Is Cosmelan is the right treatment for my hyperpigmentation on cheeks and corner of lips? (Photo)

Question

I’m a 42 year old Asian Indian, mother of 2. I started seeing hyperpigmentation on my cheek and the corner of my lips almost 2 years ago. Is this melasma or hyperpigmentation? I have never worn sunscreen because it caused acne breakouts. Early this year I was diagnosed with hypothyroidism. I have been having acne breakouts too this year. I have been doing a lot of research and was wondering if Cosmelan is the right treatment option for me? I have sensitive skin. What other options do I have?

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

This is difficult to answer without an in-person evaluation. Hyperpigmentation can be improved with a combination of lasers, Aerolase, microneedling/PRP, skin lightening, peels, Cosmelan, and skin care. Melasma also requires a combination approach and a series of treatments. Sun protection is essential. I recommend getting a formal, in-person evaluation with an experienced cosmetic dermatologist. Best, Dr. Emer

Anteneh Roba, MD · Answer

based on your photo it appears that you maybe suffering from Melasma which is a recurring skin condition characterized by patchy  hyperpigmented areas on the face.Cosmelan will definitely improve the hyperpigmentation and is a good choice, but it is not a permanent solution.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Yes, it looks like melasma, however a more detailed examination will be needed. Cosmelan is an option, be guided by your dermatologist. I use lasers, peels, and many other METHODS to treat this condition. Now, as pointed out none of these offer a cure for melasma, however used in combination, marked improvement can be seen in over 95% of cases. Review my before and afters for a full explanation. Step 1: Mask applied in Dermatology office

·      Skin is cleansed and prepared. I use an acetone mix or gentle alcohol mix

·      In some cases I use Dermaplanning as a prep, in other cases microdermabrasion to prepare your skin

·      The Cosmelan1 mask will be applied. Highest concentration is worse areas

·      The mask must stay on between seven and twelve hours.

·      A home after-care kit with detailed instructions will be provided.

Step 2: At Home Cosmelan routine

·      After the specified time, the Cosmelan mask is removed with a gentle cleanser. I prefer QV Wash or Cethaphil wash. Keep things simple

·      Peeling begins two to three days after the Cosmelan 1 mask application

·      Cosmelan 2 cream should be applied two to three times a day for 14 days

·      After completion of the phase 1 of Cosmelan 2 cream this cream is now titrated to be applied once a day

Is Cosmelan is the right treatment for my hyperpigmentation on cheeks and corner of lips? (Photo)

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