After using melalong cream my face starts burning for few sec ie for 30-90 sec . Should i continue or discontinue the cream

Thank you for your question sameer89. Melalong cream contains hydroquinone and tretinoin, two products that can irritate the skin. When first starting such product, some people get irritation. I recommend to my patients that if they have irritation they use less of the product and use it less frequently. Then the usage can gradually be ramped up over time as the skin adjusts. Please consult with a doctor for specific recommendations. Good luck!

Titrate the dose. This means use 1/5 of a pea size drop, 4/5 bland moisturiser, then increase from there. If you can not tolerate this use Meladerm, or stand alone HQ 2-5 %, once again with titration. I normally prescribe a stand alone tretinoin cream based upon irritation- universally seen in everyone on high percentages. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’)

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.