Melasma and hyperpigmentation have historically been some of the toughest skin conditions to treat because discoloration lies so deep within the skin's layers and is hard for medications to target. However, with Cosmelan and CosmelanMD, these conditions can be greatly improved.
Cosmelan is a depigmentation agent which acts by decreasing melanin from the skin. Melanin is responsible for the darkening of the skin and contributing to such factors as melasma and other skin discolorations. Melanin is increased by sun exposure, acne, aging, and hormone fluctuation. Cosmelan has the ability to inhibit an enzyme (tyrosinase) that is involved in the process of causing skin darkening. Cosmelan leads to a decrease in melanin synthesis and hence to a decrease in darkened skin color. Studies have shown that Cosmelan can effectively reduce skin discolorations by up to 90% if used appropriatesly.
Cosmelan is most often applied to the face, but can also be used on other parts of the body. It is applied in a topical cream form in the office, followed by a post-peel home care regiment.
Laser, IPL, and FotoFacial treatments can be extremely effective at treating minor melasma and skin discolorations. Most often we suggest that patients who have more excessive melasma or deeper hyperpigmentation undergo a series of FotoFacial treatments and do Cosmelan for the most effective results for these hard to treat conditions. Most often the patients will undergo a few FotoFacial treatments, then do the Cosmelan, then do a few more FotoFacial treatments. Some patients do opt to do the Cosmelan procedure as a stand-alone treatment. For patients who do both a FotoFacial series and Cosmelan, the Cosmelan portion is offered at a discounted rate.
During your consultation, it will be decided whether Cosmelan or CosmelanMD is the appropriate treatment option for your needs. Before beginning, a consent for the procedure will be signed and all steps of the procedure will be covered for your home care regimen. For the in-office portion, your face will be cleansed with acetone by a Medical Assistant. This allows the skin to be thoroughly cleaned and gives a good surface for the Cosmelan 1 peel, which is then applied. Both compounds have a yellowish hue and must remain on the skin for 8 hours. It is suggested that you return home after the peel is applied since the skin will have a yellowish, brown hue for the entire time it's on the skin. After 8 hours you will removed the peel with a light cleanser and the home care steps begin.
For your home care, you will be given instructions for daily use of the Cosmelan 2 and Vitamin K. It is important that you follow these instructions and use the products appropriately over a two week period. As well, you must use sunscreen daily (which you should do anyway!). After a few weeks, you will return to the office to meet with Dr. Rueckl and assess your results and next steps.
You should expect some peeling and flaking of the skin, more with CosmelanMD. Make-up can be applied daily and light moisturizers and sunscreens should be used throughout the treatment. No glycolic peels or other lightening agents should be used while you are using Cosmelan. You should not experience pain, but some stinging and pinkness of the skin can be expected, particularly at night when the home care products are used.
Some people are allergic to hydroquinone; although, this is rare. If you use hydroquinone products and are allergic, it can result in additional hyperpigmentation and discoloration. You should not use CosmelanMD if you have this allergy, but you can still use Cosmelan with good results, as it contains kojic acid as its active ingredient.
During the two weeks and post-treatment, you will notice a lightening of the treated discoloration and a "breaking up" of the melanin. These results will increase over time. You should use daily sunscreen, and can purchase additional home care products, to help keep the melanin from reappearing or developing new areas of pigmentation. If needed, additional full Cosmelan treatments can be performed