What is pimecrolimus cream used for?

Atopic dermatitis, also called eczema, is a chronic skin condition characterized by red, dry, itchy patches. It often begins in childhood but can occur at any age. Eczema is not contagious. Without treatment or if scratched, eczema lesions can swell, crack, crust, scale, and ooze. Symptoms tend to flare and then improve over time.

Pimecrolimus 1% cream, the generic form of Elidel, is approved by the FDA for mild to moderate atopic dermatitis in adults and children aged two years and older who have not responded to topical steroids or cannot use other treatments. Off‑label, it may be used for psoriasis.

Pimecrolimus cream should not be used if you have:

  • Netherton’s syndrome
  • A weakened immune system
  • A cancerous or precancerous skin condition

This medication is intended for short‑term use; long‑term safety has not been established.

How Pimecrolimus Cream Works

Pimecrolimus is a topical calcineurin inhibitor. It suppresses immune activity in the skin by blocking calcineurin, reducing inflammation and eczema symptoms.

Side Effects

Common side effects include:

  • Burning at application site
  • Headache
  • Viral infections (flu, common cold)
  • Runny or stuffy nose, cough, sore throat
  • Fever
  • Bronchitis
  • Upper respiratory infections
  • Viral skin infections (cold sores, chickenpox, shingles)
  • Swollen lymph nodes

Rare serious side effects:

  • Anaphylaxis (hives, facial or throat swelling, difficulty breathing)
  • Increased risk of lymphoma or skin cancer
  • Heightened sun sensitivity (use sunscreen and avoid tanning beds)

How to Use Pimecrolimus Cream

  1. Wash and dry hands before application.
  2. Apply a thin layer to affected areas twice daily or as directed.
  3. After application, wash hands unless treating the hands.
  4. Avoid bathing or swimming immediately after application.
  5. You may use approved moisturizers after the cream has absorbed.
  6. If you miss a dose, apply as soon as you remember unless it is near the next scheduled dose.

Drug Interactions

Pimecrolimus cream has no major systemic interactions but tell your doctor about all other medications, including:

  • Calcium channel blockers
  • Erythromycin
  • Itraconazole
  • Ketoconazole
  • Fluconazole
  • Cimetidine

Warnings and Precautions

  • Do not use if allergic to any ingredient.
  • Avoid use in Netherton’s syndrome, immunosuppression, or skin cancer.
  • Inform your provider if you have:
    • Cutaneous T-cell lymphoma
    • Active viral skin infections
    • Large areas of damaged skin
    • Current phototherapy treatments
    • Pregnancy or breastfeeding

Storage

Store at room temperature (68–77°F / 20–25°C). Do not freeze. Keep out of reach of children.

Treatment Duration

Apply twice daily for up to six weeks. If symptoms persist, consult your provider for reevaluation and alternative treatments.

Use on Face

Pimecrolimus may be applied to the face, scalp, and neck. Avoid contact with eyes, mouth, nose, rectum, or vagina. Rinse with cool water if inadvertent contact occurs.

Steroid-Free Treatment

Pimecrolimus cream is not a steroid. It provides an alternative when corticosteroids are ineffective or not tolerated.

Related Medications

  • Protopic Ointment (tacrolimus)
  • Lidex Topical Solution (fluocinonide)
  • Dupixent (dupilumab)
  • Elocon Cream (mometasone furoate)
  • Temovate Cream (clobetasol)

Sources