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Topical Calcineurin Inhibitors

Topical calcineurin inhibitors (TCIs) are nonsteroidal medications that are applied to the parts of the skin affected by eczema. Once absorbed in the skin, TCIs work by stopping a piece of the immune system from “switching on,” preventing it from causing certain eczema symptoms such as redness and itch.

Meant to be used after other topical treatments have failed or another treatment is not recommended, TCIs are intended to be used for a short period of time to bring symptoms under control.

TCIs can be applied to all affected areas of the skin, including the eyelids. TCIs do not cause certain side effects associated with steroid overuse, such as thinning of the skin, or stretch marks, spider veins or skin discoloration.

Common side effects with TCIs include mild burning or stinging sensation when the medication is first applied to the skin. Uncommon side effects include skin cancer and lymphoma, a type of blood cancer. Therefore, it’s important that you talk to your doctor about the benefits and risks of using a TCI to control your eczema.

It’s important to remember that with TCIs:

  • Use only on areas of the body where the skin is affected by eczema
  • Do not use on children under two years old
  • Do not use continuously for longer than six weeks

TCIs should not be used at the same time as phototherapy treatments. Take care to cover and protect your skin when out in the direct sunlight while using TCIs.

There are two topical calcineurin inhibitors available by prescription, Protopic and Elidel.