Can Pimecrolimus (Pimecrolimus) 1% cream be used to treat perioral dermatitis and what is the recommended frequency and duration of treatment?

Pimecrolimus 1% cream (Elidel) can be used for periorbital dermatitis, though it is considered an off-label use. The recommended application is a thin layer to affected areas twice daily, typically for 2-4 weeks or until clinical improvement is observed. Treatment should be discontinued once the condition resolves, as prolonged use is not recommended. When applying near the eyes, care should be taken to avoid getting the medication directly into the eyes. Pimecrolimus works by inhibiting calcineurin, which reduces inflammation and immune activation in the skin without causing the skin thinning associated with topical steroids. This makes it particularly useful for the delicate periorbital area where steroid-induced side effects are concerning. Patients should be advised that mild burning or irritation may occur upon application but typically subsides with continued use. If symptoms worsen or show no improvement after 2 weeks, patients should consult their healthcare provider for reevaluation.