{"id":12530,"date":"2026-04-12T18:10:15","date_gmt":"2026-04-12T09:10:15","guid":{"rendered":"https:\/\/miragen.clinic\/blog\/facial-atopic-dermatitis-ointments-comparing-9-options-including-bepanthen-protopic-elidel-tofacitinib-and-more\/"},"modified":"2026-07-02T00:34:09","modified_gmt":"2026-07-01T15:34:09","slug":"facial-atopic-dermatitis-ointments-comparing-9-options-including-bepanthen-protopic-elidel-tofacitinib-and-more","status":"publish","type":"post","link":"https:\/\/miragen.clinic\/en\/blog\/facial-atopic-dermatitis-ointments-comparing-9-options-including-bepanthen-protopic-elidel-tofacitinib-and-more\/","title":{"rendered":"Facial Atopic Dermatitis Ointments | Comparing 9 Options Including Bepanthen, Protopic, Elidel, Tofacitinib, and More"},"content":{"rendered":"\n<div class=\"wp-block-group alignwide has-global-padding is-layout-constrained wp-container-core-group-is-layout-134ed493 wp-block-group-is-layout-constrained\">\n<div class=\"wp-block-group alignwide has-global-padding is-layout-constrained wp-container-core-group-is-layout-0958e68c wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\">When I ask patients who come in for facial atopic dermatitis which ointments they have tried, I very often hear that they were too afraid to use steroid ointments, but have tried various non-steroidal ointments.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">They mention a wide range of products\u2014from OTC options like Bepanthen and Biafine, to prescription medications like Protopic and Elidel, and even overseas direct-purchase products like Rutinib, Opzelura, and Tofacitinib.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because facial skin is thin, topical medications are absorbed more readily\u2014so it is only natural to worry about steroid side effects.<\/p>\n\n\n\n<figure class=\"wp-block-image alignwide size-large\"><img decoding=\"async\" width=\"1024\" height=\"572\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/04\/non-steroid-topical-products-comparison.jpg\" alt=\"A side-by-side comparison photo of tubes of seven non-steroidal ointments used for facial atopic dermatitis: Protopic, Elidel, Anzupgo, Opzelura, Rutinib, Tofatas, and Bepanthen\" class=\"wp-image-10474\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">As a physician, I cannot recommend unapproved products in Korea such as Rutinib or Tofacitinib as atopic dermatitis ointments, but I am writing this because I believe it would be helpful to provide accurate information to those who are already using them. Below, I will compare\u2014based on evidence\u2014the seven non-steroidal topical treatments most frequently mentioned by patients who visit for facial atopic dermatitis. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<div class=\"wp-block-rank-math-toc-block has-custom-color-5-color has-custom-color-2-background-color has-text-color has-background has-link-color wp-elements-702a93a2022d083939f395565b5f9c4a\" style=\"padding-top:var(--wp--preset--spacing--superbspacing-xsmall);padding-right:0;padding-bottom:var(--wp--preset--spacing--superbspacing-xsmall);padding-left:0\" id=\"rank-math-toc\"><h2>\ubaa9\ucc28<\/h2><nav><ul><li><a href=\"#sec-1\">Why is facial atopic dermatitis different?<\/a><\/li><li><a href=\"#sec-2\">Ointment vs. cream | Which formulation is better?<\/a><\/li><li><a href=\"#sec-3\">Comparing 7 non-steroidal atopic dermatitis ointments<\/a><\/li><li><a href=\"#sec-4\">Hypothetical prescriptions vs. real-world prescriptions<\/a><\/li><li><a href=\"#sec-faq\">Frequently Asked Questions<\/a><\/li><\/ul><\/nav><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"sec-1\">Why is facial atopic dermatitis different?<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n\n<p class=\"wp-block-paragraph\">Compared with the arms or legs, the stratum corneum of facial skin is much thinner. A thinner stratum corneum means topical medications are absorbed more, and more quickly, into the skin.<sup><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19262357\/\" target=\"_blank\" style=\"color: inherit;\" rel=\"noopener\">1<\/a><\/sup> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That is why <a href=\"https:\/\/miragen.clinic\/blog\/%ec%8a%a4%ed%85%8c%eb%a1%9c%ec%9d%b4%eb%93%9c-%ec%97%b0%ea%b3%a0-%eb%93%b1%ea%b8%89\/\">steroid ointments<\/a> can be very effective\u2014but side effects can also be more severe. Skin atrophy and telangiectasia are concerns, but the biggest issue is rebound. After using steroids for a long time and then stopping, symptoms such as worse-than-before redness and burning can occur. Studies analyzing these rebound cases show that most occurred on the face.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25592622\/\" target=\"_blank\" rel=\"noopener\">2<\/a><\/sup> This is why many people look for non-steroidal ointments when facial <a href=\"https:\/\/miragen.clinic\/en\/atopic-dermatitis\/\">atopic dermatitis<\/a> develops.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"sec-2\">Ointment vs. cream | Which formulation is better?<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n\n<p class=\"wp-block-paragraph\">Even with the same active ingredient, ointments and creams use different bases. Ointments are oil-based and contain little to no water, while creams are emulsions that mix oil and water. This difference matters quite a bit for facial atopic dermatitis.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The advantage of ointments is safety.<\/strong> Because they contain little or no water, they require few preservatives to inhibit microbial growth. Creams, on the other hand, need preservatives because of their water content, and preservatives (such as benzyl alcohol, propylene glycol, and sorbic acid) have consistently been reported to cause contact dermatitis in patients with a compromised skin barrier.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18346395\/\" target=\"_blank\" rel=\"noopener\">3<\/a><\/sup> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The downside of ointments is acne.<\/strong> The oils can clog pores. Because the face has a high density of pores, it is fairly common for new acne to develop or existing acne to worsen after applying an ointment. In fact, I sometimes see patients return because their acne worsened after being prescribed Protopic ointment. The feel is also an issue: it is not easy to keep applying a sticky, greasy ointment to the face consistently.    <\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/06\/ointment-vs-cream-face-comparison-EN.jpeg\" alt=\"An illustration comparing skin cross-sections for ointment vs. cream formulations&#x2014;showing that ointments have fewer preservatives but can occlude pores, while creams have more preservatives but clog pores less&#x2014;serving as a guide for choosing facial atopic dermatitis ointments\" class=\"wp-image-10386\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">European expert consensus statements reflect this as well, recommending ointments for moderate-to-severe disease or for the body, and creams for the face or for mild disease.<sup><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30288799\/\" target=\"_blank\" style=\"color: inherit;\" rel=\"noopener\">4<\/a><\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In summary, <strong>ointments are generally better for efficacy and safety, but if you have acne, using a cream is more practical<\/strong>. After checking for pore blockage with a <a href=\"https:\/\/miragen.clinic\/en\/woods-lamp-examination\/\" data-type=\"page\" data-id=\"6388\">Wood\u2019s lamp exam<\/a>, I prescribe a cream formulation for patients who seem likely to develop acne. <\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/06\/wood-lamp-exam-face-treatment-1-EN.jpeg\" alt=\"A facial atopic dermatitis ointment prescribing flowchart: after checking pore status with a Wood&#x2019;s lamp exam, choose ointment if pores are open, and cream if pores are clogged\" class=\"wp-image-10497\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th class=\"has-text-align-left\" data-align=\"left\"><\/th><th class=\"has-text-align-left\" data-align=\"left\">Ointment<\/th><th class=\"has-text-align-left\" data-align=\"left\">Cream<\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-left\" data-align=\"left\">Preservatives<\/td><td class=\"has-text-align-left\" data-align=\"left\">None or minimal<\/td><td class=\"has-text-align-left\" data-align=\"left\">Relatively more<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Risk of contact dermatitis<\/td><td class=\"has-text-align-left\" data-align=\"left\">Low<\/td><td class=\"has-text-align-left\" data-align=\"left\">Relatively high<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Pore occlusion\/acne<\/td><td class=\"has-text-align-left\" data-align=\"left\">May trigger<\/td><td class=\"has-text-align-left\" data-align=\"left\">Relatively less<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Texture\/feel<\/td><td class=\"has-text-align-left\" data-align=\"left\">Sticky<\/td><td class=\"has-text-align-left\" data-align=\"left\">Lightweight<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Suitability for the face<\/td><td class=\"has-text-align-left\" data-align=\"left\">Preferred if no acne<\/td><td class=\"has-text-align-left\" data-align=\"left\">Preferred if acne is present<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"sec-3\">Comparing 7 non-steroidal atopic dermatitis ointments<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n\n<p class=\"wp-block-paragraph\">The relative efficacy of non-steroidal atopic dermatitis ointments can be understood by synthesizing results from multiple clinical trials. A 2024 analysis by the Cochrane team (291 trials, 45,846 participants) already compared Protopic, Elidel, Anzupgo, and Opzelura, and the relative efficacy of Tofacitinib and Bepanthen can be indirectly compared using separate clinical trials.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39105474\/\" target=\"_blank\" rel=\"noopener\">5<\/a><\/sup> <\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th class=\"has-text-align-left\" data-align=\"left\">Active ingredient<\/th><th class=\"has-text-align-left\" data-align=\"left\">Representative product<\/th><th class=\"has-text-align-left\" data-align=\"left\">Formulation<\/th><th class=\"has-text-align-left\" data-align=\"left\">Efficacy rating<\/th><th class=\"has-text-align-left\" data-align=\"left\">Approved in Korea<\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-left\" data-align=\"left\">Tacrolimus 0.1%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/en\/blog\/protopic-for-face-should-i-use-0-1-or-0-03\/\">Protopic 0.1%<\/a> <\/td><td class=\"has-text-align-left\" data-align=\"left\">Ointment<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605\u2605\u2605\u2605<\/td><td class=\"has-text-align-left\" data-align=\"left\">O (covered)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Delgocitinib 0.5%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/blog\/%ec%95%a4%ec%a4%8d%ea%b3%a0-%ed%81%ac%eb%a6%bc\/\">Anzupgo<\/a><\/td><td class=\"has-text-align-left\" data-align=\"left\">Cream<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605\u2605\u2605\u2605<\/td><td class=\"has-text-align-left\" data-align=\"left\">Chronic hand eczema only (non-covered)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Ruxolitinib 1.5%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/blog\/%eb%a3%a8%ed%8b%b0%eb%8b%99-%ec%97%b0%ea%b3%a0-%ec%98%b5%ec%a0%a4%eb%a3%a8%eb%9d%bc\/\">Opzelura, Rutinib<\/a><\/td><td class=\"has-text-align-left\" data-align=\"left\">Cream<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605\u2605\u2605\u2605<\/td><td class=\"has-text-align-left\" data-align=\"left\">X (direct purchase)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Tacrolimus 0.03%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/en\/protopic\/\" data-type=\"page\" data-id=\"6419\">Protopic 0.03%<\/a> <\/td><td class=\"has-text-align-left\" data-align=\"left\">Ointment<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605\u2605\u2605<\/td><td class=\"has-text-align-left\" data-align=\"left\">O (covered)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Pimecrolimus 1%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/blog\/%ec%97%98%eb%a6%ac%eb%8d%b8-%ec%97%b0%ea%b3%a0-%ed%9a%a8%eb%8a%a5-%eb%b6%80%ec%9e%91%ec%9a%a9\/\">Elidel<\/a><\/td><td class=\"has-text-align-left\" data-align=\"left\">Cream<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605\u2605<\/td><td class=\"has-text-align-left\" data-align=\"left\">O (covered)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Tofacitinib 2%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/blog\/%ed%86%a0%ed%8c%8c%ec%8b%9c%ed%8b%b0%eb%8b%99-%ec%97%b0%ea%b3%a0-%ec%a7%81%ea%b5%ac\/\">Tofatas<\/a><\/td><td class=\"has-text-align-left\" data-align=\"left\">Ointment<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605\u2605<\/td><td class=\"has-text-align-left\" data-align=\"left\">X (direct purchase)<\/td><\/tr><tr><td class=\"has-text-align-left\" data-align=\"left\">Dexpanthenol 5%<\/td><td class=\"has-text-align-left\" data-align=\"left\"><a href=\"https:\/\/miragen.clinic\/blog\/%eb%b9%84%ed%8c%90%ed%85%90-%ec%97%b0%ea%b3%a0\/\">Bepanthen, D-Panthenol<\/a><\/td><td class=\"has-text-align-left\" data-align=\"left\">Ointment<\/td><td class=\"has-text-align-left\" data-align=\"left\">\u2605 (adjunct)<\/td><td class=\"has-text-align-left\" data-align=\"left\">OTC<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Protopic 0.1% | The most well-validated choice<\/h3>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" width=\"1024\" height=\"572\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/03\/protopic-ointment-product-photo.jpg\" alt=\"A 10 g tube of Protopic tacrolimus 0.1% ointment, the longest-established non-steroidal topical treatment used as a facial atopic dermatitis ointment\" class=\"wp-image-7769\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Tacrolimus 0.1% ointment is the benchmark non-steroidal atopic dermatitis ointment, supported by more than 20 years of clinical evidence. In a Cochrane review analyzing six clinical trials (1,640 participants), 0.1% showed an 18% significantly higher physician-assessed improvement rate than 0.03%.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26132597\/\" target=\"_blank\" rel=\"noopener\">6<\/a><\/sup> In three head-to-head trials, it was clearly more effective than pimecrolimus cream with similar safety.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15858471\/\" target=\"_blank\" rel=\"noopener\">7<\/a><\/sup> The 2024 Cochrane analysis also ranked Protopic 0.1% as one of the most effective non-steroidal topical treatments.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39105474\/\" target=\"_blank\" rel=\"noopener\">5<\/a><\/sup> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The downside is stinging and burning for the first 2\u20133 days. This occurs when TRPV1 receptors are stimulated and substance P and CGRP are released all at once. However, this process is not necessarily harmful. If repeated stimulation depletes substance P and CGRP stored in nerve endings, itching, stinging, and redness may decrease over the long term. The initial discomfort usually settles within a week, and applying it after refrigeration can reduce irritation. You can find more details in the separate posts on <a href=\"https:\/\/miragen.clinic\/en\/protopic\/\">Protopic<\/a> and on <a href=\"https:\/\/miragen.clinic\/en\/blog\/protopic-for-face-should-i-use-0-1-or-0-03\/\">choosing the concentration for facial use<\/a>.    <\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Anzupgo, Opzelura, Ruti | New drugs comparable to Protopic<\/h3>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" width=\"1024\" height=\"576\" data-id=\"10149\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/04\/anzupgo-delgocitinib-cream-tube.jpg\" alt=\"A tube of Anzupgo cream (delgocitinib), the only topical JAK inhibitor approved in Korea, which&#x2014;unlike Rutinib ointment or Opzelura&#x2014;can only be used for the indication of chronic hand eczema\" class=\"wp-image-10149\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" width=\"1024\" height=\"572\" data-id=\"10108\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/04\/opzelura-rutinib-tube-comparison.jpg\" alt=\"A side-by-side product photo of an Opzelura cream tube and a Rutinib cream tube on a white background\" class=\"wp-image-10108\"\/><\/figure>\n<\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Anzupgo (delgocitinib) and Opzelura\/Rutinib (ruxolitinib) are topical treatments from a new class called JAK inhibitors. In a pooled analysis of 291 clinical trials, these two drugs showed efficacy nearly comparable to Protopic 0.1%.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39105474\/\" target=\"_blank\" rel=\"noopener\">5<\/a><\/sup> In an analysis published in 2026, ruxolitinib was even rated as having the highest efficacy among non-steroidal topical treatments.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41618061\/\" target=\"_blank\" rel=\"noopener\">8<\/a><\/sup> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In particular, significant improvement was confirmed in studies targeting facial\/neck dermatitis. In a face\/neck-specific clinical trial, ruxolitinib showed significant improvement in just two weeks,<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40132224\/\" target=\"_blank\" rel=\"noopener\">9<\/a><\/sup> and delgocitinib improved both satisfaction and symptoms in patients who switched from existing steroids or tacrolimus.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40566983\/\" target=\"_blank\" rel=\"noopener\">10<\/a><\/sup> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">However, the real-world constraints are substantial. In Korea, Anzupgo is approved only for chronic hand eczema and is non-covered (the pharmacy acquisition cost for 60 g alone is KRW 690,000), and Opzelura\/Rutinib are not approved at all, so they can only be obtained via overseas direct purchase. Their efficacy is Protopic-level and the cream formulation may feel better, but in terms of cost and accessibility, it is difficult for them to be a first-line choice.  <\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Elidel, Tofacitinib | One step down<\/h3>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" width=\"1024\" height=\"572\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/01\/elidel-cream-product-photo.jpg\" alt=\"A 10 g tube of Elidel pimecrolimus 1% cream, used as an alternative facial atopic dermatitis ointment option when acne is present\" class=\"wp-image-3733\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" width=\"1024\" height=\"572\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/04\/tofatas-tofacitinib-ointment.jpg\" alt=\"A tube of Tofatas tofacitinib 2% ointment, an alternative facial atopic dermatitis ointment option distributed via direct purchase because it is not approved in Korea\" class=\"wp-image-10327\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Pimecrolimus 1% cream (<a href=\"https:\/\/miragen.clinic\/blog\/%ec%97%98%eb%a6%ac%eb%8d%b8-%ec%97%b0%ea%b3%a0-%ed%9a%a8%eb%8a%a5-%eb%b6%80%ec%9e%91%ec%9a%a9\/\">Elidel<\/a>) has a lower anti-inflammatory effect than Protopic. In head-to-head clinical trials, it consistently performed worse than Protopic,<sup><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15858471\/\" target=\"_blank\" style=\"color: inherit;\" rel=\"noopener\">7<\/a><\/sup> and in the 2024 Cochrane analysis, it ranked in the lower tier among non-steroidal topical treatments.<sup><a style=\"color: inherit;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39105474\/\" target=\"_blank\" rel=\"noopener\">5<\/a><\/sup> Tofacitinib 2% ointment also showed only equivalent efficacy when directly compared with pimecrolimus in a phase 3 trial in India (184 participants). In other words, Elidel and tofacitinib are at a similar efficacy level.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So when do we use Elidel? Because it is a cream formulation and clogs pores less, <strong>Elidel is a more practical choice for facial atopic dermatitis with acne<\/strong>. Even if it is less effective, treatment only works if you can apply it consistently.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tofacitinib ointment is not approved in Korea, and long-term data are lacking (only 4-week clinical trials exist), so it is difficult to recommend proactively. In atopic dermatitis communities, some people say, \u201cIf you use tofacitinib wrong, you will get an acne explosion,\u201d but this is less about tofacitinib itself and more about the ointment formulation. Because the oils in ointments can clog pores and trigger acne, the same can happen with Protopic as well.  <\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Bepanthen, D-Panthenol | Adjunct<\/h3>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/04\/bepanthen-vs-dpanthenol-comparison.png\" alt=\"A comparison photo of Bepanthen ointment and D-Panthenol ointment&#x2014;both are OTC products containing 5% dexpanthenol and include lanolin as an additive\" class=\"wp-image-9872\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Dexpanthenol 5% (<a href=\"https:\/\/miragen.clinic\/blog\/%eb%b9%84%ed%8c%90%ed%85%90-%ec%97%b0%ea%b3%a0\/\">Bepanthen, D-Panthenol<\/a>) is not an anti-inflammatory medication, but an adjunct that helps repair the skin barrier. There are no studies directly comparing it with Protopic or Elidel, but in pediatric atopic dermatitis trials, it showed efficacy similar to hydrocortisone 1%, the mildest steroid. Because Elidel is also classified in guidelines as comparable to mild steroids, Bepanthen\u2019s anti-inflammatory effect is presumed to be lower than or similar to Elidel. However, because it is an ointment, it can trigger acne, and lanolin\u2014an additive\u2014was selected as the 2023 Contact Allergen of the Year. Since it can cause contact dermatitis in patients with a compromised barrier, it is difficult to recommend as a facial atopic dermatitis ointment.    <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"sec-4\">Hypothetical prescriptions vs. real-world prescriptions<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n\n<p class=\"wp-block-paragraph\">If we ignore regulations and cost and make a hypothetical prescription for facial atopic dermatitis ointments based only on the literature, the order would be as follows. If efficacy is the same, creams are more advantageous than ointments for facial atopic dermatitis, so the first choice would be cream-formulation JAK inhibitors such as Anzupgo, Opzelura, and Rutinib; second, Protopic 0.1%; third, Protopic 0.03%; fourth, Elidel; and fifth, tofacitinib. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But reality is different. In Korea, Anzupgo is approved only for hand eczema, not atopic dermatitis, and the pharmacy acquisition cost is KRW 690,000 for 60 g. Opzelura, Rutinib, and Tofatas are not approved at all, so they can only be obtained via direct purchase. And because Rutinib and Tofatas are drugs approved in Bangladesh and India\u2014where the regulatory environment differs from the U.S. or Korea\u2014it is difficult to know how rigorously they have been validated.   <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If we limit ourselves to medications approved and covered in Korea, Protopic 0.1% is the most practical first choice if there is no acne, while Elidel is the most practical first choice if there is acne or significant pore blockage. In my own practice, I also prescribe mainly these two, and specifically follow this order: <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>If the Wood\u2019s lamp exam shows clogged pores or acne<\/strong> \u2192 Start with Elidel cream. If the effect is insufficient, switch to Protopic 0.1% ointment. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>If the Wood\u2019s lamp exam shows no pore blockage and there is no acne<\/strong> \u2192 Start with Protopic 0.1% ointment. If acne develops after use, switch to Elidel cream. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">References<\/h3>\n\n\n\n<ol class=\"wp-block-list has-custom-color-5-color has-text-color has-link-color has-superbfont-xxsmall-font-size wp-elements-2fd45b244505112a90b0e53769cf1976\">\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19262357\/\" target=\"_blank\" rel=\"noopener\"><em>Pariser D. Topical corticosteroids and topical calcineurin inhibitors in the treatment of atopic dermatitis: focus on percutaneous absorption. Am J Ther. 2009;16(3):264-273.  <\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25592622\/\" target=\"_blank\" rel=\"noopener\"><em>Hajar T, Leshem YA, Hanifin JM, et al. A systematic review of topical corticosteroid withdrawal (&#8220;steroid addiction&#8221;) in patients with atopic dermatitis and other dermatoses. J Am Acad Dermatol. 2015;72(3):541-549.e2.   <\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18346395\/\" target=\"_blank\" rel=\"noopener\"><em>Coloe J, Zirwas MJ. Allergens in corticosteroid vehicles. Dermatitis. 2008;19(1):38-42.   <\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30288799\/\" target=\"_blank\" rel=\"noopener\"><em>Remitz A, De Pit\u00e0 O, Mota A, et al. Position statement: topical calcineurin inhibitors in atopic dermatitis. J Eur Acad Dermatol Venereol. 2018;32(12):2074-2082.   <\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39105474\/\" target=\"_blank\" rel=\"noopener\"><em>Lax SJ, Van Vogt E, Candy B, et al. Topical anti-inflammatory treatments for eczema: network meta-analysis. Cochrane Database Syst Rev. 2024;8(8):CD015064.<\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26132597\/\" target=\"_blank\" rel=\"noopener\"><em>Cury Martins J, Martins C, Aoki V, et al. Topical tacrolimus for atopic dermatitis. Cochrane Database Syst Rev. 2015;2015(7):CD009864.<\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15858471\/\" target=\"_blank\" rel=\"noopener\"><em>Paller AS, Lebwohl M, Fleischer AB Jr, et al. Tacrolimus ointment is more effective than pimecrolimus cream with a similar safety profile in the treatment of atopic dermatitis. J Am Acad Dermatol. 2005;52(5):810-822.   <\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41618061\/\" target=\"_blank\" rel=\"noopener\"><em>Zhang L, Gong X, Gu Y, et al. Efficacy and safety of treatments for atopic dermatitis: a model-based meta-analysis of randomized controlled trials. Eur J Clin Pharmacol. 2026;82(2):62.   <\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40132224\/\" target=\"_blank\" rel=\"noopener\"><em>Chiesa Fuxench ZC, Lai JS, Kuo KL, et al. Ruxolitinib cream monotherapy for facial and\/or neck atopic dermatitis: results from a decentralized, randomized phase 2 clinical trial. J Dermatolog Treat. 2025;36(1):2480744.<\/em><\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40566983\/\" target=\"_blank\" rel=\"noopener\"><em>Abe M, Igarashi A, Kitajima M, et al. Treatment satisfaction, efficacy, and safety of delgocitinib ointment for atopic dermatitis-induced rash on the face and neck. J Dermatol. 2025;52(8):1232-1242.   <\/em><\/a><\/li>\n<\/ol>\n<\/div>\n\n\n\n<div class=\"wp-block-group alignwide is-style-superbaddons-card has-custom-color-2-background-color has-background has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\" style=\"border-style:none;border-width:0px;border-top-left-radius:16px;border-top-right-radius:16px;border-bottom-left-radius:16px;border-bottom-right-radius:16px\">\n<h2 class=\"wp-block-heading has-custom-color-4-color has-text-color has-link-color wp-elements-fec4206f5af5888537ae11aefd49af22\" id=\"sec-faq\">Frequently Asked Questions<\/h2>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-custom-color-5-color has-alpha-channel-opacity has-custom-color-5-background-color has-background is-style-wide\" style=\"margin-top:var(--wp--preset--spacing--superbspacing-xsmall);margin-bottom:var(--wp--preset--spacing--superbspacing-xsmall)\"\/>\n\n\n<div id=\"rank-math-faq\" class=\"rank-math-block\">\n<div class=\"rank-math-list \">\n<div id=\"faq-1\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">For facial atopic dermatitis ointments, which is better\u2014ointment or cream?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>If you do not have acne, an ointment (Protopic) is advantageous in terms of efficacy and safety. Ointments contain fewer preservatives, so the risk of contact dermatitis is lower. However, if acne develops or worsens after using an ointment, it is more practical to switch to a cream (Elidel).  <\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-2\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Is it normal for Protopic to sting and make my skin red?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>For the first 2\u20133 days, TRPV1 receptor stimulation can cause stinging, burning, and redness. It usually settles within a week. Applying it after refrigeration can reduce initial irritation. If it continues to worsen for more than three days, contact dermatitis is possible\u2014stop using it and seek medical care.   <\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-3\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Is it okay to use overseas direct-purchase ointments (Opzelura, tofacitinib)?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Products not approved in Korea have not been verified for quality control or bioequivalence. Because Protopic and Elidel can be prescribed in Korea and are covered by insurance, I recommend starting treatment with these medications first. <\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-group has-custom-color-2-background-color has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-ffa602f6 wp-block-group-is-layout-constrained\" style=\"border-top-left-radius:16px;border-top-right-radius:16px;border-bottom-left-radius:16px;border-bottom-right-radius:16px;padding-top:0;padding-right:0;padding-bottom:0;padding-left:0\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-8c970b27 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<figure class=\"wp-block-image size-full\" style=\"margin-right:0;margin-left:0\"><img decoding=\"async\" width=\"600\" height=\"600\" src=\"https:\/\/miragen.clinic\/wp-content\/uploads\/2026\/01\/doctor-han-namecard-profile.png\" alt=\"\" class=\"wp-image-3537\"\/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-top:var(--wp--preset--spacing--superbspacing-small);padding-right:var(--wp--preset--spacing--superbspacing-small);padding-bottom:var(--wp--preset--spacing--superbspacing-small);padding-left:var(--wp--preset--spacing--superbspacing-small);flex-basis:60%\">\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-dec8e639 wp-block-group-is-layout-constrained\" style=\"padding-top:0;padding-right:0;padding-bottom:0;padding-left:0\">\n<p class=\"has-custom-color-3-color has-text-color has-link-color has-superbfont-large-font-size wp-elements-9a43ded5a855c918bdce811724da93c4 wp-block-paragraph\" style=\"font-style:normal;font-weight:600\">We treat atopic dermatitis, rosacea, and seborrheic dermatitis.<br\/><\/p>\n\n\n\n<p class=\"has-custom-color-5-color has-text-color has-link-color has-superbfont-small-font-size wp-elements-b0ed9896cd87c4dc29ef35753e45458c wp-block-paragraph\">Thanks to the valuable reviews you have shared in the community, many of you visit us even from far away.<br\/>We will repay you with sincere, attentive care.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-custom-color-6-color has-alpha-channel-opacity has-custom-color-6-background-color has-background is-style-wide\"\/>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-e1e686a6 wp-block-columns-is-layout-flex\" style=\"padding-top:0;padding-bottom:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<div class=\"wp-block-group is-vertical is-layout-flex wp-container-core-group-is-layout-19afc361 wp-block-group-is-layout-flex\">\n<p class=\"has-custom-color-3-color has-text-color has-link-color has-superbfont-small-font-size wp-elements-5046f5cbf2504632740a9221c469d447 wp-block-paragraph\"><strong>DK Han<\/strong><\/p>\n\n\n\n<p class=\"has-custom-color-5-color has-text-color has-link-color has-superbfont-xsmall-font-size wp-elements-f628b1a898e0079d43059baed3da5249 wp-block-paragraph\">Chief Director, MIRAGEN Clinic<\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p class=\"has-custom-color-5-color has-text-color has-link-color has-superbfont-xsmall-font-size wp-elements-0a159b55280bf6519f7c0f2e7a7ab305 wp-block-paragraph\">Graduate of University of Michigan, Ross School of Business<br\/>Graduate of Chungnam National University School of Medicine<br\/>(Former) Representative Director of Ewha Phoenix Rehabilitation Hospital<br\/>(Current) Representative Director of MIRAGEN Clinic<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>When I ask patients who come in for facial atopic dermatitis which ointments they have tried, I very often hear that they were too afraid to use steroid ointments, but have tried various non-steroidal ointments. They mention a wide range of products\u2014from OTC options like Bepanthen and Biafine, to prescription medications like Protopic and Elidel, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":12531,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_miragen_jsonld":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-12530","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-1"],"_links":{"self":[{"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/posts\/12530","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/comments?post=12530"}],"version-history":[{"count":2,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/posts\/12530\/revisions"}],"predecessor-version":[{"id":12533,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/posts\/12530\/revisions\/12533"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/media\/12531"}],"wp:attachment":[{"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/media?parent=12530"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/categories?post=12530"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/miragen.clinic\/en\/wp-json\/wp\/v2\/tags?post=12530"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}