Pimecrolimus Cream (Elidel) for Eczema Without Steroids
If you have eczema and steroid creams have not worked well enough for you, or are not a good fit for the area you need to treat, you may have been told about pimecrolimus cream. Pimecrolimus 1% cream, sold under the brand name Elidel, is a non-steroid prescription cream used to treat mild to moderate eczema (atopic dermatitis)[1][2]. Elidel and pimecrolimus are the same medicine.
Pimecrolimus belongs to a group of medicines called topical calcineurin inhibitors[2]. It calms the immune activity in the skin that drives eczema, which eases itching, redness and rash[1][2]. Through Starfish.com, you can request pimecrolimus by name. A licensed clinician reviews your answers and, if it is right for you, sends a prescription to your pharmacy, usually within 1 to 2 hours.
Pimecrolimus Cream vs a Steroid Cream
| Pimecrolimus cream (Elidel) | Triamcinolone cream | |
|---|---|---|
| What it is | A non-steroid cream, called a topical calcineurin inhibitor[2] | A corticosteroid (steroid) cream[3] |
| What it treats | Mild to moderate eczema (atopic dermatitis)[1] | Itching and inflammation of skin conditions that respond to steroids, including eczema and psoriasis[4][5] |
| Where it fits | An option when other prescription creams have not worked well enough or are not a good fit[1] | Commonly used to calm eczema flare-ups[5] |
| Skin thinning | Does not cause skin thinning[6] | Can thin the skin, especially on sensitive areas such as the face and eyelids[6] |
| Most common side effect | Burning where it is applied, mostly in the first few days[1] | Burning, itching, irritation or dryness where it is applied[4] |
Why Pimecrolimus Is Used
Steroid creams work well for many eczema flare-ups. But they can thin the skin, and that matters most on thin, sensitive skin such as the face, eyelids and genitals[6]. Pimecrolimus does not cause skin thinning, which is the main reason it is used as an alternative[6].
The label describes it as a second-line treatment. It is meant for short periods, and for repeated use over time when needed, but not continuously[1]. You stop using it when the itch, rash and redness clear up[1].
Request Pimecrolimus by Name
Tell us what you have tried before. A licensed clinician reviews your answers and decides whether pimecrolimus is right for you.
What the Boxed Warning Means for You
Elidel cream carries a boxed warning on its label, which says the long-term safety of this group of medicines has not been established[1]. Here is where it came from and what the evidence shows.
- Where it came from. The warning is based on animal studies and rare case reports of cancer, including skin cancer and lymphoma, in people using these creams. A link to the cream itself has not been shown[1][2][6].
- What the trials found. The clinical trials did not find extra cancers in people using it, though they were too small to rule out a very small risk[6].
- How to use it within the label. Apply it only to areas with eczema, stop when the rash clears, and avoid long-term continuous use[1]. It is not approved for children under 2 years old[1].
Used this way, pimecrolimus lets you treat eczema on thin, sensitive skin such as the face and eyelids without the skin thinning that steroid creams can cause[6].
Side Effects and Safety Points
The most common side effect is burning where the cream is applied. In an adult trial, about 26% of people using it reported burning. It was most common in the first few days and usually eased as the skin healed[1]. Other points from the label:
- Sunlight. Limit sun exposure and avoid tanning beds and UV light therapy while you use it, even when the cream is not on your skin[1][2].
- Skin infections. It is not used on skin that is infected. The label notes a possible higher risk of chickenpox or shingles virus and herpes skin infections[1].
- Coverings. Do not cover the treated skin with a tight or airtight dressing[1].
- Who should not use it. People with a weakened immune system should not use it[1].
List any other conditions and medicines in your questionnaire, so the clinician can check that pimecrolimus is safe for you.
When to Stop or See a Clinician in Person
Your eczema has not improved after 6 weeks. The label says you should be examined again, and a questionnaire cannot do that[1][2].
You notice swollen glands. The label says this should be checked by a clinician[1].
You have painful, dome-shaped blisters with a fever. This can be a herpes infection of the skin called eczema herpeticum, which needs medical care right away[7].
You are pregnant. We do not treat anyone who is pregnant, so contact your obstetrician.
FAQ
What is Elidel cream used for?
Elidel cream is the brand name for pimecrolimus 1% cream. It treats mild to moderate eczema (atopic dermatitis) in people who have not done well enough on other prescription creams, or who should not use them[1][2].
Is pimecrolimus cream a steroid?
No. It is a topical calcineurin inhibitor, a different type of medicine that does not cause skin thinning[2][6].
What is the difference between pimecrolimus vs tacrolimus?
Both are non-steroid creams in the same group, and both carry the same boxed warning[1][8]. Pimecrolimus is a cream for mild to moderate eczema. Tacrolimus is an ointment approved for moderate to severe eczema[8]. In studies that compared them, tacrolimus 0.1% helped more people improve, while burning was common with both[6].
Can I use pimecrolimus on my face?
Steroid creams can thin the skin on sensitive areas such as the face and eyelids, which is one reason pimecrolimus is used as an alternative there[6]. Mention the area you want to treat in your questionnaire.
Is pimecrolimus used for psoriasis?
Pimecrolimus is approved for eczema, not psoriasis[1]. For psoriasis, see our psoriasis treatment.
Get Eczema Treatment Without an Appointment
A licensed clinician reviews your answers and, if treatment is right for you, sends the prescription to your pharmacy within 1 to 2 hours.
References
- U.S. National Library of Medicine, DailyMed. “Pimecrolimus cream, 1%.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5b0403a-065f-42e3-96d6-7dcb9ab127d3
- MedlinePlus, U.S. National Library of Medicine. “Pimecrolimus Topical.” https://medlineplus.gov/druginfo/meds/a603027.html
- MedlinePlus, U.S. National Library of Medicine. “Triamcinolone Topical.” https://medlineplus.gov/druginfo/meds/a601124.html
- U.S. National Library of Medicine, DailyMed. “Triamcinolone acetonide cream.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5d2fe6c2-3856-47f6-843f-077b2e1080a0
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Atopic Dermatitis: Diagnosis, Treatment, and Steps to Take.” National Institutes of Health. https://www.niams.nih.gov/health-topics/atopic-dermatitis/diagnosis-treatment-and-steps-to-take
- Hitzeman N, Kinnevey C. “Topical Tacrolimus for Eczema.” American Family Physician, 2016. https://www.aafp.org/pubs/afp/issues/2016/1001/p549.html
- American Academy of Dermatology. “Atopic Dermatitis: Signs and Symptoms.” https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis/symptoms
- U.S. National Library of Medicine, DailyMed. “Tacrolimus ointment 0.1%.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=43b38551-6c5e-48a4-a453-9286f1c16b34
