Apr 13, 2023

What Is A Cosmelan Peel?

"The results of the treatment can be significant and long-lasting, making it a worthwhile investment for some patients."

Happy Friday! This week, we spoke with Dr. Alpana Mohta to answer the Formulate Community's questions on cosmelan peels. 

In this conversation, we'll discuss:

  • What a cosmelan peel is.
  • What the process of getting this peel is like.
  • How to deal with the amount of time the peel must remain on the face.
  • The evidence base for this treatment.
  • Potential risks and how to avoid said risks.
  • If the peel is worth the price tag.

If any of those areas of inquiry are intriguing to you, we encourage you to read on to learn more! 

All of these lovely questions were submitted by members of the Formulate community. If you don't see your exact question, fear not. Some questions were edited for length and clarity before being submitted to Dr. Mohta, while others were the result of multiple similar questions being combined into one. If you don't see your question here at all, it's only because we ran out of room! We encourage you to submit another during our next callout for questions. 

Finally, here's a bit more about our interviewee: Dr. Alpana Mohta, MD, DNB is a dual-board certified dermatologist and cosmetologist. She has a keen interest in research which is evident by her 80+ research publications in noted scientific journals. She has won numerous medals and awards from the American Academy of Dermatology, the European Academy of Dermatology and Venereology, and the Society of Pediatric Dermatology. We thank Dr. Mohta for her time and willingness to answer these questions!

Now, onto the interview!

What is a cosmelan peel? How does it work?

Dr. Mohta: A cosmelan peel is a depigmentation treatment used to treat various skin conditions, including melasma, hyperpigmentation, and age spots. It contains a blend of active ingredients, namely, azelaic acid, retinoic acid, kojic acid, niacinamide, ascorbic acid, arbutin and phytic acid. These ingredients work together to reduce the production of melanin, which causes the darkening of the skin. They inhibit an enzyme called tyrosinase, which is responsible for the production of melanin; and exfoliate superficial pigmented skin. This process breaks up melanin clusters and reduces the overall amount of pigment in the skin. The result is a more even and brighter complexion.

What does getting a cosmelan peel entail, step by step? 

Dr. Mohta: Before a cosmelan peel, I first examine the patient's skin and medical history to ensure they are a good candidate for the procedure. The treatment process then involves the following steps:

  1. Thoroughly cleanse the skin to remove any dirt, oil, or makeup.
  2. The face is treated with the Cosmelan 1 peel, which is kept on for 6-10 hours. The skin will begin to peel severely on the third day.
  3. The second stage, using Cosmelan 2, is administered after 7 days to avoid recurrence. This is a tyrosinase inhibitor that acts by reducing melanin synthesis.
  4. To help soothe the skin and reduce any potential inflammation or irritation, the cosmelan peel is followed up with specific aftercare products.

How much time does it take to get a cosmelan peel?

Dr. Mohta: The process is fairly quick. A cosmelan peel is a lunch time peel. Typically, the application of the cosmelan mask takes about 15 minutes. As I said earlier, it needs to be kept on for 6-10 hours though.

What does the peel look like when it's on the face? During the 6-10 hours it is on the face, will it be noticeable to others?

Dr. Mohta: The cosmelan 1 peel or mask is a light yellow-brown colored cream that dries down on the face like a regular face mask. It may be noticeable to others that a peel is on the face, but it should not be too obvious unless it is applied too thickly or unevenly. It is important to keep the face moist with a spray bottle of water to avoid excessive drying.

Is there rigorous evidence for the effectiveness of cosmelan peels? How long has it been a part of mainstream dermatology?

Dr. Mohta: Yes, there is rigorous evidence for the effectiveness of cosmelan peels. Many clinical studies have shown significant improvement in patients with hyperpigmentation and melasma. The treatment has been a part of mainstream dermatology for several years. It is a widely recognized and trusted depigmentation treatment.

Are there any risks involved with a cosmelan peel?

Dr. Mohta: Some patients may experience temporary redness, swelling, or peeling. Photosensitivity is also an issue. In rare cases, patients may develop an allergic reaction to one of the ingredients in the treatment. Gentle moisturizing and strict sun protection can minimize risks.

How bad is the peeling aspect of the cosmelan peel? What do you advise patients to do if they're embarrassed by the peeling?

Dr. Mohta: The peeling aspect of the cosmelan peel has been variable in my experience. Some patients may experience significant peeling, while others may only experience mild flaking. I advise patients to expect some peeling and to plan accordingly by avoiding social events or important meetings during the peeling process (at least for 5 days). I also recommend using gentle pH-balanced cleansers and ceramide moisturizers to help minimize any discomfort or visible peeling.

Is medical oversight preferred or required for a cosmelan peel? Why?

Dr. Mohta: Medical oversight is preferred and highly recommended for a cosmelan peel especially for the Cosmelan 1 peel*. While it is possible to purchase the cosmelan treatment online, I would always recommend seeing a dermatologist first. Medical oversight can help to minimize any potential risks or complications associated with the treatment.

*Editor's note: recall that the Cosmelan 1 peel is the first peel that is applied to the skin, and is the one that must stay on for 6-10 hours. The second, the Cosmelan 2, is administered seven days later.

If someone is dead set on doing a cosmelan peel on their own and without the supervision of a dermatologist, what advice would you give them for preventing complications?

Dr. Mohta: It is highly recommended to seek the supervision of a dermatologist when doing a cosmelan peel. However, if someone is determined to do the peel at home without supervision, It is important to follow the instructions carefully. Avoid any temptation to peel the skin prematurely. Practice strict sun protection while the skin is peeling. Seek medical attention if any complications arise.

If you are using it at home, thoroughly degrease your face to ensure there is not excessive oil on your face. Then, apply a thin layer of cosmelan 1 peel on your face. Keep it on for 6-10 hours. Since it's like a face mask, it tends to dry quickly. Spray water on your skin to avoid excessive drying throughout the day while the peel is still on.

Wash off the peel after 10 hours. Apply the melan recovery cream for the next two days. From day two you will start noticing peeling of skin and dryness. There might also be some inflammation. Avoid the temptation to peel your skin on your own as it can lead to permanent scarring. 

Keep using the melan recovery cream for moisturization. From day seven start using the cosmelan 2 cream thrice a day (use only pea-sized amounts) followed by recovery cream. Do this for the next month. The package also comes with sunscreen. Use it during the daytime over your cosmelan 2 and recovery cream. After the first month, use the cosmelan 2 cream twice a day for the next 2 months. 

Cosmelan peels seem quite expensive. Are they worth the price tag, or would you first recommend a different treatment to someone who is trying to be cost-effective?

Dr. Mohta: Yes, in my experience they are worth the price. The results of the treatment can be significant and long-lasting, making it a worthwhile investment for some patients. For those who are looking for a less expensive option, there are other depigmentation treatments available. These include OTC chemical peels containing 10-30% AHA and 1-2% BHA. They may require more frequent treatments to achieve the desired results.

Do you have any success stories that involve cosmelan peels that you'd like to share?

Dr. Mohta: Yes, I do. One patient who had struggled with melasma for years came to me for treatment. After a series of cosmelan peels, her skin improved significantly, and she was very happy with the results. Another patient who had significant sun damage and hyperpigmentation saw a noticeable improvement in the texture and tone of her skin after just one cosmelan peel. These are just a few examples of the success stories I have seen with these peels.

Many thanks to Dr. Mohta for her willingness to answer these questions.

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