Should I be using moisturizer after ZO melamin/melamix?

Question

I've been using ZO medical melamin (am) and melamix/trentinoin (pm) for several weeks and am seeing some great results. In the morning I use a physical spf50 after applying melamin. My question is, should I be using a moisturizer after the melamin/melamix or will this dilute the products and therefore make my results less drastic? I have vitiligo and melasma and am very fair. We are treating the melasma to lessen the contrast between my pigmented skin and vitiligo areas.

Jason Emer, MD · Answer

I recommend seeing a cosmetic dermatologist for skin care recommendations. Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + Brilliant, peels (Cosmelan), Microneedling/PRP, Aerolase, and sometimes Erbium laser (cool laser) to get the best results. I suggest seeing an expert for a formal evaluation. Best, Dr. Emer

Davin Lim, MBBS, FACD - Account Suspended · Answer

Dilution is not an issue if you apply 30 min before or after. With a moisturiser, the treatment can be more effective as 1. More is absorbed into the basal layer of your epidermis 2. Side effects such as skin irritation is markedly improved. Now, if you do have side effects with ANY cream using a bland moisturiser can help, you can either apply to prevent, or use it as a dilution and titrate according to skin sensitivities. 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 by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin 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 according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher.

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia. Real Self Advisory Board

Should I be using moisturizer after ZO melamin/melamix?

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Should I be using moisturizer after ZO melamin/melamix?

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