When I'm done using Tri-luma will my melasma return?

Thank you for your question.  I would suggest doing a fractional treatment for melasma.  Apply hydroquinone morning and evening two weeks prior to your treatment.  The fractional treatment would help to suppress the discoloration and improve texture of your skin along with shrinking your pores.  

Melasma is associated with hyperpigmentation caused by a combination of hormones, sun exposure, inflammation, and deposition of melanin pigment. In our office, we specialize in melasma treatments and start with Melapads, Melarase AM, Melarase PM, and Replenish; followed by pulsed dye laser to eliminate inflammatory erythema and light fractional laser.

Best,

Dr. Karamanoukian

Realself100 Surgeon

Hello, It is wonderful news that you have responded so quickly to the Triluma treatment. Melasma is a chronic disease so prevention is so important once you discontinue the Triluma in another month.As your dermatologist has already suggested, wear a hat whenever outdoors, and wear a sunscreen daily. I am now recommending sunscreens with at least an SPF of 50 and which also has Infrared protection. A great sunscreen is Skin Medical SPF 50, Total Defense and Repair which can protect you from IR and to some extent, visible ligt that can also trigger melasma. I would also encourage you to use a retinol every evening and Lytera 2.0 2 x per day. Best of luck.

Melasma is a chronic skin condition that never goes away completely but it can be controlled. Triluma will definitely help but the problem is exposure to sunlight will trigger the process and cause the melasma to return. You can't use the Triluma indefinitely. It contains a steroid which can damage the skin if used too long. I would focus on using sunscreen every two to three hours when you are out and about and try to avoid the sun as much as possible.   You can use plant based lightening products like kojic acid for a prolonged period of time alternating with and or in conjunction with Vitamin A.

Picosure is the best, state of the art, laser for Melasma and irregular pigmentation with no downtime. you should plan on 3 treatments, each done a month apart.david berman md

Most likely it will return, and hence most of us will have a melasma prevention program, using lower strength HQ or rotating it with Lytera. Melasma can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours.
I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I usually start my patients on laser (low dose Q switch or Picosure) a few weeks after they commence on creams. Another laser I use is the Clear and Brilliant in the Permea setting combined with creams.

In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient.

All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia