What is Elidel?

Elidel contains pimecrolimus 1%, a topical calcineurin inhibitor. It reduces inflammation in the skin by a different route from a steroid, and does not thin the skin or cause the rebound flare that steroid creams are known for.

How does it treat perioral dermatitis?

Pimecrolimus damps down the local immune response that drives the rash. Trials in perioral dermatitis have shown it shortens the time to clearance, particularly where the rash was caused by a steroid cream in the first place.

Who this is suitable for

Adults with perioral dermatitis diagnosed by a healthcare professional, where antibiotics are unsuitable, have not worked, or you would rather not take one. Our prescribers will also consider your symptoms, allergies, medical conditions, pregnancy or breastfeeding status and current medicines.

When this is not the right starting point

This is not suitable if your immune system is suppressed, whether by a condition or by medication such as methotrexate, ciclosporin, azathioprine, a biologic or long-term oral steroids. It is also not for use on infected or broken skin, or where you have had a skin cancer at the same site. See your GP or a dermatologist if the rash involves your eyes, is weeping, or you feel unwell with it.

Sun protection

Protect treated skin from strong sunlight and do not use sunbeds or UV treatment while you are using it. Use a daily SPF.

Stopping steroid creams

Perioral dermatitis is very often caused by a steroid cream used on the face. If that applies to you, stopping the steroid is the single most important part of treatment. Expect the rash to flare for two to four weeks after you stop before it begins to settle. This is normal and is not a sign the treatment has failed.

How to use Elidel for perioral dermatitis

If prescribed, apply a thin layer twice a day, morning and evening. Always follow your pharmacy label.

Clean First: Wash the area with a mild, non-soap cleanser and pat dry.
Apply Thinly: Spread a thin layer over the affected area and rub in gently until it disappears.
Avoid: Keep it away from your eyes, your lips and the inside of your nose.
Do Not Cover: Do not put a dressing or bandage over treated skin.
Wash Your Hands: Wash your hands afterwards, unless your hands are being treated.
Stop When Clear: Stop once the rash has cleared rather than continuing indefinitely.

If you miss an application

Apply it when you remember, unless it is nearly time for the next one. If it is nearly time, skip the missed application and carry on as normal.

What to expect at first

A burning, warm or stinging feeling where you apply it is very common in the first few days and usually settles. Alcohol may cause facial flushing or warmth while you are using it.

Who should not use Elidel

Anyone allergic to pimecrolimus, to other macrolactams such as tacrolimus, or to any of the other ingredients
Anyone with a congenital or acquired immunodeficiency, or taking immune-suppressing medication
Anyone with an active skin infection at the treatment site, until that has been treated
Anyone with a current or previous skin cancer at the site

Off-label use

No medicine holds a UK licence specifically for perioral dermatitis. This treatment is prescribed off-label, which means your prescriber is using it outside the terms of its licence because the evidence supports it. You will be asked to confirm you understand this during your consultation.

Active ingredient

Each gram of cream contains 10mg of pimecrolimus (1%).

Other ingredients

Medium chain triglycerides, oleyl alcohol, propylene glycol, stearyl alcohol, cetyl alcohol, mono- and di-glycerides, sodium cetostearyl sulphate, benzyl alcohol, anhydrous citric acid, sodium hydroxide and purified water. Inactive ingredients differ between manufacturers. Read the patient information leaflet supplied with your pack for the complete ingredient list, particularly if you have an allergy or intolerance. If you have a known allergy, tell us during your consultation so our clinicians can check the pack before we dispense.

Like all medicines, pimecrolimus can cause side effects, although not everyone gets them.

Common or recognised effects

A burning or warm feeling where you apply it, usually in the first few days
Skin irritation, itching or redness at the application site
Facial flushing or warmth after drinking alcohol
Cold sores, folliculitis, impetigo or other skin infections

The burning feeling in the first few days is expected and settles as your skin gets used to the cream.

Stop using pimecrolimus and call 999 or go to A&E if you develop

Swelling of the face, lips, tongue or throat, difficulty breathing, or a widespread itchy rash
A severe rash with blistering or peeling skin

Contact your GP or call NHS 111 promptly if you develop

Skin that becomes very sore, swollen or weeping
Signs of a skin infection, such as spreading redness, crusting or pus
Any reaction that gets worse rather than settling after the first few weeks
Cold sores or shingles, or any skin infection that is spreading
Any new or changing mole, lump or skin lesion – lymphomas and skin cancers have rarely been reported with this class of cream, and although no causal link has been established you should get anything new checked