Qr8’s Founder, Dr Michele Squire, has done the research and is here to share her findings. What’s best for you and your skin – a Qr8 fading cream or a Cosmelan peel?

Choosing a depigmentation treatment that fits your skin’s needs and expectations can be a daunting task, especially when you have hormonal pigmentation (aka Melasma, read more about it HERE). Melasma is frustrating because it can be a chronic condition, with the pigment returning (sometimes even darker than before) after fading treatment is complete. So fading is only half the story – finding a solution that works long term is key to managing recurrent pigment.

We get SO many questions around the popular depigmenting treatment, Cosmelan, and how it compares to Qr8 fading treatment, we thought it would be useful to compare the benefits and drawbacks of each. Both of these treatments are excellent at fading pigment, and either one of them may be right for you, depending on your budget, timeframe, and appetite for downtime. Where they really differ is in terms of cost and maintenance of fading results, which we explain below.

1. Method of Action

Cosmelan is a chemical peel that removes surface pigmentation combined with an at-home pigment management cream. After a few weeks of skin preparation using special products at home, the peel is applied in a clinic and washed off at home after 8-12 hours. By 24 hours, you will start to experience the strong heat, peeling, swelling and redness you would expect from a chemical peel, with an approximate intense peeling stage of 7-14 days. You are also supplied with an aftercare pack, which includes a maintenance cream that is applied 2-3 times daily (morning, afternoon, evening) for 2-4 weeks, then once daily. The entire process is designed to work for 6 months, at which point strong pigment returns if you suffer from chronic melasma.

Qr8 is a prescription-only treatment cream. The Qr8 fading ingredients work on a cellular level to reduce the production of new pigment, speed up skin’s natural turnover to shed pigmented skin cells, and, as a bonus, also build collagen, and may even be able to target breakouts at the same time. You will see a Qr8 doctor in a secure video telehealth consult. If you are appropriate for prescription ingredients, the doctor will prescribe a dose and combination that is best for you. Your custom cream is made in a compounding pharmacy and delivered to you. You apply the cream daily alongside a simple skincare routine of cleanser, moisturizer and sunscreen. Qr8’s melasma treatment is designed as an ongoing melasma management program that can continue indefinitely to manage initial pigment fading, keep return of pigment minimal, and periodically fade any small amount of returned pigment.

2. Side Effects and Downtime

Cosmelan users typically experience a downtime of 7-14 days, although redness, sensitivity, itching and flaking may continue until full healing which can be around the 2 month mark. Makeup can’t be worn during the initial peeling stage.

During Qr8 treatment there isn’t an intense ‘downtime’ period. You will generally experience some level of increased dryness, sensitivity, redness and flaking or scaling that is far less dramatic than a peel but can make heavy makeup and fake tan look patchy. These side effects are not always present for every patient, and generally start to reduce with consistent and continued use of the Qr8 treatment, and the right supporting skincare. Our nurse works closely with you to help keep these side effects to an absolute minimum because increased inflammation can drive more pigment production in the skin (read more about that HERE).

Many people are concerned about a permanent side effect of hydroquinone use with the scary name of ‘exogenous ochronosis’. This is actually extraordinarily rare in practice and is not been reported when patients are under close medical and nursing supervision like we provide at Qr8.

Others are concerned that a side effect of hydrocortisone is ‘thin skin’, but there’s no need to worry when it’s used in combination with other ingredients for a short time period (read why HERE).

3. Time to Results

Cosmelan users can expect noticeable results within 2 weeks to 2 months, while Qr8 requires a bit more patience, with results typically becoming significant between 3-6 months.

4. Suitability During Pregnancy and Breastfeeding

Cosmelan can’t be performed during pregnancy or breastfeeding, while Qr8 can still be used (excluding hydroquinone, hydrocortisone and tretinoin, which are not prescribed during pregnancy or breastfeeding. See why, HERE).

5. Cost

Cosmelan’s cost varies between $1500-$3000 per treatment depending on location, number of initial peels required to fade pigment (it is often more than 1) and inclusions in the peel kit (this varies from clinic to clinic). Since the process is designed to only last 6 months, you may need a repeat peel at this time. Some people use Cosmelan to manage recurrent pigment, having a peel each 3-4 months.

Qr8 offers a more cost-effective approach. Qr8 treatment costs between $1100-$1900 per year, depending on whether 1 or 2 creams are prescribed each 3 months (80% of our patients only use 1 cream at night).

6. Ingredients

Cosmelan does not reveal it’s formulation, so the ingredients and their concentrations are unknown.

Qr8’s melasma fading cream is based on the triple combination (Kligman’s) formula of hydroquinone, tretinoin and hydrocortisone. This is considered the gold standard treatment for melasma in the scientific literature, with laser and peels down the list (read a journal paper about this HERE). We also have non-hydroquinone fading ingredients available in evidence-based concentrations, for use during pregnancy and breastfeeding, for those who don’t want to use hydroquinone, and for maintenance of fading results. These include azelaic acid 20%, kojic acid 4%, tranexamic acid 3%, niacinamide 5%. Tretinoin, the gold-standard anti-aging ingredient which can also target breakouts, can also be combined with these ingredients if safe to do so. When used correctly, azelaic acid can be as effective as hydroquinone (read more about the evidence for this HERE).

risk of post-inflammatory hyperpigmentation (PIH), which is why it’s important to seek professional advice before starting any treatment.

7. Additional Skincare Products

Both treatments require additional skincare products like a cleanser, moisturiser, and sunscreen. Cosmelan users may also need additional fading products, especially as pigmentation starts to return after 6 months.

No additional pigment fading products are required to manage pigment return with Qr8. You can see how we successfully manage pigmentation return over 2 years, HERE.

8. Maintenance

Cosmelan maintenance cream contains a single evidence-based fading ingredient: kojic acid (see the full ingredients list HERE). However, the concentration is undisclosed, so we are unsure of its potency. It also lists ascorbic acid, but the scientific evidence for this ingredient’s fading effects is poor (read more HERE).

Qr8’s maintenance treatment contains multiple fading ingredients, including kojic, tranexamic and azelaic acids, niacinamide, and tretinoin. These components are used in evidence-based concentrations, offering a comprehensive approach to maintenance of fading results.

As for anti-aging, Cosmelan uses retinyl palmitate, a form of cosmetic retinol that requires 2 conversion steps to be in a form that is usable by skin cells. Unfortunately, this makes it the weakest form of Vitamin A, and lacks scientific evidence supporting its anti-aging benefits (read more HERE). Retinyl palmitate is also light-sensitive, limiting its effectiveness during daytime application.

This is where Qr8 really shines! We can include the gold-standard anti-aging ingredient, tretinoin, which is also light-sensitive, but is used at night only.

So, what’s the verdict?

Both Cosmelan and Qr8 offer unique benefits and are both equally great at fading pigment. Cosmelan can be a faster but potentially more uncomfortable and expensive solution with greater downtime, while Qr8 provides a slower, gentler, and more comprehensive treatment for both fading and maintenance of results. For personalised advice about what is right for you, we recommend you consult with a Qr8 doctor before making a decision.