# A-18 — Tirbanibulin

Five days, then you stop. The shortest course in this register and the largest treatment difference after bimatoprost — for the photodamaged population every anti-ageing trial excluded.

- **Canonical:** https://www.30plusskin.care/actives/tirbanibulin
- **Site:** 30+/SKIN — Skincare, published as a spec sheet.
- **Issue:** ISSUE NO. 13 / REV. 2026.10
- **Standing terms:** INDEPENDENT · AFFILIATE-FUNDED · NOT MEDICAL ADVICE

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## Datasheet

- **INN / INCI:** Tirbanibulin
- **Family:** Microtubule inhibitor
- **Molecular weight:** 431.5 g/mol
- **Layer reached:** EPIDERMIS
- **Prescription only:** yes
- **Evidence grade:** A
- **Controlled trials on file:** 2
- **Strength range recorded:** 1%–1%
- **Representative reference concentration:** 1%
- **Irritation (0–10):** 8
- **Onset:** 8 WK
- **Stability:** UNIT-DOSE PACKETS · SINGLE USE

## Mechanism

The concentration marker is not a recommended dose or a claim that other strengths are untested. Compare the vehicle, indication and trial population.

Disrupts tubulin polymerisation in rapidly proliferating cells. Applied as a field treatment rather than lesion by lesion, so it acts on the subclinical damage around visible lesions as well as the lesions themselves.

## Measured endpoints

| Endpoint | Effect vs comparator | Window | Record |
| --- | --- | --- | --- |
| Complete (100%) lesion clearance | +42% | 8 WK | REF-29 — Klisyri — study 2 (NCT03285490), actinic keratosis of the face or scalp (Double-blind, vehicle-controlled, five-day course; average subject age 70, range 45 to 96, n=351, grade A) |
| Erythema worse than baseline | -57% | 1 WK | REF-30 — Klisyri — pooled local skin reactions, collected independently of adverse events (Investigator-graded local skin reactions in the treatment area, pooled across both Phase 3 trials, n=702, grade A) |

## Layering

- **Do not layer with:** Occlusion after application, Skin not yet healed from prior treatment or surgery, Eyes, mouth and nostrils
- **Pairs with:** Daily sunscreen, permanently, afterwards

## Notes

- Unit-dose packets remove the dosing judgement entirely — one packet, once a day, five days, with nothing left to over-apply.
- The endpoint was complete clearance: no clinically visible lesions remaining, not fewer.
- Local skin reactions are severe by the standards of this register — erythema worse than baseline in 91% of subjects — and they are the treatment working over a five-day course that then heals.
- The face clears roughly twice as reliably as the scalp, and the label reports the two separately rather than pooling them.
- Its trial population averaged 70 years old. Renova's excluded anyone with visible actinic keratosis, which is the same population seen from the other side.

## Products in the register containing it

| No. | Product | Stance | Score | Document |
| --- | --- | --- | --- | --- |
| R-54 | Almirall Klisyri | RECOMMENDED | 83/100 | /reviews/klisyri-tirbanibulin-review |

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## Elsewhere in the register

- [Review register](/reviews)
- [Active monographs](/actives)
- [Brand register](/brands)
- [Evidence register](/evidence)
- [The ledger](/ledger)
- [How we test](/how-we-test)
- [Agent guide](/llms.txt)
- [Sitemap](/sitemap.xml)

_SOURCE-BASED ASSESSMENTS. PUBLISHER PREFERENCES ARE IDENTIFIED SEPARATELY._