Background  Both clobetasol propionate 0·05% (CP 0·05%) and tacrolimus 0·1% (T 0·1%) ointments have been shown to be efficacious and safe in treating vitiligo in the paediatric population.

Objectives  To assess efficacy and safety of these two therapies compared with each other and with placebo.

Methods  In this prospective study, children aged 2–16 years with vitiligo, stratified into ‘facial’ (= 55) and ‘nonfacial’ (= 45) groups, were randomized into three arms: CP 0·05% ointment (= 30), T 0·1% ointment (= 31) and placebo (= 29) for 6 months. Successful repigmentation, defined as > 50% improvement, was evaluated by comparing photographs taken at baseline and at 2, 4 and 6 months.

Results  In the facial group, 58% of the CP 0·05% group responded successfully compared with 58% of the T 0·1% group, and in the nonfacial group, 39% of the CP 0·05% group responded compared with 23% of the T 0·1% group (> 0·05). There was a significant difference in response between the CP 0·05% group vs. placebo (< 0·0001) and the T 0·1% group vs. placebo (= 0·0004). Spontaneous repigmentation was evaluated as 2·4%. No significant clinical adverse events were noted in any group.

Conclusions  Both CP 0·05% and T 0·1% ointments offer similar benefit in paediatric vitiligo, both facial and nonfacial. The facial lesions responded faster than the nonfacial ones.