Living with eczema means dealing with more than just dry, itchy skin. It can affect how you sleep, what you wear, and even how confident you feel in your own skin. Some days, eczema is only a small patch of discoloration. Other days, it can be painful, cracked, or hard to ignore. To manage these ups and downs, doctors often recommend prescription creams or ointments that soothe inflammation and help prevent flare-ups from coming back.

Two medications often used for eczema are tacrolimus and triamcinolone. While they both help reduce eczema symptoms, they are not the same. Each works in a different way, has different side effects, and is used for different parts of the body or types of flare-ups.

In this article, we’ll explain how these two medications compare, when they’re used, what side effects to watch out for, and how to know which one might be best for your skin.

What Is Tacrolimus?

Tacrolimus is a prescription ointment (a type of medicine applied to the skin) that helps to quiet the immune system effects on the skin. It belongs to a group of medications called calcineurin inhibitors.

Doctors usually prescribe tacrolimus for mild to moderate eczema, especially on parts of the body where the skin is thin or sensitive. This includes places like the face, eyelids, neck, and groin — spots that can easily get irritated or damaged by stronger medications. It’s often used twice a day during flares and can be used less often once symptoms improve.

Members of MyEczemaTeam have reported using tacrolimus. For example, one member said that they “take bleach baths a couple of times a week along with tacrolimus ointment on affected areas.”

What Is Triamcinolone?

Triamcinolone is a topical corticosteroid, meaning it’s a steroid-based cream, ointment, aerosol spray, or lotion that is applied directly to the skin. It helps reduce swelling and itching by calming the body’s inflammatory response. Triamcinolone also comes in other forms, like injections or nasal sprays, but for eczema, doctors specifically use topical triamcinolone.

Doctors usually prescribe triamcinolone for moderate to severe eczema, especially during a flare when the skin is more irritated than usual. It’s often used on thicker skin areas, like the arms, legs, hands, and feet, where a stronger medicine is needed to reach deeper into the skin layers.

Triamcinolone is usually only used for short periods of time. Healthcare providers often recommend using it for just a few days to a couple of weeks. After that, they may suggest switching to a gentler cream like tacrolimus or stopping treatment altogether once your flare has improved.

Members of MyEczemaTeam also report using triamcinolone. “Most days, I have some kind of itching. I am taking a steroid, triamcinolone, for two weeks at a time, then I stop it for a week. During the off week, I use CeraVe, an over-the-counter itch relief moisturizing cream,” commented a member.

How Do Tacrolimus and Triamcinolone Work?

Although both tacrolimus and triamcinolone help relieve eczema, they go about it in different ways.

Tacrolimus works by stopping certain immune cells in your skin from creating inflammation. This reduces redness and itching without damaging the skin over time.

Triamcinolone, on the other hand, uses steroids to quickly shut down the body’s inflammatory response. It works fast, but steroids can harm the skin if used too often. That’s why doctors are careful about how long and how often people use it. It’s used more often during strong eczema flares.

In many cases, a combination works best. A doctor may start with triamcinolone to calm a flare quickly, then switch to tacrolimus to help keep the skin healthy and avoid future flare-ups.

Side Effects and Risks

Each medication has its own set of possible side effects.

Tacrolimus

Tacrolimus is often chosen for people who need long-term treatment, especially on sensitive skin. Like any medication, it comes with the risk of some side effects, including:

• Burning or stinging when first applied, especially during the first few days
• Skin discoloration or irritation at the application site
• Increased sensitivity to sunlight, which means you should avoid tanning beds and limit sun exposure
• Possible risk of infection, especially if used on broken skin
• Concerns about cancer risk, though studies have not found strong evidence linking topical tacrolimus to cancer when used properly

“I started treatment with tacrolimus yesterday. It stings a bit,” reported a member of MyEczemaTeam.

These side effects are usually mild and tend to go away with time, especially the burning or tingling. Still, it’s important to follow your doctor’s instructions and let them know if any reactions last more than a few days.

Triamcinolone

Since triamcinolone is a steroid, it must be used with care. Side effects include:

• Thinning of the skin with long-term use
• Stretch marks, especially on the arms, legs, or groin
• Blistering or flaking of the skin
• Potential for decreased effectiveness over time

In some cases, people who have used strong steroids like triamcinolone over a long time may also experience topical steroid withdrawal, which can cause discoloration, burning, or worsening of symptoms after stopping the medication. That’s why it’s important to follow your doctor’s instructions closely and check in regularly if you’re using steroid creams for more than a couple of weeks.

Common Questions

People often have questions about how these two medications compare, especially when deciding which one is right for their skin or wondering how they work in everyday use.

Does Tacrolimus Work Better Than Triamcinolone?

The answer to this question depends on your needs. Neither medication works “better” than the other. They just work differently and are used in different situations, as explained above.

Does Tacrolimus Get Rid of Eczema?

Tacrolimus can help control eczema, but it’s not a cure.

Does Triamcinolone Heal Eczema?

Triamcinolone helps calm flares quickly by reducing redness, itching, and swelling. It brings relief, but like tacrolimus, it’s not a cure for eczema. It’s used to get symptoms under control.

Is Tacrolimus Better Than Hydrocortisone for Eczema?

Hydrocortisone is a very mild steroid. While it’s good for light irritation, it may not work well for more severe eczema or for people who need long-term treatment. According to a study comparing the two medications, tarcolimus and hydrocortisone are equally effective for treating eczema on the chest, abdomen, arms, and legs, while tacrolimus is more effective for face and neck eczema. Another study found that, for children, tacrolimus is safer and has less severe side effects than hydrocortisone.

What To Keep in Mind When Choosing an Eczema Treatment

Choosing the right treatment for eczema depends on many factors, like where your rash is, how bad it is, and other skin conditions you might have. That’s why it’s important to talk to your primary doctor or dermatologist (skin specialist) before starting or changing your treatment.

With the right plan and guidance, eczema can become much easier to live with.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you ever been prescribed topical tacrolimus or triamcinolone? Share your experience in the comments below, or start a conversation by posting on your Activities page.