Will Cosmelan peel remove my hyperpigmentation? I am 64, Filipino. (photo)

Question

I am 64, Filipino. I have this brown spot on my left cheek, not too big but been bothering me for years. I used Musely for about 6 months two years ago but did not work for me. I used to have chemical peels at doctors' offices /did not have problem with it. I had microneedling, did not help with the brown spots. Recently, we moved to Houston and my skin is so dry. Not sure if it is the air or me just changing. I am using vitamin c, retinol, niacinamide, all from The Ordinary. Thanks.

Hamid Bimesl, MD · Answer

Hi there,Cosmelan is absolutely an option for lightening your stubborn pigmentation.Cosmelan differs from other peels as it inhibits an enzyme called Tyrosinase which is an enzyme in the melanin formation process. There is also a home care package that comes with Cosmelan that you will use to continue your skincare journey at home and continue to improve the tone of your skin overall. There are pre and post-care considerations for Cosmelan use. Be sure to receive a thorough consultation with an educated provider before your Cosmelan journey! Best of luck!

Harold J. Kaplan, MD · Answer

Hello M. If the spot is an age spot, then laser treatments work well. NOT IPL, but rather a q-switched laser for just that small area (see link). Because of your skin type, you may get some Post Inflammatory Hyperpigmentation (PIH) that is related to the healing process and can make the area look brown again even after the spot crusts and falls off. If this happens, then you would go back to using Musely for another hydroquinone based product for a short time to get rid of that side effect.

If, on the other hand, what you have is Melasma, then there is no cure and hydroquinone bleaching is our preferred way to maintain a less visible spot. Best of luck.

If, on the other hand, what you have is Melasma, then there is no cure and hydroquinone bleaching is our preferred way to maintain a less visible spot.  Best of luck.

Nelson Lee Novick, MD · Answer

The problem in the photo is a fairly common one. In my experience, the type of brown spot shown in the photo typically responds to a series of in-office superficial chemical peel treatments, such as high concentrations of glycolic or salicylic acid, Jessner's solution, or TCA in concentrations of 25 to 35%, accompanied by the at-home application of prescription topical bleaching agents. You would be wise to consult a board certified cosmetic dermatologist. Best of luck.

Milan Doshi, MS, MCh · Answer

Thank you XYZ for your question and photographs.
 Photographic evaluation is incomplete without personal examination to give the most appropriate answer
 However from the photographs, it seems that,
We must first determine whether the brown spot is age-related or due to localized hyperpigmentation. If it is age-related then Laser treatments will work on it in a better way. However, if it is localized hyperpigmentation then Cosmelan peel can be a good option for you. As you mentioned your skin has become dry then you must keep in mind that after using Cosmelan peel there will be peeling of your skin for a period of 10 to 15 days which will increase your skin's dryness.

Please consult a board-certified dermatologist near you and discuss this in detail.
Wish you an alluring look.

Will Cosmelan peel remove my hyperpigmentation? I am 64, Filipino. (photo)

Answers (4)