Dermatology (Skin conditions)

Topical Tacrolimus

Topical tacrolimus is a new kind of treatment for eczema. It is an ointment that reduces the inflammation in eczema and works in a completely different way to other treatments such as topical corticosteroids.

This product has been approved in the UK for use on patients older than two years old with atopic eczema. As this is a new treatment we are reserving its use for patients whose eczema has not responded to moisturisers and topical steroids.

Treatment will be started by a dermatologist in the hospital outpatients department. The potential benefits and any unwanted effects of this treatment will be discussed with you.

How to apply topical Tacrolimus
A thin layer of topical tacrolimus should be applied twice daily for one week to all areas of active eczema. During this period you may experience a burning/stinging sensation but this should soon settle. After one week you will be able to reduce the frequency of application to once daily. As your eczema clears you can reduce the amount of topical tacrolimus that is applied. You should not use topical steroids on the same area of skin as topical tacrolimus.

Strengths Available

Tacrolimus ointment is available in two strengths. A 0.1% ointment is used in adults and a lower 0.03% strength is recommended for use in children.

Side Effects
• As mentioned above most patients experience a burning/stinging sensation when first using this ointment.
• Absorption through the skin is extremely low and the ointment does not normally cause any generalised side effects.
• There is a theoretical concern about the increased risk of skin infections. If you notice the appearance of crusting or small blisters, please consult your GP or hospital doctor.
• There is also a theoretical concern of an increased risk of skin cancer in sun exposed sites. You are therefore advised to use a sunblock on a regular basis on sun exposed sites receiving treatment. You are also advised to stop using topical tacrolimus whilst away on holiday in sunny climates e.g. (the Mediterranean). You should not use sunbeds or receive ultraviolet phototherapy whilst using topical tacrolimus.

Follow Up

Your dermatologist will prescribe the first four weeks of topical tacrolimus, and will monitor your initial response to treatment. If the dermatologist is happy with your progress, your GP will then be asked to continue prescribing your treatment. If you have problems with your eczema or treatment you should consult your GP in the usual way. However, the dermatologist will continue to review you in the outpatient clinic, and an earlier review can be arranged through your GP if necessary.

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