Creams for PIGMENTATION | Dermatologist Review

  / drdavinlim  
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Creams for PIGMENTATION | Dermatologist Review
Skin pigmentation is one of the most frequent presentations to a dermatologist. Specialists will employ treatments specific to the cause of pigmentation. Treatments include creams, peels & lasers.

Causes of skin pigmentation: The most common causes include melasma, freckles, sun spots and age related pigment. Other rare causes include drugs, inflammatory skin disorders, genetic pigmentation and skin cancer. Always give a diagnosis to the cause of pigment. This is the essence of medicine!

Skin science: Meladerm is a cream made by Civant skincare. This formulation does not require a prescription, unlike compounded topical formulations. Skin care actives includes Retinol, Vitamin B3 or niacinamide, Vitamin E, as well as ascorbic acid / Vitamin C. Other actives include botanicals, including licorice, and berry extracts. These root and plant extacts improve pigmentation by reducing skin inflammation as well as inhibiting Tyrosinase. Other pigment correctors present in Meladerm include kojic, and citric acid. Free from hydroquinone, parabens and artificial fragrance.

Clinical application: Skin pigmentation. Meladerm is marketed as a topical to treat almost all forms of skin pigmentation, however it is most useful in the management of melasma, cholasma, and post inflammatory skin hyperpigmentation. PIH can be due to many inflammatory skin conditions including acne, dermatitis, and repeated rubbing. Meladerm can also reduce freckles and dark patches.

Best applied: At night. Your dermatologist may cycle Meladerm with other topicals including hydroquinone, retinoids and other skincare actives. Application frequency will depend on the diagnosis, your treatment protocol as well as variables such as skin sensitivity.

How to use: Apply to dark areas only. As always start slowly and increase as tolerated. Be guided by your skin care professional if you are using other actives.

Caution: Product information states increased sensitivity to sunburn - due to AHA and Retinol. Lemon juice can be implicated in phytophotodermatoses.

Caution: In patients with sensitive skin start slowly. The blend of hydroxy acids as well as Vitamin C can cause irritation in patients with rosacea. Lemon juice which is in meladerm is potentially an instigator in phytophotodermatits.

Cost: From $50 USD for 50mls $$, available online. If treating large areas, cost can be prohibitive. Most dermatologists agree that hydroquinone is the Gold Standard in depigmentation. See Protip below.

Davin’s Protip: Naturalskin care with botanicals such as argan, bearberry, & licorice, can improve pigmentation without any potential side effects from hydroquinone. In clinical practice I prescribe formulations similar to Meladerm during the maintenance phase of melasma treatment. This formulation can be a good stepping stone in patients with brown pigmentation from acne. Meladerm can be safely combined with lasers and chemical peels to give better results than monotherapy.

DAV score rating 17/30. Meladerm is useful as a safe alternative to hydroquinone. In my clinical practice I rotate HQ free products such as cystamine, Meladerm, Melacream, compounded formulations of Kojic, Ascorbic, AHA, & other actives during the ‘off’ cycle / maintenance of depigmenting programs.

1. Skin Science ⅗ Good data for retinol, niacinamide, kojic acid, in addition to the safety profile of other ingredients. Botanicals proven in small industry funded research.

2.Ease of use ⅗ Warnings as above with skin sensitivity and sunburn.

3. Compatibility with other products ⅗ as described.

4. Subjective feel ⅗ Personally I find it sticky and tacky. Product has odour, despite being fragrance free.

5. Packaging ⅗ Protects from air and light, important to reduce oxidative stress. Downside is that some of the product is wasted with this form of packaging.

6. Price ⅖ Price point is steep for 50 ml of product- 50 USD. As a reference, bespoke formulation of topicals compounded by a pharmacist range between 40 USD to 60 USD for similar quantity.

Total Dav Score: 17/30

Dr Davin Lim
@cliniccutis @drdavinlim
2019, Brisbane. Australia.