Join Our 2nd Annual Art, Science & Beauty Event on October 24!

Details & RSVP Here
Contact
Give Dr. Anu Antony a phone call at (919) 296-0256

A Science-Driven Approach to Stubborn Pigmentation

Pigmentation is one of the most common reasons patients visit the Antony Institute of Aesthetic and Plastic Surgery. Many have already tried brightening creams, facials, or lasers with little lasting change. Dr. Antony starts by identifying what kind of pigmentation you have, because melasma, sun spots, and post-acne marks each respond differently.

Dr. Antony's background in both chemistry and plastic surgery shapes how she treats the skin. She is the founder of Anu Science of Beauty, her own medical-grade skincare line. That expertise helps her build treatment plans that fade existing pigment and help keep it from coming back. 

What Is Melasma?

Melasma is a common skin condition that causes brown or gray-brown patches, most often on the face. According to Cleveland Clinic, it typically appears on the cheeks, forehead, nose, upper lip, and jawline. Melasma is not harmful, but it can affect confidence and is known for coming back.

Several factors can trigger or worsen melasma. The American Academy of Dermatology names sunlight, birth control pills, and even stress as common triggers. Pregnancy and other hormonal changes also play a role, which is why melasma is sometimes called "the mask of pregnancy."

Melasma can sit in the top layer of skin, the deeper layer, or both. The deeper the pigment, the more patience and layered treatment it usually takes. Dr. Antony evaluates your skin closely to understand how deep your pigmentation goes before recommending a plan.

Background media

Types of Hyperpigmentation We Treat

Hyperpigmentation is a broad term for any area of skin that is darker than your natural tone. Dr. Antony treats several types, including:

  • Melasma, symmetrical patches linked to hormones and sun exposure
  • Post-inflammatory hyperpigmentation (PIH), dark marks left behind after acne, rashes, or skin injury
  • Sun spots and age spots, flat brown spots caused by years of UV exposure
  • Uneven skin tone, overall dullness or blotchiness across the face

Each type has a different cause, so an accurate diagnosis comes first. Treating melasma the same way as sun spots can sometimes make it worse.

Cosmelan and Dermamelan Depigmentation Treatments

Cosmelan and Dermamelan are professional depigmentation treatments from mesoestetic, a skincare company based in Spain. Both combine a single in-office mask with a structured at-home cream routine. According to mesoestetic, the method treats melasma, post-inflammatory hyperpigmentation, sun spots, and freckles. The two treatments share the same core approach. Dermamelan is the medical-line version, administered under physician supervision. Dr. Antony recommends the option that best fits your pigmentation type, skin sensitivity, and goals.

How Cosmelan and Dermamelan Work

These treatments do more than exfoliate the surface. A standard chemical peel can fade dark spots, but the spots may return if the skin keeps overproducing pigment. Cosmelan and Dermamelan both fade existing pigment and help regulate how much new pigment the skin makes.

The process follows two main phases:

  • In-office mask. Your provider applies a depigmenting mask to cleansed skin. You wear it home and wash it off several hours later, as directed. 
  • At-home maintenance. You apply a depigmenting cream on a set schedule for several months. The routine gradually tapers as your skin tone evens out.

In a 2025 study published in the International Journal of Aesthetic Plastic Surgery, 34 melasma patients received a Cosmelan or Dermamelan peel as part of a multimodal plan. Melasma severity scores dropped significantly at six months, and 82% of patients were satisfied with their results. The study was small, and results vary from person to person.

Benefits of Cosmelan and Dermamelan

Patients choose these treatments for several reasons:

  • Treats the cause and the spots, fading pigment while helping control new pigment production
  • Just one in-office session, followed by an easy at-home routine
  • No lasers or needles for the main treatment
  • Suited to many skin tones when planned and supervised carefully
  • Gradual, natural-looking results that build over several weeks
Background media

Treating Pigmentation Safely in All Skin Tones

Melasma is especially common in medium and deeper skin tones. Research notes that it most often affects women with Fitzpatrick skin types III through V, which covers many medium to deep skin tones. Yet these same skin tones are also more likely to darken after an overly aggressive treatment.

That is why careful planning matters. Treatments that create too much heat or inflammation, such as some lasers and deep peels, can trigger new post-inflammatory hyperpigmentation. Dr. Antony selects gentler, pigment-regulating options and adjusts timing and strength to your skin.

Her approach for richer skin tones includes:

  • Accurate diagnosis first, so treatment targets the right type and depth of pigment
  • Pigment-regulating treatments like Cosmelan or Dermamelan over heat-heavy procedures
  • Customized strength and timing, adjusted to your skin's sensitivity
  • Close follow-up to catch irritation early and adjust the plan

Other Hyperpigmentation Treatments at the Antony Institute

Cosmelan and Dermamelan are not the only options. Depending on your skin, Dr. Antony may recommend another treatment on its own or as part of a combined plan:

  • Chemical peels: Options such as the pigment balancing peel and the Enlighten Peel by ReveSkin brighten skin and fade surface spots.
  • RF microneedling: Improves texture and tone and may help address deeper pigment when paired with brightening serums.
  • Medical-grade facials: Support maintenance between treatments.
  • Medical-grade skincare: Daily brightening products, including options from Anu Science of Beauty, help maintain results. 

No matter which treatment you choose, sun protection is essential. The AAD recommends broad-spectrum sunscreen with SPF 30 or higher, shade, and a wide-brimmed hat to keep melasma from darkening.

Banner media

Are You a Candidate for Melasma Treatment?

Most adults with melasma or hyperpigmentation can benefit from professional treatment. Dr. Antony confirms the best option during your consultation. You may be a good candidate if you:

  • Have melasma, sun spots, or dark marks from past acne or irritation
  • Have tried over-the-counter products without lasting results
  • Are not currently pregnant or breastfeeding
  • Can commit to daily sunscreen and an at-home skincare routine
  • Want gradual, natural-looking improvement rather than a quick fix

If you are pregnant or nursing, Dr. Antony can suggest safe ways to manage pigmentation until you are ready for treatment.

Background media

Why Choose Dr. Antony for Hyperpigmentation Treatment in Cary?

Pigmentation treatment works best when it is guided by a physician who understands skin at a scientific level. Dr. Anu Antony offers:

  • More than 20 years of experience as a Harvard- and Stanford-trained plastic surgeon
  • Board certification from the American Board of Plastic Surgery and Fellowship in the American College of Surgeons
  • A master's in public health from Harvard, with a focus on clinical outcomes and evidence-based care
  • Chemistry and skincare expertise as the founder of Anu Science of Beauty
  • An artist's eye, refined through fine arts training in Florence, for natural, even-toned results

Dr. Antony and her team welcome patients from Cary, Raleigh, and across the Triangle. Her physician-led approach means your plan is based on a careful diagnosis, not a one-size-fits-all package.

What to Expect With Cosmelan and Dermamelan Treatment

Consultation and Cost

  • Dr. Antony examines your skin and identifies your pigmentation type and depth.
  • She reviews your triggers, medications, and past treatments.
  • She recommends Cosmelan, Dermamelan, or another option, and may prepare your skin beforehand.
  • Your quote includes the in-office mask and your at-home products. Our team can review financing options.

Treatment Day

  • Your skin is cleansed and prepped.
  • The depigmenting mask is applied in the office, which takes less than an hour. 
  • You go home wearing the mask and remove it at the time you are given.

Recovery and Results Timeline

  • Redness, dryness, and peeling are common for the first one to two weeks. Many patients return to work within a few days. 
  • Pigment begins to visibly fade over the first several weeks.
  • You continue the at-home cream on a tapering schedule for several months.
  • Dr. Antony schedules follow-ups to track your progress and adjust your plan.
Background media

Melasma & Hyperpigmentation FAQs

Can melasma be cured permanently?

How many Cosmelan or Dermamelan treatments will I need?

Is Cosmelan safe for darker skin?

What are the side effects of Cosmelan?

When is the best time of year for pigmentation treatment?

Is melasma treatment covered by insurance?

Can melasma be cured permanently?

Melasma can be greatly improved, but it is a chronic condition that can return. Sun exposure, heat, and hormonal changes are the most common reasons it comes back. Daily sun protection and a maintenance routine help keep results lasting longer.

How many Cosmelan or Dermamelan treatments will I need?

Most patients need just one in-office mask, followed by several months of at-home care. Some patients with deeper or stubborn pigment benefit from added treatments later. Dr. Antony will set expectations based on your skin.

Is Cosmelan safe for darker skin?

Yes, Cosmelan and Dermamelan are suitable for many skin tones when planned and supervised by an experienced provider. Dr. Antony adjusts each plan to your skin type to lower the risk of irritation or new dark spots.

What are the side effects of Cosmelan?

Cosmelan is well tolerated by most patients. Temporary redness, dryness, tightness, and peeling are common in the first couple of weeks. Following your aftercare instructions and wearing sunscreen helps your skin heal comfortably. Dr. Antony and her team are available to answer questions throughout your recovery.

When is the best time of year for pigmentation treatment?

According to mesoestetic, the treatment can be done any time of year with careful sun protection. Some patients opt for fall and winter because sun exposure is lower.

Is melasma treatment covered by insurance?

Melasma treatment is usually not covered. The AAD notes that most insurers do not consider it medically necessary. Our team can walk you through pricing and financing.

Schedule Your Melasma Treatment Consultation in Raleigh & Cary

If stubborn dark patches have been holding you back, Dr. Anu Antony can help. She offers Cosmelan and Dermamelan in Raleigh and Cary, along with a full range of personalized pigmentation treatments. Schedule your consultation at the Antony Institute today.

This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.

Sources

Schedule a Consultation

This field is required.
This field is required.
This field is required.
This field is required.
This field is required.
This field is required.
This field is required.
Submit Contact Form

Privacy Policy Terms & Conditions

Background media
Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at (919) 296-0256.
Contact Us