Am I a candidate for Cosmelan?

Question

A few docs have recommended Cosmelan for a mixture of sun damage and melasma for m olive skin. I am quite nervous about any peels or lasers for fear of making it worse. My local derm said a laser would do the trick and tested a few spots which only made it worse. Thank you for your expertise! This is giving me hope!

Jason Emer, MD · Answer

Hi Mindy. 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 like Cosmelan, microneedling/PRP, Aerolase, and sometimes Erbium (Cool Laser) to get the best results. See an expert for a formal evaluation to determine what is best. Best, Dr. Emer

Anteneh Roba, MD · Answer

Its hard to tell from the photos if you have melasma or just sun damage. Either way Cosmelan is a good choice

Davin Lim, MBBS, FACD - Account Suspended · Answer

Yes you are a good candidate for the Cosmelan peel. 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

F. Victor Rueckl, MD (in memoriam) · Answer

You do appear to have quite a bit of sun damage and possibly some PIH or melasma. Please see an experienced dermatologist for proper diagnosis. Cosmelan is a great choice for melasma. Sunscreen use is 100% necessary on a daily basis! "This answer has been solicited without seeing this patient and 
cannot be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

Am I a candidate for Cosmelan?

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Am I a candidate for Cosmelan?

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Everything you need to know about Cosmelan

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