Melasma Treatment at Brisa: Cosmelan and Dermamelan Explained
Melasma is one of those skin conditions that seems to laugh at everything else you've tried. Serums, spot treatments, even the "miracle" cream your friend swore by — and the patches are still there, especially after a weekend in the sun. That's because melasma isn't surface-level pigmentation. It runs deeper, and it needs a medical-grade approach to actually shift.
That's where Cosmelan and Dermamelan come in — two of the most established depigmentation protocols in aesthetic medicine, and both available at Brisa. They're related treatments from the same family, but they're not interchangeable — which one your skin needs depends on how deep and how stubborn your melasma actually is.
First: What's the Difference?
Cosmelan and Dermamelan come from the same family of treatment and work on the same principle: a professional-strength mask applied in-clinic, followed by months of home-care maintenance that does most of the real work.
The difference is strength. Dermamelan is roughly 20–30% more concentrated than Cosmelan, which is why it's reserved strictly for medical administration — you won't find it offered outside a physician's care. Cosmelan is comparatively gentler and better tolerated by sensitive skin.
Simple version: Cosmelan treats lighter, more recent pigmentation. Dermamelan is built for deep, stubborn, or hormonal melasma.
When Does Cosmelan Work Best?
Cosmelan is best suited for mild to moderate pigmentation — sun spots, early-stage melasma, and general unevenness that hasn't fully set in.
Cosmelan works well for:
Sun spots and early hyperpigmentation
First-time melasma that hasn't become deeply entrenched
Patients with more reactive or sensitive skin
Those who want noticeable improvement with a gentler initial reaction
The at-home maintenance phase runs about six months, and most patients experience less redness and peeling in the first days after application.
When Does Dermamelan Work Best?
Dermamelan is the stronger protocol, designed for melasma that's deep, recurring, or resistant to other treatments — including the hormonal melasma that often appears during or after pregnancy or with long-term hormonal contraceptive use.
Dermamelan works well for:
Severe or long-standing melasma
Hormonally driven pigmentation that keeps coming back
Cases where previous treatments haven't produced lasting results
Patients prepared for a more intensive initial reaction (redness, peeling) in exchange for stronger results
The intensive phase typically runs about four months, though outcomes depend heavily on strict adherence to sun protection and home care.
Why Both Are Performed by a Physician at Brisa
Cosmelan is sometimes offered in spas under esthetician supervision. Dermamelan, because of its strength, is not — it's used exclusively under medical administration everywhere it's offered.
At Brisa, we don't split the difference. Both Cosmelan and Dermamelan are applied personally by Dra. Sheena Nandwani, our aesthetic medicine physician. That means a proper diagnosis of your pigmentation type and depth before we ever recommend a protocol, a home-care plan built around your actual skin, and hands-on management if your skin reacts more than expected. Melasma is a medical condition — we treat it like one.
How Do I Know Which Protocol My Skin Needs?
Melasma can look the same on the surface and behave very differently underneath — which is why guessing rarely goes well. What looks like a stubborn case might respond fully to Cosmelan. What looks mild might actually need Dermamelan's strength to fully clear.
At Brisa, your consultation with Dra. Sheena Nandwani includes a real assessment of your pigmentation, your skin history, and your goals — not a one-size-fits-all recommendation.
Quick Reference: Cosmelan vs. Dermamelan
Treatment | Ideal for | Strength | Duration | Who administers it |
|---|---|---|---|---|
Cosmelan | Mild to moderate pigmentation, early melasma | Standard | ~6 months | Certified professional (at Brisa: physician) |
Dermamelan | Moderate to severe, hormonal, or resistant melasma | 20–30% stronger | ~4 months | Physician only |
Ready to Take the Next Step?
Book your melasma consultation at Brisa Wellness Center in Plaza Itskatzú, Escazú. Dra. Sheena Nandwani will evaluate your pigmentation and help you understand which protocol is the right fit for your skin.
📍 Plaza Itskatzú, Escazú, San José · 📞 +506 6231 2222 · 🌐 brisawellnesscenter.com · 📱 @BrisaWellnessCenter