Alcohol Intolerance and Facial Flushing in Patients Treated With Topical Tacrolimus

Local intolerance reactions are a common adverse effect of treatment with tacrolimus ointment. A burning sensation occurs in up to 50% of patients,¹ but symptoms are usually ephemeral and disappear after a few applications. Alaiti et al² were the first to differentiate facial flushing from the well-recognized burning reaction. The association of facial flushing with alcohol ingestion was later observed in 6% of 316 adult patients in an open study,³ and in a controlled trial, the phenomenon was recorded in 7% of adult patients treated with 0.1% tacrolimus ointment.¹