Protopic (Tacrolimus) and Moisturiser: Which Goes First, and How Long to Wait?

Protopic (tacrolimus) ointment is a steroid-free treatment that dermatologists prescribe for eczema that hasn't settled with the usual creams, and for areas such as the face and eyelids where we would rather not use a steroid for long. It's licensed for children from the age of two and for adults. Almost everyone who starts it asks the same question: what do I do about moisturiser?

The answer is different from the one for steroid creams, and it's worth getting right.

The Short Answer

Leave two hours between Protopic and moisturiser. The patient leaflet says you can use moisturising creams and lotions during treatment, but they should not be used within two hours of applying Protopic. That is much longer than the 20 to 30 minutes suggested for a steroid cream, so the usual routine needs a little planning. Apply Protopic as a thin layer to the affected areas only, on completely dry skin, and wash your hands afterwards unless your hands are being treated. If your dermatologist has given you a different routine, follow theirs.

Why Two Hours, Not Twenty Minutes?

The 20 to 30 minute gap is general NHS guidance for emollients used alongside other skin treatments. The Protopic leaflet is more specific, and a product-specific instruction wins: the manufacturer states that emollients should not be applied to the same area within two hours of the ointment. Protopic is an ointment that needs to stay where it was applied, at the strength it was made, and moisturiser on top too soon can dilute it or move it. Two hours is the gap the manufacturer has tested, so it's the one to use.

A Routine That Works

Most families find one of these two patterns fits the day. The treated patches get their moisturiser outside the two-hour windows; everything else is moisturised as normal.

• Protopic first. After washing, pat the skin completely dry and apply Protopic to the affected patches. Moisturise the rest of the body straight away, and come back to the treated patches two hours later.
• Moisturiser first. Bath early in the evening, pat dry, and moisturise all over within a few minutes as usual. Apply Protopic to the patches two hours later, at bedtime, on dry skin.

Pick whichever you can keep up every day. The treatment works through consistency, not perfect timing.

How to Apply Protopic

• Thin layer, affected areas only. It's not a moisturiser and shouldn't be spread over clear skin.
• Completely dry skin. The leaflet is specific that skin should be fully dry after a bath or shower before Protopic goes on.
• Children aged two and over use the 0.03% strength: twice a day for up to three weeks, then once a day until the patch has cleared. Adults may be prescribed 0.1%. Follow your prescription.
• Expect some burning or itching where it's applied for the first few days. This is very common, usually mild to moderate, and generally goes within a week. If it's severe or doesn't settle, speak to your doctor.
• Not under dressings or bandages. Occlusive dressings aren't recommended with Protopic.
• Not on infected skin. Any infection at a treatment site should be cleared before Protopic is started. If the skin is crusty, weeping or has blisters or cold sores, see your GP first.
• Sun. Keep treated skin out of long periods of sunlight and away from sunbeds. If you're outdoors after applying it, the leaflet advises sunscreen and loose clothing that covers the skin.
• Review at two weeks. If there's no improvement after two weeks, go back to your doctor rather than carrying on.

Some people whose eczema clears but keeps returning are moved on to a maintenance routine of twice-weekly applications. That is a decision for your doctor, and the two-hour rule still applies on those days.

What About Elidel?

Elidel (pimecrolimus) cream is a related steroid-free treatment, usually prescribed for the face and neck in children. Its leaflet has its own instructions on moisturiser, so check the leaflet in the box or ask your pharmacist rather than assuming the two-hour rule applies.

Keep Moisturising

Protopic treats the patches that have flared. The emollient is what keeps the rest of the skin's barrier strong, and it should carry on at least twice a day, every day, throughout treatment. The only change is timing on the treated patches. If you find the two-hour gap means those patches are going without emollient, say so at your next review; the routine can usually be adjusted.

When to Check with Your Doctor

• No improvement after two weeks of treatment
• Burning or itching that is severe or hasn't settled after the first week
• Signs of infection on treated skin: crusting, weeping, blisters, or cold sores
• Any new lump, mark or change in the skin that you're not sure about
• Before using it on a child under two, as it isn't approved for that age group

For steroid creams, the order and gap are different: see Steroid Cream or Moisturiser First?. For a daily routine for adult skin, see Dr Tim's adult eczema skincare routine.

About Ovée

The Ovée Dermatologist Lipid Cream for adults and the Baby & Child Moisturising Cream are fragrance-free, paraffin-free, steroid-free everyday moisturisers. Either can be used alongside Protopic, with the two-hour gap on treated skin. Neither is a treatment for eczema, and neither replaces one. See the adult range.

Sources

• Protopic 0.03% ointment: patient information leaflet, electronic medicines compendium (emc), Leo Laboratories, updated February 2026. The two-hour moisturiser rule, dry skin after bathing, sun advice, infected skin, and side effects.
• Protopic 0.03% ointment: summary of product characteristics, emc. Age range, dosing for children and adults, review at two weeks, maintenance treatment, no occlusive dressings.
• Atopic eczema: treatment, NHS. Emollients at least twice a day and continuing to moisturise as eczema improves.

Dr. Tim Clayton is a Consultant Paediatric Dermatologist, President of the British Society for Paediatric and Adolescent Dermatology, and Co-Founder of Ovée Skin Health.