Dr. Batul Patel is a passionate and dedicated dermatologist based out of South Mumbai with expertise in all fields of dermatology, trichology and aesthetic dermatology. Having completed her M.B.B.S., D.D.V. and M.D., she has successfully consulted and treated a wide variety of dermatological cases. Our Group Editor Vaidehi Taman spoke to Dr Batul Patel to know more about the pros and cons of Cosmelan treatment.
What are the indications for the Cosmelan treatment?
Cosmelan is a chemical peel, which includes a combination of different depigmentation agents. These agents decrease melanin production on the skin by inhibition of enzymes tyrosinase. Melanin is responsible for darkening of the skin which result in formation of brown spots due to sun exposure as well as formation of melasma when influenced by hormones. The following are indications for Cosmelan treatment:
Post-inflammatory hyper-pigmentation of dermatitis and acne scars
Prevention of hyper-pigmentation post-laser and post-peel
What are the Pre-procedure instructions?
Avoid any facial or salon activity for one week before the peel. Protect your skin from sun before and after peel. Priming of the skin must be done with few depigmenting creams before the treatment.
What are the steps for the Cosmelan treatment?
The initial treatment with Cosmelan is always done in the doctor’s office. The first part involves evaluation of the skin type by the doctor. The cleansing of the skin is done with the degreasing agent in order to remove the dead cells, skin oils and old debris. After the degreasing step, Cosmelan one mask is applied and left for a total of 10 to 14 hours depending on the skin type. I like to apply a uniform layer all over and sometimes apply two coats on the resistant and depigmenting areas. After the mask application, you are able to go home with the mask on. Avoid sun exposure with the mask on. In my clinic, I advise my patients to perform this treatment in the evening after sunset so that patient is not exposed to the sun rays immediately after the mask is put on.
After appropriate amount of time has elapsed, the mask is removed with water and a neutral cleanser. I also advise my patient not to rub or scrub the face with any facewash or soap. Face needs to be cleansed with lots of plain water. Immediately following the cleansing of the face, the mesoestetic Hydra-vital factor K cream is applied on the treated area.
What are the contents of the Cosmelan peel?
I instruct my patient to read the contents of the peel and talk to them about the advantage of each agent and assure them that it is a hydroquinone free peel.
Cosmelan 1 – mask
Azelaic Acid, Kojic Acid, Phytic Acid, Ascorbic Acid, Arbutine, and Titanium Dioxide
Cosmelan 2 – Maintenance Cream (30g)
Titanium Dioxide, Kojic Acid, Phytic Acid, Ascorbic Acid
Mesoestetic Hydra Vital Factor K Cream (50ml)
Hydro nutritional cream for face and neck. Hydroviton, VItamin K, Vitamin E, Amniotic fluid, Glycerine, Silicone oil.
What steps are to be followed after the Mask is removed?
The second stage is the home maintenance program. It consists of the daily application of the Cosmelan 2 cream. The cream is applied 2-3 times a day, for the first two weeks following the application of the mask, then once a day from then on. Continual daily use is recommended for the best results. If skin is dry I like to give my patient Cetaphil Damn moisturizing cream to be applied several times in a day along with Mesoestetic Hdrya- vital factor K. I advise physical blockade for 2 to 3 weeks after the peel. I ask my patient to carry an umbrella or a scarf if possible along with application of sunscreen which is a very vital step.
What to expect after the Cosmelan treatment?
During the first two days of the treatment, the skin may turn red. If the skin is very sensitive, the patient may experience an itching feeling. Slight burning and tightening of the skin is also absolutely normal, especially during the first 24 to 48 hours after starting the treatment. To relieve these problems, it is advisable to apply the Mesoestetic Hydra-vital factor K whenever necessary. Slight reddening and swelling of the face is also likely to occur which will take 4 to 5 days to settle. On the fourth and fifth day flaking will occur on all skin types. In this case it is advisable to apply the Mesoestetic Hydra-vital factor K cream, repeat this process every two hours on the day when the flaking is most intense repeat this every two hours until it improves. On the seventh and eighth day skin appears healthy and luminous and the marks begin to fade.
What instructions should be followed after the procedure?
Do not rub or scratch the skin or try to pull or cut flakes. Do not use exfoliants, scrubs or peels and avoid steam baths, saunas. Avoid swimming for two weeks after the procedure. Don’t use makeup till flaking occurs.
What are the advantages of Cosmelan treatment?
Cosmelan treatment very effective in all types of Melasma especially deep seated severe Melasma or post inflammatory hyperpigmentation PIH. It is effective for pigmentation that has failed to resolve after traditional skin lightening topical products It is also effective for pigmentation that has failed to resolve after traditional treatments such as superficial peels. The treatment is compatible with ALL skin types and treatment can be used all year round. It does not contain Hydroquinone or TCA. There are no side effects
What are the disadvantages of Cosmelan treatment?
The disadvantages of Cosmelan treatment is that there is downtime for the patient. It should not be performed during summer months
What is the visit follow up schedule?
I ask my patient to visit my clinic within eight days of the treatment, 15 days after, and a follow up visit every month thereafter.
How long does the result last?
The results continue to improve with the use of Cosmelan 2 cream and with strict sunscreen application. The results are long term and with continued use of a good skin care routine patients experiences very healthy and pigmentation free skin.