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Why Cosmelan Is Still My Go-To for Treating Melasma

At VIDASKIN, melasma is one of the most common skin concerns patients consult me for. Understandably, many patients walk in expecting to treat it with a laser right away — it’s fast, high-tech, and feels like the obvious solution. However, when it comes to melasma, things are rarely that straightforward.

The truth is: melasma is a chronic, complex condition. It cannot be “cured” per se, but with the right treatments and consistent care, it can be very effectively controlled. In fact, many of my patients go on to enjoy clearer, brighter skin for years — as long as we follow a personalised treatment plan that addresses the root causes of melasma.

Understanding Melasma: More Than Just Pigmentation

A close-up of a person's cheek showing melasma, with dark brown patches of pigmentation on the skin. The image highlights uneven skin tone and hyperpigmentation concerns.

Melasma is a form of hyperpigmentation that appears as blotchy, brown patches — typically on the cheeks, forehead, upper lip, and chin. While it may look like superficial pigmentation on the surface, melasma is far more complex beneath the skin.

Melasma is now recognised as a multifactorial condition. While melanin overproduction plays a central role, recent studies show that other key factors contribute to its persistence and recurrence:

  • Vascular involvement: Increased blood vessel formation in melasma-affected skin contributes to inflammation and pigmentation.
  • Hormonal fluctuations: Pregnancy, birth control, and hormone therapy are well-known triggers.
  • Inflammation and oxidative stress: Chronic low-grade inflammation leads to persistent stimulation of melanocytes.
  • UV and visible light exposure: Even low levels of light, including from screens and indoor lighting, can trigger melasma in susceptible individuals.
  • Genetics and skin barrier dysfunction also play a role in making some skin types more prone to recurrence.

Because of its underlying complexity, melasma requires a nuanced, layered approach — and not just one single treatment.

What the Guidelines Say: Lasers Are Not First-Line Treatment

Despite popular belief, lasers are not the gold standard for melasma treatment — and they are certainly not the first-line option. In fact, most dermatological guidelines (including those from the American Academy of Dermatology) clearly recommend topical depigmenting agents as the cornerstone of melasma therapy.

While lasers can have a role later in the treatment plan, using them too early — especially without proper pigment suppression — can actually worsen melasma. This is due to the risk of rebound pigmentation and inflammation, which may further stimulate melanocytes.

Why Cosmelan Remains My First-Line Treatment

Cosmelan is a professional-grade depigmentation system that has consistently delivered excellent results for my patients with melasma. It is designed to not only reduce existing pigmentation, but also regulate melanin production at a deeper level — helping to prevent recurrence.

Here’s why Cosmelan continues to be my go-to:

  • Multifaceted action: Cosmelan acts on multiple steps in the melanin production pathway, unlike single-agent treatments like hydroquinone.
  • Medical strength: As a professional system, it delivers higher potency than over-the-counter skincare, and is performed under medical supervision.
  • Safe for long-term use: The maintenance phase of Cosmelan helps to keep pigmentation under control, without long-term skin thinning or irritation.
  • Well-tolerated across skin types: Cosmelan has been shown to work effectively in Asian and darker skin types, which are more prone to post-inflammatory hyperpigmentation from lasers.

With proper pre- and post-treatment care, most of my patients experience significant brightening, smoother skin texture, and a noticeable improvement in their melasma within weeks.

Supporting Your Skin Beyond Treatment: Lifestyle Matters Too

Walking young adult southeast asian woman traveller wear blue hat and backpack. People traveling in city lifestyle at outdoor with sunlight. Staycation summer trip concept.

Controlling melasma requires more than just in-clinic treatments. Preventive lifestyle strategies are just as important to help prolong your results and reduce the risk of recurrence:

  • Daily sun protection: Broad-spectrum SPF 50, re-applied every 2–3 hours. Don’t forget hats and physical barriers.
  • Avoiding heat exposure: Heat — even from cooking or hot yoga — can stimulate pigmentation.
  • Reducing inflammation: Gentle skincare, antioxidants, and barrier-repairing products help support skin health.
  • Hormonal balance: If melasma is hormone-related, coordinating with your GP or gynaecologist may be part of the plan.
  • Avoiding unnecessary laser or peels during flare-ups, as these can worsen pigmentation.

The Role of Lasers: As An Adjunct, Not a Primary Tool

Laser removal of permanent make-up on face eyelashes of young woman in salon. Concept rejuvenation procedure skin care.

While not first-line, lasers still have a place in treating melasma — but they must be used judiciously and strategically. At VIDASKIN, we may introduce gentle pigment-suppressing lasers or vascular lasers once the pigmentation is under control with topical therapy.

Used this way, lasers can help:

  • Suppress deeper melanin production
  • Improve skin tone and texture
  • Target underlying vascularity
  • Reduce recurrence when used in maintenance

Every laser session is carefully calibrated to your skin type and current melasma condition, to ensure safety and optimal results.

Final Thoughts

Melasma can be a challenging condition — but it’s also one of the most rewarding to treat when the right approach is taken. At VIDASKIN, we believe in empowering our patients with clear, evidence-based solutions. Cosmelan continues to be a cornerstone in our melasma treatment protocol because it offers reliable, long-term results — and when paired with the right lifestyle adjustments and in-clinic care, it truly transforms skin.

If you’re struggling with melasma, we’d love to help you find a personalised, sustainable solution. Book a consultation with us today to get started.

Dr Vicki Leong

  • author
Founded in 2015, Dr Vicki has grown with the clinic, to become one of the leading aesthetic clinicians in Singapore. She is an appointed key opinion leader and trains other aesthetic doctors on how to best use prestigious brands and treatments.
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