Pimecrolimus

Key facts

• Pimecrolimus (brand name Elidel) is a topical calcineurin inhibitor, a non-steroid cream that calms an overactive immune response in the skin.
• It treats mild-to-moderate atopic dermatitis (eczema) and is usually a second-line option after topical corticosteroids, applied as a thin layer twice daily.
• It carries a boxed warning: rare cases of skin cancer and lymphoma have been reported with long-term use of calcineurin inhibitors, so use the lowest amount for the shortest time and avoid continuous daily use over long periods.
• See a doctor if the treated rash is worsening or looks infected instead of applying more cream.

What pimecrolimus treats

Pimecrolimus treats mild-to-moderate atopic dermatitis (eczema), especially on the face, eyelids, neck and skin folds, where steroid creams carry a higher risk of thinning the skin. It's approved for adults and children age 2 and older. It does not treat infected or broken skin and is not a cure.

How pimecrolimus works

Pimecrolimus blocks calcineurin, an enzyme immune cells need to release inflammatory signals. By inhibiting this pathway in the skin, it reduces the redness, itching and inflammation of eczema without the skin-thinning effect that comes with steroid creams.

Before you take it

• Do not use it on skin infections, or under a bandage or occlusive dressing, without medical advice.
• Tell your doctor if you have a weakened immune system, lymphoma, or skin cancer, since long-term calcineurin-inhibitor use is linked to a small increase in malignancy risk.
• Avoid applying it right before strong sun exposure, tanning beds, or phototherapy, and use sun protection on treated skin.
• It's not recommended for children under 2 years old.

Side effects

Common effects are burning or stinging at the application site, especially in the first few days, along with mild redness and headache.

Seek urgent medical care for:

• Signs of skin infection at the treated area: pus, spreading warmth, fever.
• A severe or spreading rash, or blistering.
• Signs of an allergic reaction: swelling of the face or throat, difficulty breathing.
• Swollen lymph nodes or unexplained weight loss, which are rare but have been reported with calcineurin inhibitors.

Safety essentials

• Use pimecrolimus for flare-ups, not as continuous long-term therapy, because of its boxed warning for a rare risk of skin cancer and lymphoma.
• Minimise sun exposure on treated areas and avoid tanning beds while using it.
• Do not apply it to broken or infected skin, and stop if the treated area worsens or shows signs of infection.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.