen plus ultraviolet-A radiation). Treatment depends upon the severity and type of alopecia areata. Tablet Tacrolimus is an immunomodulator that is used in patients before transplant. There are many case studies of oral Tacrolimus in alopecia areata with good results. However, since I have not seen your clinical picture, I cannot comment on the severity of alopecia areata or the type. I have never used oral Tacrolimus for my alopecia areata patients. If you are experiencing any side effects from Tacrolimus, discuss with your dermatologist the other treatment option mentioned above. I hope this helps. Thank you.