Using Triluma with Epilite lotion. If I use Epilite in artificial light it will be worse?

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

Thank you for your question about Melasma and Triluma.   It is important to remember that there is no complete cure for Melasma, only improvement.  I know you say you have only been using Triluma for one month, but it may be that what you have described is still a side effect of the treatment.  
Triluma is a strong medicine and should only be used for a maximum of 3 months consecutively.  After that you should stop for at least 3 months before recommencing use.  
It is very important when you are using Triluma, to make sure you wear sunscreen daily.  If you are inside working with computers you should still wear sunscreen as the computers will emit radiation.  In my own experience the best way to treat Melasma are specific types of lasers and lights (such as SRA+) in combination with skin peels, but it is important to first understand what type of Melasma you have.  

Looks like Triluma is working, however you do need to be under the supervision of a dermatologist. I usually add low dose laser therapy as it can be more effective in combination with Triluma. 
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