Tacrolimus

Tacrolimus is used to treat severe eczema, especially when standard treatments like steroids haven't been effective. It contains tacrolimus monohydrate, which helps to stop flare-ups and reduce inflammation. This medication can be used for different types of eczema, such as atopic and discoid eczema. Although the packaging states it's for atopic eczema, using Tacrolimus ointment for discoid eczema is considered 'off-label'. This means it's not mentioned in the patient information leaflet, but there is clinical evidence supporting its use.

Atopic eczema is a long-term condition that causes your skin to become dry, itchy, and inflamed. Discoid eczema, on the other hand, appears as round or oval patches on the skin that are filled with fluid. These patches eventually dry out, becoming crusty and cracked. It's often very itchy and can easily become infected, so it's crucial to treat it promptly to avoid infections.

Both types of eczema are often managed with emollients and thick creams to restore moisture to your skin. In more serious cases, topical steroids might be applied. If these aren't effective, a topical calcineurin inhibitor (TCI) such as Tacrolimus may be an option.

Atopic and discoid eczema are conditions caused by several factors, with the immune system being one of them. People with eczema often have an overactive immune system. When exposed to allergens and irritants, their immune system reacts, leading to flare-ups and inflammation.

Tacrolimus monohydrate is a topical calcineurin inhibitor. These medicines help suppress your immune system to stop it from reacting. It works by attaching to molecules such as FKBP12, which block the action of calcineurin. This stops the production of inflammatory molecules, which in turn reduces swelling and inflammation.

Tacrolimus comes in two strengths: 0.1% and 0.03%. You should apply it twice daily, once in the morning and once in the evening, for as long as your clinician advises. This is typically up to six weeks, but it might be longer if your symptoms are more severe.

Eczema is mainly characterised by dry skin, so using emollients like Fifty:50 can be an effective way to bring back and keep moisture in your skin. This helps repair your skin's barrier and wards off infections.

If your eczema is moderate to severe, your doctor might suggest a stronger treatment, such as a topical steroid. Steroids are anti-inflammatory medicines that help decrease swelling and redness. Examples of these steroids include Dermovate and Betnovate.

If emollients and steroids aren't effective, TCIs such as Tacrolimus might be prescribed. Whether Tacrolimus is the right treatment varies from person to person. Some people find steroids work best for them, while others may need a TCI. It's crucial to remember that each individual's needs are different, so treatment should be tailored accordingly.

A review of 20 studies showed that Tacrolimus is an effective treatment for eczema. The review involved 5,885 patients who used either tacrolimus or a placebo for varying durations. In one study with 371 participants, Tacrolimus 0.1% proved to be more effective than low-strength topical corticosteroids.

In another study that compared tacrolimus with pimecrolimus 1% (another TCI), people using tacrolimus were nearly twice as likely to notice an improvement in their symptoms.

In general, all the studies indicate that tacrolimus 0.1% is an effective treatment for skin conditions such as atopic eczema.

As with all medications, Tacrolimus can have some side effects that might impact you. These include:

While alcohol doesn't impact the effectiveness of tacrolimus, it could cause your face to become red, flushed, or irritated.

Before you start using Tacrolimus, let your clinician know if you're pregnant or breastfeeding. It's best to avoid using it during pregnancy or breastfeeding unless it's absolutely essential.

No, you can only get Tacrolimus with a prescription. This ensures it's safe and appropriate for you. If you believe Tacrolimus might help with your eczema, you can answer a few questions online, and our clinician will determine if it's the right choice for you.