2. Tacrolimus (tah-crow-luh-mus) ointment: Brand name: Protopic®Approved to treat moderate to severe eczema.03% approved to treat patients 2 years of age and older..01% approved to treat patients 15 years of age and older.Both are FDA approved for: Non-continuous use for up to 12 monthsTreating patients who have an immune system that can fight infectionsSafety and effectivenessTCIs are “steroid sparing.” This means that using a TCI avoids side effects possible with topical corticosteroids, such as thinning skin.TCIs have a good safety record when used as directed.The most common side effects are burning and stinging, which are normal and tend to disappear as the skin heals.Some (not all) topical corticosteroids can be safely used along with a TCI. Dermatologists have the expertise to know which ones can be combined safely — and which ones cannot.Always consult your child’s dermatologist before using both a TCI and a corticosteroid — even a topical corticosteroid like hydrocortisone, which you can buy without a prescription.Because TCIs are newer medicines, the long-term safety of these medicines is unknown. In studies, tacrolimus has been found to be as effective as a mid-potency topical corticosteroid. It is believed (no studies conducted) that pimecrolimus is as effective as a low-potency topical corticosteroid. Best results are obtained when used along with , an , and .Why do TCIs include a cancer warning? In clinical trials, TCIs were found to help many patients with eczema. A few patients with eczema who have used a TCI, however, have developed skin cancer or lymphoma (cancer that begins in a lymph gland). Scientists do not have enough evidence to know whether these people would have developed one of these cancers if they had not used a TCI. Due to this situation, the general conclusion right now is: “At this time, the risk of developing cancer remains unknown.” Scientists say the risk is unknown because several studies have noted that people with severe eczema may have a greater risk of developing lymphoma. This occurs in people who have never used a TCI. As such, when dermatologists prescribe a TCI, they take the following precautions. They: Watch each patient closely.Prescribe for the shortest time considered safe, often just long enough to calm the skin so that it can heal.Tell patients to stay out of the sun and avoid tanning beds while a TCI is part of the treatment plan. This reduces the possible increased risk of skin cancer.Do not prescribe phototherapy while a patient is using a TCI.How to useIf your child has a skin infection, treat the infection and make sure it is gone before applying a TCI.Follow the dermatologist’s instructions carefully. You may need to apply a TCI to certain areas of your child’s body and a topical corticosteroid to other areas. Another possibility is that you may need to apply a topical corticosteroid for a few days and then switch to a TCI.Apply TCIs only to the eczemaPossible side effects, Overview What are prescription topical treatments? Topical treatments, or “topicals,” for eczema are medications, including creams, gels and foams, that are applied to the skin to manage symptoms and reduce inflammation. There are a few different types of topicals for eczema. Prescription topicals require a prescription from a doctor (as opposed to over-the-counter products you can , Always consult your child’s dermatologist before using both a TCI and a corticosteroid — even a topical corticosteroid like hydrocortisone, which you can buy without a prescription. Because TCIs are newer medicines, the long-term safety of these medicines is unknown..