Topical calcineurin inhibitors (TCIs)

TCIs include medicines such as tacrolimus and pimecrolimus. They reduce signals from immune cells that drive eczema inflammation, itching, and redness. They are often considered for delicate areas such as the face, eyelids, skin folds, or other places where repeated steroid use may need careful supervision.

A warm or burning feeling can occur when treatment begins, particularly on irritated skin, and often settles as the flare improves. These medicines are prescription treatments; the strength, amount, and schedule should match the plan from your clinician.

Apply a thin layer to the affected areas as directed, then wash your hands unless the hands are being treated. Keep the medicine away from the eyes and inside of the mouth. Continue regular moisturiser use, leaving enough time between products if your clinician recommends it.

Protect treated skin from strong sunlight and avoid tanning devices. Do not apply a TCI to a suspected untreated skin infection. If burning is intense, blisters appear, or the rash changes suddenly, pause and contact the prescriber for advice.

Seek prompt review for spreading redness, pus, fever, painful blisters, or eye involvement. These features may signal infection or a different condition that needs assessment. Contact your clinician if eczema repeatedly flares despite correct application, since triggers, diagnosis, or the treatment plan may need reconsideration.

Ask where the TCI should be used, whether it is for flares or maintenance, and how it fits with moisturiser. Ask what warmth is expected, which symptoms suggest infection, and whether tacrolimus or pimecrolimus better suits the treated area.