Topical calcineurin inhibitors
Both pimecrolimus and tacrolimus are topical calcineurin inhibitors (TCI) that are approved
for the treatment of atopic eczema. Calcineurin phosphatase is a key enzyme in the activation
of T-cells and propagation of the inflammatory response.
Topical calcineurin inhibitors can be a useful treatment option for people whose eczema is not controlled with the maximum safe strength of topical corticosteroid or who are at risk of serious side-effects such as skin thinning.
Only pimecrolimus (10mg/g cream) is authorised for use in children over two years of age. It can be used for mild-moderate atopic eczema in situations such as:
- Intolerance to topical corticosteroids
- Lack of effect of topical corticosteroids
- Use on the face and neck where prolonged intermittent treatment with topical corticosteroids may be inappropriate.
The most frequent side-effect is a burning sensation. This effect usually only lasts a few days and patients should persevere with treatment.