Protopic

| 7 min read

What is protopic?

Protopic works to reduced overactivity of the immune system in the skin it is used in a similar way to topical steroids for conditions such as eczema, however unlike topical steroids it does not cause skin thinning, stretch marks or pigmentary change.

How to use protopic

• Protopic should be used until the skin is no longer red or itchy and then intermittently as required whenever the rash returns.
• As an example you may need to use for a week at first then 1-2 times per week for a couple of months, but gradually less over time.
• Protopic should be applied according to the fingertip unit - this is the amount of cream or ointment that just covers the end of an adult finger from the tip to the crease of the first joint when squeezed from an ordinary tube. This is enough to cover an area of skin the size of two hands with the fingers together. It helps to ensure you are using the correct amount – not too much and not too little.

Risks

• Tingling or burning which usually resolves within a week or so.
• Folliculitis (inflammation of the hair follicles)
• Reactivation of the herpes virus resulting in cold sores or shingles: you should not apply to areas of skin where there is skin infection or cold sores present.
• Some patients may experience significant facial flusing or irritation when drinking alcohol whilst using protopic

Other important information

As protopic is an immune suppressor there have been theoretical concerns that absorption through the skin might slightly increase the risks of skin cancer or lymphoma. A large study found some association between use of a topical calcineurin inhibitor and risk of lymphoma (a form of blood cancer) but not skin cancers but concluded that the risk for any individual patient is likely very small and I have prescribed for many patients over the last decade without issue. Pimecrolimus has not been proven to be safe during pregnancy and should not be used if pregnant.

As for any medication it is essential to read the information leaflet that comes within the packaging and contains critical safety information as well as a full list of all recognised side effects:

Protopic Information Leaflet