Tri Luma Usage Making Melasma Darker?

In my practice, I try to stay away from these combination regimens, as cortisones are non-selective inhibitors of melanocytes.  I would recommend my patients to start Melarase AM and Melarase PM for the pigmentation.
I would start with an intense skin rejuvenation protocol for age spots that includes fractional laser, Covalent chemical peels, and daily skin brightening creams to improve your skin’s complexion. Laser therapy, he adds, must be combined with a proper skin regimen to enhance and maintain youthful results.
He recommends the following skincare products for dark age spots: Melarase
MelaClenz Brightening CleanserMelarase AM: Day-time skin lightener with SPF 30Melarase PM: Night-time skin lightenerMelapads: Daily Exfoliating PadsReplenish Retinoid Cream: Exfoliating and skin-stimulating night creamBest, 
Dr. Karamanoukian
Realself100 Surgeon

I suggest a formal consultation if you feel skin care is worsening your skin you may need alternative treatments.  Best, Dr. Emer.

If TriLuma is making your skn darker and more sensitive, use a gentler product like Melarase (see below).Daily good habits with topicals may well help you chieve your goals with a good skin system like the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 
Melarase AM is non hydroquinone based and allowed for use in the EU and UK.
Best

H Karamanoukian MD FACS

Thank you for your question texasbling. Melasma is a common condition characterized by dark patches on the skin. TriLuma is a great product to treat melisma. It contains hydroquinone, retinoic acid, and a steroid. Pigment from melasma can be in different layers of the skin. When it is in the surface layers it appears darker and when it is in the deeper layers it appears lighter. TriLuma and similar products can bring the pigment to the surface, making it appear darker. There can also be some irritation with use of these products. When my patients have irritation form such products I recommend backing off and using them less frequently and using less of it. The skin will slowly adjust and most patients will gradually be able to use it every day. Other options such as kojic acid, alpha-arbutin, and vitamin C are alternatives for those intolerant to hydroquinone. Please contact your doctor for specific recommendations. Good luck!

Stop this for a few days, the ingredients of HQ and vitamin A can irritate your skin. See your specialist for suggestions, including dilution of Triluma with bland emollient, short course of topical CS, or addition of other lasers and devices. See video to guide you. Dr Davin Lim. Brisbane. Australia.