Protopic Ointment (tacrolimus)

What is Protopic Ointment?


Protopic ointment (tacrolimus) reduces the itching and inflammation of atopic dermatitis by supressing the body’s excessive activation of the immune response. In Japan, Protopic Ointment 0.1% was approved in 1999 for patients ages 16 and up, and Protopic 0.03% was approved in 2003 for children ages 2 to 15. As of 2014, it is marketed or approved in over 75 countries worldwide. The active ingredient, tacrolimus, was discovered in the soil at the foot of Mount Tsukuba.

The name derives from the “”Pro”” of Prograf (trademark for tacrolimus hydrate capsules, granules, and injection), the “”Topic”” of atopic dermatitis and topical treatment.

Features of Protopic Ointment

In atopic dermatitis treatment, it is important to keep the skin in good condition using topical steroids and protopic ointments to reduce any itching and inflammation.

Protopic ointment is not a topical steroid, but it is a topical medication that is highly effective in reducing inflammation. It rarely causes side effects common with long-term use of topical steroids, such as skin atrophy and telangiectasia (spider veins).


In addition, because of the large molecular weight of its active ingredients, it is believed that Protopic ointment is absorbed by the areas with poor skin condition and hardly absorbed by the normal skin areas.

This is a major feature of Protopic ointment. It works where it needs to and is hardly absorbed through the improved or normal skin areas, so there is no need to worry about overapplication as with topical steroids.

The anti-inflammatory effectiveness of the ointment is said to be comparable to that of medium to strong topical steroids, and it is expected to be effective against itching.

» Click here for more information topical steroids.

How to use Protopic Ointment

Recommended Amount of Application


Protopic ointment, like other ointments and other products, should be applied to an area the length of the first joint of the index finger (1 fingertip unit: 1 FTU) on the palm of an adult hand.

Method of Application

Gently apply and spread ointment over the affected area, focusing on the area of eczema.

Side Effects of Protopic Ointment

About the sensation of irritation

Protopic ointment may cause temporary skin irritations (burning, tingling, itching) immediately after its application. This is known as a burning sensation, and the feeling varies from person to person. The sensation usually subsides within a week or so as the skin condition improves. For those who do not like this sensation, other ointments that cause less irritation, such as Corectim or Moizerto, are also available.
Note that the sensation may be stronger when the body is hot, for instance, during or after a bath. It is recommended that the Protopic ointment is applied after the burning sensation is gone.

Applying moisturizer first, and then cooling the area where the ointment was applied may help reduce the irritation.

If irritation occurs, a steroid may be used for a short period of time before the Protopic ointment is applied.

Reason for the Sensation of Irritation


The burning sensation is caused by the absorption of tacrolimus, the active ingredient in Protopic ointment. When tacrolimus is absorbed through the skin, it has an effect on the irritation and the skin’s sensory nerves. A large amount of the substance that causes itching is released. This is why the burning sensation is felt at the beginning of use.

With continued application of Protopic ointment, the sensation will gradually decrease as the skin becomes accustomed to the irritation and itchiness and as all the substances causing them are released.

About Lymphoma

Experiments with mice have shown that lymphoma is more likely to occur with application of Protopic ointment if patients persistently have high blood levels. However, if patients used the treatment correctly, blood levels are not likely to remain high enough to cause problems in people. There have been reports of lymphoma and skin cancer among patients who have used the Protopic ointment. However, recent research reports that the incidence of lymphoma and skin cancer is no different amongst Protopic ointment users and the general population.

Patients Eligible for Protopic Ointment

Protopic 0.1% is for individuals ages 16 and up; Protopic 0.03% is for children ages 2 to 15.

Available Online Medical Care

Our clinic supports online medical care from your very first visit, so you can get your perscription without having to visit the clinic. If you wish to see a doctor, please click the link below to apply.

Notes and Requests Regarding Protopic Ointment

Precautions for use

  • Avoid contact with eyes when applying around the eyes.
  • Avoid using tanning or ultraviolet lamps on the applied areas.
  • Do not expose applied areas to strong sunlight for long periods of time.

*Daily outings are not a problem. However, avoid using Protopic ointment before going to the mountains or the beach and only use it after returning home.

Areas to Avoid Applying

  • Areas where the skin is wet or oozing
  • Areas where skin infections caused by bacteria, viruses, or mold develop, including acne and pimples
  • Areas other than the skin (such as mucous membranes in the mouth or nose) and the vulva.

If symptoms do not improve after 2 weeks of use, please consult us.

Copayment and Drug Fees

The drug fee for Protopic Ointment 0.1% is 92.2 yen per gram. Since each bottle is 5 grams, the cost of the bottle is 461 yen. For a patient with 30% copay, the drug fee will be 138.3 yen.

Similarly, the drug fee for Protopic Ointment 0.03%, for children, is 96.6 yen per gram. With a 5 gram bottle, it is 483 yen per bottle. For a patient with 30% copay, the drug fee will cost 144.9 yen.

*If you have a medical subsidy card from one of the 23 wards of Tokyo, you can receive subsidies for medical expenses up to the age of 15, without any income limit and copayment. Patients living outside of the 23 wards of Tokyo will be treated under the regular insurance system.


Clinic info

Clinic name
Sugamo Sengoku Dermatology
1-20-10 5F Sugamo Toshima-ku, Tokyo
3 minutes on foot from JR Yamanote Line Sugamo Station, 4 minutes on foot from Sengoku Station on the Toei Mita Line
Practice time
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☆Closed day: Wed, Sun, Holiday