How long after Cosmelan peel to get Clear and Brilliant, PRP microneedling?

Question

It has been two weeks since my Cosmelan peel. I have pretty thick and un-sensitive skin which is great for harsher treatments. However, I would rather be safe than sorry. I was told two weeks after my peel is sufficient to start the other treatments but I was also told 6-8 weeks by my old practice. Can someone advise? Thanks!!!!

Jason Emer, MD · Answer

Thank you for your question, Microneedling and PRP are great addition to a peel. You can start all of the above mentioned treatments 2 weeks after your peel. I hope this was helpful. Best, Dr. Emer.

Davin Lim, MBBS, FACD - Account Suspended · Answer

2 weeks is fine. We say 2-8 weeks DEPENDING on your clinical outcome and presentation. I prefer to use low dose lasers as maintenance after Cosmelan.

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

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