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A Comprehensive Review of the Long-Term and Short-Term Treatment of Melasma with a Triple Combination Cream

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Abstract

Melasma is a common disorder of hyperpigmentation and generally involves areas of the face and neck. Hyperpigmentation is especially prevalent in darker complected patients and is often difficult to treat. Hydroquinone, tretinoin, and topical corticosteroids are well established monotherapeutic agents for treating melasma and hyperpigmentation; however, a stable, once-daily formulation triple combination cream containing 0.05% tretinoin, 4.0% hydroquinone, and 0.01% fluocinolone acetonide (Tri-Luma®) represents the only commercially available combination of all three agents. This product is approved by the US FDA for the treatment of facial melasma. A number of publications have described the safety and efficacy of triple combination cream in over 2000 patients with melasma, some of whom were treated for >12 months.

In the initial 8-week study, 29% of patients experienced complete clearing of melasma by week 8, and 77% were clear or almost clear by week 8. Similarly, good results were seen in the two long-term studies, with the clear/mild rate ranging from 78% to 84% of patients at month 6 and from 81% to 94% of patients at month 12. Adverse events were almost always mild in severity and typically occurred only at the application site. The primary concern for most physicians using corticosteroid-containing products on the face is skin atrophy. However, only two cases of skin atrophy were reported across the three published studies.

Overall, the results of these extensive studies indicate that triple combination cream is efficacious in treating melasma and exhibits a safe profile with low potential for adverse events.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgments

The author has acted as a consultant for Galderma Laboratories LP, Intendis, Coria, and Barrier Therapeutics; as a speaker for Galderma Laboratories LP, Allergan, Novartis, Amgen, and Genentech; and as an investigator for Collagenex, Medicis, Stiefel, and Dermik. No sources of funding were used to assist in the preparation of this review.

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Correspondence to Helen M. Torok.

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Torok, H.M. A Comprehensive Review of the Long-Term and Short-Term Treatment of Melasma with a Triple Combination Cream. Am J Clin Dermatol 7, 223–230 (2006). https://doi.org/10.2165/00128071-200607040-00003

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