Pimecrolimus cream, like tacrolimus ointment, is a calcium-regulated phosphatase inhibitor that achieves anti-inflammatory effects by inhibiting T cells and reducing the release of inflammatory substances in inflammatory skin diseases. Both drugs are used to treat atopic dermatitis/eczema, but there are some differences in their use. Today we will learn more about 1% Pimecrolimus Cream. What diseases can be treated? 1. Pimecrolimus cream is mainly used for the treatment of mild to moderate atopic dermatitis/eczema (tacrolimus ointment is mainly used for moderate to severe patients); 2. It can be used for short-term treatment in the acute phase and also for long-term intermittent treatment to prevent recurrence of eczema. Who can use it? 1. 1% pimecrolimus cream can be used for children over 2 years old and adult patients; 2. Pregnant women and nursing mothers, it is not recommended. How to use? 1.The conventional use is for eczema lesions twice a day. However, if the lesions do not improve after 6 weeks of continuous use, it is recommended to discontinue the medication and seek prompt medical attention; 2. It can be used on the head, face, neck, skin folds and skin abrasion areas; 3. It cannot be used on mucous membrane areas and skin infection areas, and the packet cannot be sealed after use (same as tacrolimus ointment). Pimecrolimus cream precautions Pimecrolimus cream precautions during use are similar to those of tacrolimus ointment, which also requires sun protection and may also experience a transient irritation reaction after use. However, the burning and pins and needles sensation of pimecrolimus cream is usually weak and relatively short-lived, and can be tolerated by most people. Can I use it in patients under 2 years of age? This is a difficult question that is often thrown at us by patients. Most patients with atopic dermatitis are infants and children under the age of 5. Parents of children with atopic dermatitis are even more apprehensive about topical hormones and often fail to use the medication as prescribed, resulting in difficult to control or recurring rashes in children, but both tacrolimus ointment and pimecrolimus cream instructions state that they are for use in patients over the age of 2. So, can children under 2 years old use them? What is the safety profile? A 2015 article published in the American Journal of Pediatrics describes a 5-year study to evaluate and compare the efficacy and safety of long-term use of pimecrolimus cream versus a weak intermediate-acting hormone for atopic dermatitis in infants and children under 2 years of age. The study involved 191 hospitals in 28 countries worldwide (4 hospitals in mainland China) and enrolled 2418 children aged 3 months to 12 months with mild to moderate atopic dermatitis, divided into two groups: one group was treated with 1% pimecrolimus cream and the other group was treated with a weak medium-acting hormone (1% hydrocortisone cream/0.1% hydrocortisone butyrate cream/0.1% Mometasone furoate cream) was used for treatment. Patients in both groups were treated with regular topical creams twice daily during episodes of eczema until the eczema completely resolved, along with long-term moisturizing emollients as needed, and medication was started as soon as early signs of eczema recurrence appeared and until the eczema resolved. The study lasted 5 years and by the end of the study the children had mostly graduated from kindergarten. Here’s a look at how well these children were treated. Efficacy of 1% pimecrolimus cream for atopic dermatitis in infants and children After 5 years of long-term intermittent treatment, children in both the 1% pimecrolimus treatment group and the hormone treatment group had good outcomes, with more than 95% of the children having cleared facial eczema and more than 85% of the children having cleared generalized eczema by the end of the 5-year treatment period. Children in the 2 treatment groups had near-zero eczema by 78 weeks of prolonged intermittent treatment (about a year and a half) and continued to do so until the end of the study. This suggests that with maintenance treatment for about a year and a half after eczema control, the majority of children achieve long-term remission without recurrence. Safety of 1% pimecrolimus cream for atopic dermatitis in infants and children The safety of medication in infants and children under 2 years of age is of particular importance, especially with regard to its effect on the child’s growth and development. The main objective of this study was also to observe the effects of long-term medication on the physical development and immune system development of children. 1. No effect on physical development Physical development was monitored by regular height and weight measurements during the study period, and physical development was within normal limits in both the 1% pimecrolimus-treated and hormone-treated groups at the end of the 5-year treatment period. 2. No effect on immunization Some of the children were tested for protective antibodies after tetanus, hepatitis B, measles and varicella vaccination during the study period, and it was found that the children in both the 1% pimecrolimus and hormone treatment groups were able to produce effective protective antibodies, which were at the level of normal children after immunization. 3. No effect on the development of the immune system Some of the children in the study were tested for immunoglobulin levels and the number and function of immune cells, and there was no difference in the level of immune system development between the 1% pimecrolimus cream and hormone treatment groups and normal children. In conclusion, this costly and time-consuming study provides clinical evidence of the safety and efficacy of long-term intermittent hormonal and non-hormonal medication in children under 2 years of age with atopic dermatitis/eczema through adequate research data. To date, there are more than 4,000 clinical studies published in professional journals on the use of 1% pimecrolimus cream in infants and children under 2 years of age with atopic dermatitis/eczema, and therefore European and American pediatric dermatologists recommend that when treating infants and children under 2 years of age with atopic dermatitis/eczema: 1. topical weak to moderate hormones are still the treatment of choice for infants and children with atopic dermatitis/eczema; 2, For parents who are too afraid of topical hormones to adhere to standard treatment, or when treating sensitive areas such as the face, neck and folds, 1% pimecrolimus cream can also be a safe and effective option; 3. Long-term intermittent maintenance treatment is recommended after eczema control to effectively reduce eczema flare-ups.