Melasma Therapy Options
A prescription combination cream, Tri-Luma manufactured by Galderma, is the FDA approved. Dermatologists have long referred to the trio as Kligman’s Formula. (Dr. Kligman has used the formula of of mixing tretinoin, hydroquinone and a steroid for melasma therapy). Tri-Luma contains the active trio of 0.5% tretinoin (the active agent in Retin A), 4% hydroquinone and a potent topical steroid, fluocinolone acetonide 0.01%.
A one-time application bedtime cream, Tri-Luma is a kick-start to melasma management. It is applied every night for no more than 8 weeks. The reason for this is the presence of the high potency topical steroid which if used for a longer period of time may result in skin atrophy. The manufacturer has performed studies showing the product is safe andconsiderably effective.
Tri-Luma is quite new and anecdotal reports are circulating about dermatologists placing patients on all types of on-again, off again regimens to eradicate the melasma while trying to avoid thinning of the skin.
Anything new in the treatment of melasma is always welcome, but it is very important to understand this is NOT a product to receive from your doctor and go off and use on your own for long periods of time particularly unsupervised. If you find you develop spider veins, thin skin, loss of skin color and even stretch marks as side effects to abuse of Tri-Luma, you will be even unhappier than the discoloration you set out to treat.
If you aren’t participating in a supervised on again, off again routine, and still call for further treatment, some non-steroid based method of bleaching needs to be continued after stopping Tri-Luma. Either switching to one of the other combination products to finish up the job or adding some super separates such as Retin A or Tazorac (they will help your skin rejuvenation and any acne, too), perhaps some Azelex (the acne med that helps with reducing unwanted skin discoloration) and of course a good primary bleaching ingredient can help complete the process.