A non-steroid eczema cream
Pimecrolimus
A non-steroid cream for eczema, used especially on the face and skin folds when steroids are unsuitable.
What is Pimecrolimus?
Pimecrolimus is a non-steroid cream for eczema (atopic dermatitis), often used on the face and skin folds where steroids are less suitable. It calms the overactive immune response that causes the rash and itching. It commonly causes brief burning or stinging when first applied, and you should avoid strong sunlight and sunbeds and not use it on infected skin.
Education and reference only. This is a plain-language guide to Pimecrolimus — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Pimecrolimus is a cream applied to areas of eczema, belonging to a group called topical calcineurin inhibitors. It is used as an alternative to steroid creams, particularly on delicate areas such as the face, eyelids and skin folds where long-term steroids can cause problems. In the UK it is usually prescribed for mild to moderate eczema when steroids are unsuitable or are best avoided. It is generally applied twice a day during flare-ups.
How it works
Eczema involves an overactive immune response in the skin that drives redness, itching and inflammation. Pimecrolimus dampens this immune over-activity by blocking a signalling pathway in immune cells, which calms the inflammation and itch. Unlike steroids, it does not thin the skin, which is why it is useful on the face and other delicate areas.
Company & origin
Originated / developed by: A topical eczema treatment.
A topical calcineurin inhibitor used in the UK for eczema when steroid creams are unsuitable.
What it treats
Conditions Pimecrolimus is used for
Practical use
How to take Pimecrolimus
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Apply a thin layer to the areas of eczema, usually twice a day during a flare-up, and rub it in gently.
- Wash your hands after applying it unless your hands are the area being treated.
- Do not use it on infected, broken or weeping skin — treat any infection first and ask your prescriber for advice.
- Avoid strong sunlight, sunlamps and sunbeds, and use sun protection on treated areas.
- If you forget an application, apply it when you remember unless it is nearly time for the next one, then skip the missed dose.
Weighing it up
Advantages & disadvantages of Pimecrolimus
Advantages
- A steroid-free option that does not thin the skin, even on the face and skin folds.
- Useful when steroid creams are unsuitable or have been used too much.
- Helps control the itch and redness of eczema flare-ups.
Disadvantages
- Commonly causes brief burning or stinging when first applied.
- Should not be used on infected or broken skin, and sun exposure must be limited.
- A theoretical long-term safety concern means it is usually used for short or intermittent courses.
Practical use
Good to know
It is normal to feel a brief burning, warmth or stinging when you first apply it, and this usually settles after the first few days. It should not be used on skin that is infected, broken or weeping, so any infection needs treating first. You are advised to avoid strong sunlight, sunlamps and sunbeds and to use sun protection on treated areas. Because it acts on the immune system in the skin, there has been theoretical discussion about a possible long-term risk of skin cancer or lymphoma, which is why it is generally used for short periods or intermittently rather than continuously. Used as advised on the right areas, it is a valuable steroid-free option.
Who should not take it / use with caution
- It should not be used on skin that is infected, broken or weeping until the infection is treated.
- People with significantly weakened immune systems should use it only on specialist advice.
- Anyone who has reacted badly to pimecrolimus or similar treatments should avoid it.
Monitoring
- No routine blood tests are needed for normal short-term or intermittent use.
- Your prescriber reviews how your eczema responds and checks the affected skin over time.
- Report any new growths, persistent sores or signs of skin infection on treated areas.
Side effects
- Burning, warmth, stinging or itching at the application site, especially in the first few days.
- Redness of the treated skin, and occasionally skin infections such as cold sores flaring.
- Flushing or skin irritation after drinking alcohol in some people.
Key interactions
- Very little is absorbed into the body, so important interactions with tablets are uncommon.
- Avoid using other strong skin treatments on the same area at the same time unless advised.
- Tell your prescriber about medicines that affect your immune system before starting it.
Available as: A cream applied to the skin.
Answers
Pimecrolimus: frequently asked questions
Can I use it on my face?
Yes, it is often chosen for the face, eyelids and skin folds because, unlike steroids, it does not thin the skin in these delicate areas.
Why does it sting when I apply it?
A brief burning, warmth or stinging is common in the first few days of use and usually settles as your skin gets used to it.
Can I use it on infected skin?
No, it should not be used on infected, broken or weeping skin; any infection needs treating first, so ask your prescriber for advice.
Is it safe in the sun?
You should avoid strong sunlight, sunlamps and sunbeds and use sun protection on treated areas while using it.
Is there a cancer risk?
There is a theoretical long-term concern about skin cancer and lymphoma, which is why it is usually used for short or intermittent courses rather than continuously.
The wider class
About Topical calcineurin inhibitors
Pimecrolimus belongs to the topical calcineurin inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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