Preparations for Atopic Eczema

NHSL Medicines Guidance
NHS Lanarkshire

General Notes: Atopic Eczema

Step 1

  • Topical corticosteroid
    • Potent to very potent topical corticosteroids are not recommended for regular use over prolonged periods because of concern over long-term adverse effects.
    • See section Topical Corticosteroids.

Step 2

  • Ichthammol 1% and zinc oxide 15% in yellow soft paraffin
    • Unlicensed product, available from NHS Scotland Pharmaceutical 'Specials' Service (previously Tayside Pharmaceuticals).

Step 3

  • Topical immunomodulators, oral immunosuppressants or systemic corticosteroids
    • should only be initiated on specialist advice, with responsibility of monitoring agreed.

Further information, including presentation, management and referral criteria available at the Dermatology Patient Pathways - Atopic Eczema (Adult). 

Topical Immunomodulator

Specialist initiation (S1)

TACROLIMUS 0.1% or 0.03% ointment

  • Use is restricted to initiation by doctors with a specialist interest and experience in treating atopic dermatitis using immunomodulatory therapy.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.