565 PROCEDURE GUIDE

Gentle Melasma Protocol — Step-by-Step Clinical Application Guide for Practitioners

Melasmonil Peel · 4-Agent Combo Peel Self-Neutralizing · 2–3 Hr Contact Fitzpatrick II–VI

Product Overview

prodermic® 565

Gentle Melasma Protocol · Melasmonil Peel

Type	4-Agent Combo Peel
Total Active	4-Agent Combo
Size	30ml jar
Yield	~24 sessions per jar
Fitzpatrick	II–VI
Peel Depth	Very Superficial

Active Composition

Glycolic

Lactic

Citric

Kojic

Mechanism of Action

Agent	Mechanism
Glycolic Acid	Gentle surface exfoliation at low concentration tolerable for reactive skin. Promotes cell turnover and enhances penetration of other actives.
Lactic Acid	Hydrating exfoliation that strengthens the skin barrier and supports ceramide synthesis. Ideal for sensitive and darker skin types.
Citric Acid	Antioxidant buffer and pH adjuster that prevents irritation. Provides additional brightening action through melanin pathway inhibition.
Kojic Acid	Steady tyrosinase inhibition that blocks pigment production with minimal irritation. Key depigmenting agent targeting melasma at the source.

Clinical Indications

Sensitive Melasma

Rosacea-prone

First-time Peels

Patient Selection & Pre-Procedure

Ideal Patient Profile

First-time peel patients who have never undergone chemical peeling before
Sensitive and reactive skin types that cannot tolerate aggressive peels
Rosacea-prone skin requiring a conservative approach to melasma treatment
Fitzpatrick V–VI patients needing a low-risk, gentle depigmenting protocol
Entry point for melasma treatment — escalation path: 565 → 580 for progressive results
Patients seeking gradual, controlled improvement with minimal downtime

Contraindications

DO NOT TREAT IF

Active skin infections in the treatment area
Compromised skin barrier (eczema, dermatitis flare)
Pregnancy (consult physician)
Oral isotretinoin use within the last 6 months
Topical tretinoin/retinoid use within 72 hours of session
Open wounds, cuts, or abrasions in the treatment area
Known allergy/sensitivity to glycolic acid, lactic acid, citric acid, kojic acid, or any of the active ingredients

Pre-Procedure Patient Preparation

Skin Assessment: Evaluate skin type, melasma severity, sensitivity level, rosacea presence, and prior peel history to determine suitability.
Sun Exposure: Advise patient to avoid direct sun exposure for at least 1 week prior. Melasma patients must already be on strict SPF 50+ routine.
Discontinue: Stop topical retinoids 72 hours before. Stop AHAs/BHAs 48 hours before.
Informed Consent: Discuss expected outcomes, downtime (1–3 days of mild flaking), self-neutralizing nature (patient washes off at home after 2–3 hours), and possible side effects.
Photography: Take standardized baseline photographs under consistent lighting. Document melasma patches with close-up images.

Step-by-Step Procedure

KEY: SELF-NEUTRALIZING GENTLE FORMULA

prodermic 565 is a self-neutralizing gentle peel specifically designed for sensitive skin. It is applied in-clinic and the patient leaves with the peel on. The peel self-neutralizes over 2–3 hours. The patient washes it off at home after the contact period. The gentle concentration means significantly less irritation risk compared to aggressive peels, making it ideal for rosacea-prone and reactive skin types.

Cleanse & Degrease

Cleanse the treatment area with a gentle, non-residue cleanser. Remove all makeup, sunscreen, and surface impurities. Then degrease the skin using a pre-peel degreasing solution (e.g., glycolic prep, acetone, or alcohol prep) applied with gauze or cotton pads. Wipe across the entire treatment area to ensure uniform acid penetration.

Degreasing contact: 1–2 minutes. Wipe clean. Allow skin to dry for 30 seconds before proceeding.

Patch Test (First Session Only)

For the patient's first session, perform a mandatory patch test. Apply a small amount of prodermic 565 to the post-auricular area (behind the ear). Wait 10 minutes and observe for signs of excessive irritation, burning, or allergic reaction.

If the patient shows no adverse reaction after 10 minutes, proceed with full application. If irritation occurs, do NOT proceed — remove product immediately. Given the gentle formulation, adverse patch test reactions are uncommon but must still be checked.

Apply prodermic 565

Using a fan brush, apply a thin, even layer of prodermic 565 across the entire treatment area. This is a gentle peel specifically designed for sensitive skin — the lower concentration ensures tolerability even for reactive and rosacea-prone patients. Work systematically:

Forehead: Apply in horizontal strokes from center outward
Cheeks: Apply from the nose outward toward the ears — focus on melasma patches
Nose: Light application across the bridge and sides
Chin: Apply in upward strokes
Upper lip: Light, thin application (sensitive area, common melasma site)

Use approximately 1–1.25ml of product per full-face application. Avoid the periorbital area (around eyes), lips, and nostrils. Apply slightly more product over visible melasma patches for targeted treatment.

Observe Initial Response (3–5 Minutes)

After application, observe the patient in-clinic for 3–5 minutes to ensure no adverse immediate reactions. Mild warmth is expected. Sensitivity should be significantly less than with aggressive peels due to the gentle formulation.

Mild warmth: Normal — this is the expected initial response for a gentle peel
Slight tingling: Normal and should subside quickly as the peel begins self-neutralizing
Moderate stinging or burning: Unusual for this gentle formulation — monitor closely and consider removal if it persists

Once you confirm tolerance, the patient is ready for discharge with at-home instructions. Observation time is shorter than aggressive peels because 565 is formulated for sensitive skin.

Discharge with At-Home Instructions

Once the initial observation is complete and the patient shows no adverse reaction:

Leave the peel on: The patient leaves with the peel on their face
Contact time: Instruct the patient to leave it on for 2–3 hours (as per progressive protocol)
Wash off at home: After the prescribed contact time, rinse thoroughly with lukewarm water until all residue is removed
Apply a soothing recovery moisturizer immediately after washing
No other actives or makeup for the rest of the day

Provide the patient with written or WhatsApp post-care instructions before they leave. Schedule next session in 10–14 days.

Post-Peel Soothing (At Home)

After washing off the peel at home:

Pat skin dry gently — do not rub
Apply a thick, bland recovery moisturizer or balm generously
Do not apply any actives, serums, or makeup until the next morning
Sleep on a clean pillowcase

Mild redness post-wash is normal and should subside within a few hours. Redness will be less intense than with aggressive peels — reassure the patient that this gentle formulation is designed to minimise post-procedure irritation.

Early Removal & Adverse Reactions

INSTRUCT PATIENT TO WASH OFF IMMEDIATELY IF

Burning or pain that does not subside or is escalating
Excessive redness or swelling beyond mild warmth
Hives, welts, or allergic reaction signs
Blistering or skin breakdown
Inability to tolerate the sensation

Emergency Removal Steps (At Home)

Rinse the treatment area thoroughly with cold water until all product is removed
Continue rinsing until all tingling/burning completely stops
Apply a thick, bland moisturizer (no actives)
Apply a cold compress for comfort if needed
Contact the clinic immediately to report the reaction
Document the reaction — reduce contact time for the next session

PATIENT COMMUNICATION

Ensure the patient has the clinic's WhatsApp/phone number before leaving
Advise them to send a photo if they notice anything unusual
Mild warmth is normal — reassure the patient that this is one of the gentlest peels available
If in doubt, instruct them to wash it off early — better safe than sorry

Post-Procedure Care Instructions

Provide these instructions to the patient (verbal + printed/WhatsApp):

Day 0 (Day of Procedure)

Leave the peel on for 2–3 hours as instructed
Wash off thoroughly with lukewarm water
Apply recovery moisturizer immediately after
No other actives, no makeup for the rest of the day
Sleep on a clean pillowcase

Day 1 (Tightness Phase)

Skin may feel slightly tight — this is expected and mild compared to aggressive peels
Cleanse with a gentle, soap-free cleanser twice daily
Apply a thick, bland moisturizer or recovery balm 3–4 times daily
Apply SPF 50+ broad-spectrum sunscreen every 2–3 hours if going outdoors
Avoid direct sun exposure, saunas, steam rooms, strenuous exercise
Do NOT pick, pull, or scrub — even if skin feels rough

Days 1–2 (Mild Flaking Phase)

Very mild flaking may occur — this is normal for a gentle peel
Some patients may not peel visibly at all — this is also normal and does not mean the peel is not working
Do NOT pick, pull, or force peeling skin off — let it shed naturally
Continue moisturizer 3–4 times daily + SPF 50+

Day 3+ (Recovery)

Skin should feel smoother and brighter
Continue moisturizer + SPF 50+
May resume light makeup once any flaking is complete
Continue avoiding harsh actives (retinoids, AHAs, BHAs) until Day 5

Days 5–14 (Between Sessions)

Maintain strict sun protection (SPF 50+, physical avoidance) — critical for melasma patients
Can resume normal skincare routine
Consider prescribing depigmenting serums between sessions for continued melasma suppression

Expected Peeling Timeline

Day 0

Application

Applied in-clinic, wash off at home after 2–3 hrs

Day 1

Mild Tightness

Skin feels slightly tight

Day 1–2

Mild Flaking

Very mild flaking — may not peel visibly

Day 3

Smoother Skin

Skin feels smoother, brighter

Day 10–14

Next Session

Repeat protocol

Treatment Program

Parameter	Recommendation
Total Sessions	6–8 sessions (assess at session 3)
Session Interval	10–14 days between sessions
Contact Time	2–3 hours (self-neutralizing, washed off at home)
Downtime	1–3 days mild flaking per session
Full Program Duration	2–3 months (6–8 sessions at 10–14 day intervals)
Product per Session	Approximately 1–1.25ml (full face)
Yield per Jar	~24 full-face sessions from one 30ml jar
Maintenance	1 session every 4–6 weeks after initial program, or as needed

Progressive Protocol Guide

Adjust contact time progressively across sessions based on patient tolerance. Start conservatively — especially important for sensitive skin:

Session	Contact Time	Notes
Session 1	1.5 hours	Conservative first exposure for sensitive skin. Assess skin response and tolerance the next day.
Session 2	2 hours	Increase if Session 1 was well tolerated with no adverse effects.
Session 3	2–2.5 hours	Continue increasing if good tolerance. Assess clinical results so far — evaluate melasma response.
Session 4+	2.5–3 hours	Maximum contact time. Do not exceed 3 hours.

Expected Outcomes

After Session 1–2: Mild brightening and reduced skin sensitivity. Skin begins to tolerate the peel well, building confidence for progressive treatment.
After Session 3–4: Visible improvement in melasma patches, more even skin tone, and noticeable brightening effect. Pigmentation begins to lighten.
After Session 6–8: Significant melasma fading, clearer complexion, and more uniform skin tone. Patient may be ready to escalate to prodermic 580 if further improvement is desired.

Set realistic expectations: The 565 is a gentle, conservative protocol. Results are gradual and cumulative — melasma responds best to consistent, low-aggression treatment over multiple sessions. Patients who tolerate 565 well may be escalated to prodermic 580 for more intensive depigmentation.

Full Ingredient List

Glycolic Acid, Lactic Acid, Citric Acid, Kojic Acid, Liquorice Extract, Tea Tree Extract