A non-steroid eczema ointment
Tacrolimus (skin ointment)
A non-steroid ointment for moderate to severe eczema, used when steroids are unsuitable, including on the face.
What is Tacrolimus (skin ointment)?
Tacrolimus skin ointment is a non-steroid treatment for moderate to severe eczema (atopic dermatitis), used when steroid creams are unsuitable. It calms the overactive immune response that drives the rash and itch. It commonly causes brief burning or stinging at first, should not be used on infected skin, and you should avoid strong sunlight and sunbeds while using it.
Education and reference only. This is a plain-language guide to Tacrolimus (skin ointment) — 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
Tacrolimus skin ointment is applied to areas of eczema and belongs to a group called topical calcineurin inhibitors. It is used as an alternative to steroid creams, including on the face and skin folds, and is helpful for moderate to severe eczema that is hard to control or where steroids cannot be used. In the UK it comes in different strengths for adults and children and is usually started by a doctor experienced in treating eczema. It is generally applied twice a day during flare-ups, then less often to keep flares away.
How it works
Eczema is driven by an overactive immune response in the skin that causes redness, itching and inflammation. Tacrolimus blocks a signalling step in immune cells, reducing this over-activity and so calming the inflammation and itch. Because it does not thin the skin like steroids, it is particularly useful on the face and other delicate areas and for longer-term, intermittent control.
Company & origin
Originated / developed by: A topical eczema treatment.
A topical calcineurin inhibitor used in the UK for eczema when steroid treatments are unsuitable.
What it treats
Conditions Tacrolimus (skin ointment) is used for
Practical use
How to take Tacrolimus (skin ointment)
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, then reduce as your skin improves or for maintenance as directed.
- 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 seek advice if unsure.
- Avoid strong sunlight, sunlamps and sunbeds, and use sun protection on treated skin.
- If you forget an application, apply it when you remember unless it is almost time for the next one, then skip the missed dose.
Weighing it up
Advantages & disadvantages of Tacrolimus (skin ointment)
Advantages
- A steroid-free option that does not thin the skin, suitable for the face and skin folds.
- Effective for moderate to severe eczema and for keeping flares away with intermittent use.
- Useful when steroid creams cannot be used or have already been used heavily.
Disadvantages
- Commonly causes burning or stinging when first applied, especially on inflamed skin.
- Should not be used on infected or broken skin, and sun exposure must be limited.
- A theoretical long-term safety concern means it is used intermittently rather than continuously.
Practical use
Good to know
A burning or stinging feeling when you first apply it is common and usually eases after the first few days; it can be worse if the skin is very inflamed. It should not be applied to skin that is infected, broken or weeping, so any infection should be treated first. You are advised to avoid strong sunlight, sunlamps and sunbeds and to protect treated skin from the sun. As with this group of treatments, there has been theoretical discussion about a possible long-term skin-cancer or lymphoma risk, so it is used for flare-ups and intermittent maintenance rather than continuously. Drinking alcohol can sometimes cause flushing of the treated skin.
Who should not take it / use with caution
- It should not be used on skin that is infected, broken or weeping until that is treated.
- People with significantly weakened immune systems should use it only on specialist advice.
- Anyone who has reacted badly to tacrolimus or similar treatments should avoid it.
Monitoring
- No routine blood tests are needed for normal topical use.
- Your prescriber reviews how your eczema responds and inspects the treated skin over time.
- Report any new growths, persistent sores or signs of skin infection on treated areas.
Side effects
- Burning, stinging, warmth or itching at the application site, particularly in the first days.
- Redness of the treated skin and an increased chance of skin infections such as cold sores.
- Flushing of treated skin after drinking alcohol in some people.
Key interactions
- Very little is absorbed into the body, so interactions with tablets are generally uncommon.
- Avoid applying other strong skin treatments to the same area at the same time unless advised.
- Tell your prescriber about any medicines that affect your immune system before starting it.
Available as: An ointment applied to the skin.
Answers
Tacrolimus (skin ointment): frequently asked questions
How is it different from a steroid cream?
It controls eczema without thinning the skin, so it can be used on the face and skin folds and for longer-term, intermittent control where steroids are less suitable.
Why does it burn when I apply it?
Burning or stinging is common in the first few days, especially on very inflamed skin, and usually settles as the eczema improves.
Can I use it on infected eczema?
No, it should not be used on infected, broken or weeping skin; the infection should be treated first, so seek advice if you are unsure.
Do I need to avoid the sun?
You should avoid strong sunlight, sunlamps and sunbeds and protect treated skin from the sun while using it.
Is there a long-term cancer risk?
There is a theoretical concern about skin cancer and lymphoma, which is why it is used for flare-ups and intermittent maintenance rather than continuously.
The wider class
About Topical calcineurin inhibitors
Tacrolimus (skin ointment) 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.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.