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Ask the doctor about… topical calcineurin inhibitors

Want to learn more about topical calcineurin inhibitors? Eczema Society of Canada asked dermatologist Michele Ramien, MD, FRCPC about topical calcineurin inhibitors and what patients would need to know about their role in treating atopic dermatitis (AD).

What are topical calcineurin inhibitors?

Topical calcineurin inhibitors (e.g. Protopic® and Elidel®) are a group of medications that help control the inflammation of atopic dermatitis (AD), commonly known as eczema. The vehicle that delivers the topical calcineurin inhibitors is either a cream (as with Elidel®) or an ointment (as with Protopic®).  AD flares occur due to an inflammatory response in the skin, and the immune system plays a role in this inflammation.  Topical calcineurin inhibitors work by quieting down an overactive immune response in the skin.

How are topical calcineurin inhibitors used?

Topical calcineurin inhibitors are medications which are applied directly to the skin. They come in either a cream or ointment formulation and can be used to help manage acute AD flares or to prevent eczema from coming back in chronic recurrent areas. It may be helpful to ask your health care provider for a written care plan to ensure you have clear instructions on which medication is applied to which area of the body and when to use one medication or another.

If you find your AD is not responding to this medication, be sure to let your doctor know. Be sure to speak with a qualified health care professional, such as a dermatologist, if you have any questions related to your/your child’s treatment plan.

Will this medication sting my skin?

Some users report stinging, burning, or a sensation of warmth for a few minutes when a topical calcineurin inhibitor is first applied. For some people, this only occurs for the first few days of use, so if you can, it is best to keep applying the cream regularly as if you stop and start, the burning sensation can last longer. Speak with your prescribing health care provider about how you should use your topical treatments.

Eczema Society of Canada thanks Michele Ramien, MD, FRCPC for her volunteer contribution to this educational content.

Disclaimer: Information provided in this resource does not constitute medical advice and is not intended to be used as a diagnostic tool.  The information is up-to-date at time of publication. All medications, interventions, and treatment plans have risks and benefits, and it is important that individuals discuss their or their child’s specific health care needs with a qualified health care professional. 

August 2021

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