Topical immunomodulators/topical calcineurin inhibitors

Like topical steroids, these new drugs are applied directly to the skin as ointments or creams, and they work to reduce immune-system overactivity, thus diminishing the rash and itching. But unlike steroids, which have general anti-inflammatory effects on many kinds of cells, the new medicines are targeted more specifically at skin cells.

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These medicines can be particularly useful for patients who do not respond to conventional therapy. They also are used to treat rashes on the face and neck, where the thinning of the skin occasionally caused by steroids can be a particular problem.

The most commonly seen side effect is a burning sensation on the skin, but this usually does not last long.

Currently, approved topical immunomodulators include Protopic (tacrolimus) ointment and Elidel (pimecrolimus) cream.