Januloma is a combination cream used for the treatment of moderate to severe dark facial melasma.
Melasma is an acquired skin disorder characterized by brown to dark gray patches (hyperpigmentation) that appear on sun-exposed areas of the face, particularly the cheeks, forehead, and chin.
Januloma cream is contraindicated during pregnancy and breastfeeding. If you plan to become pregnant, consult your physician before using this medication.
Use the cream exactly as prescribed by your doctor and at the specified intervals. Do not exceed the prescribed dosage. Overuse may cause redness, peeling, or discomfort at the application site.
Januloma may cause skin discoloration. If any bluish-purple discoloration occurs, stop using the cream and consult your physician.
Extreme weather conditions, such as intense heat or cold, may irritate patients using Januloma. This medication is for topical use only. If irritation occurs or worsens at the application site, discontinue use. Seek medical attention if blisters, severe peeling, burning, swelling, or irritation of mucous membranes (eyes, nose, mouth, or tongue) appear.
Do not apply the cream around or inside the eyes, nose, mouth, genitals, cuts, or damaged skin. Januloma can be absorbed through the skin; overuse may damage the adrenal glands.
Avoid prolonged exposure to sunlight, tanning lamps, or UV light. Patients who are frequently exposed to sunlight due to work should use sunscreen with at least SPF 30 and protective clothing (e.g., hats).
Avoid using Januloma with other topical medications that severely dry the skin, contain high concentrations of alcohol or irritants, or have exfoliating effects during treatment. It may interact with medications that increase photosensitivity.
Patients with asthma should avoid using this cream due to the presence of sodium metabisulfite.
Side effects are observed in approximately 10–40% of patients, including erythema, peeling, burning, dryness, and itching, and in 1–5% of patients, effects may include acne, tingling, telangiectasia, severe sensitivity, pigment changes, papules, rosacea, dry mouth, or vesicles.
Store Januloma in a refrigerator at 2–8°C, protected from light and freezing.
The treatment duration with Januloma is typically 8 weeks; however, this period may be adjusted at the physician’s discretion.
The dosage and method of application are determined by the doctor for each patient, but the usual directions for Januloma cream are as follows:
First, cleanse your face with a mild cleanser. Apply a thin layer of the cream to the affected area every night, about 30 minutes before bedtime. Avoid covering or bandaging the area after applying Januloma. Upon waking, wash your face with a gentle cleanser and apply a suitable sunscreen and moisturizer.
For individuals with very sensitive skin, the physician may recommend washing the face with water and a mild cleanser up to three hours after applying Januloma, so the medication does not remain on the skin overnight. In some cases, doctors prefer to start treatment by applying Januloma every other night, and then continue nightly for up to eight weeks.
Always wash your hands after each application of Januloma cream.
Can Januloma cream be used for areas other than facial spots, such as hands, elbows, legs, scars, burns, bikini line, genitals, underarms, or age spots on hands?
Januloma is effective for lightening and removing spots on hands, elbows, legs, and areas with scars or burns. However, it is ineffective for pigmentation caused by aging or for darkening in the genital and bikini areas. Regarding underarms, due to the exfoliating and inflammatory effects of Januloma and the susceptibility of underarm skin to damage and wounds from sweat, its use is not recommended.
How to manage side effects like redness, itching, dryness, and peeling?
These are expected side effects of Januloma’s active ingredients. To reduce dryness, peeling, and itching, use a moisturizer, hydrating cream, mild cleanser, and sunscreen with at least SPF 30 and UVA protection.
What if nightly use causes skin redness?
Patients experiencing redness can reduce application to every other night.
Recommended sunscreen and moisturizer during Januloma treatment:
Use SPF 30+ sunscreen, preferably colorless, with adequate UVA protection. Apply a suitable moisturizer for sensitive skin. Sunscreen is essential in melasma treatment.
Can Januloma be used simultaneously with treatments for active acne, like clindamycin solution or clindamycin and tretinoin creams?
No. Januloma should not be used on active acne, and since tretinoin is an active ingredient in Januloma, combining it with other acne medications is not recommended.
Treatment course and maintenance with Januloma:
The standard treatment is 8 weeks nightly, followed by twice-weekly maintenance after completion.
Application: Clean the face or affected area, apply a thin layer of cream 30 minutes before bedtime, and wash with a mild cleanser in the morning, followed by sunscreen and moisturizer. For very sensitive skin, a physician may recommend washing the face up to 3 hours after application. Some doctors may start with every other night application and then continue nightly for eight weeks.
Storage and oxidation concerns:
Januloma should be stored in a refrigerator at 2–8°C. If left at room temperature briefly, it is still usable if no color change occurs. If the cream darkens or its consistency changes, it should not be used. Transporting Januloma for up to 2 hours from pharmacy to home or during urban travel does not require refrigeration and does not affect stability.
Use in adolescents:
Allowed if the area does not have active acne.
Use during pregnancy or breastfeeding:
Prohibited.
Sun exposure or tanning during treatment:
Avoid sunlight, tanning lamps, UV exposure, and tanning the treated area. Patients with occupational sun exposure should use sunscreen and protective clothing (e.g., hats).
Use of laser devices during treatment:
Due to Januloma’s exfoliating properties, which may thin and inflame the skin, it is recommended to stop the cream for at least one week before laser procedures.
Accidental contact with lips or mouth:
Wipe off with a clean tissue and rinse thoroughly with water. Do not try to remove with the tongue or swallow.
Accidental contact with eyes:
May cause moderate irritation and itching. Do not rub eyes. Rinse immediately with plenty of water for at least 15 minutes, opening and closing the eyes repeatedly. If irritation persists, consult a physician.
Accidental ingestion:
Give plenty of water or milk immediately to dilute the active ingredients, then go to the hospital at once. Do not induce vomiting.
