Will Tri-Luma lose its integrity if it reaches a certain temperature?

Refrigerated products should be kept at the suggested temperature. Our first line therapy for melasma includes Clear and Brilliant laser and Melarase creams in the Brightening Kit. Best, Dr. KaramanoukianLos Angeles

Refrigerated products lose effectiveness and potency when not properly refrigerated.Combination therapy with chemical peels, PRP, fractional laser, among others as well as a pretreatment regimen of a topical system using Melarase will help. 
ADD one of two of these oral supplements for pigmentary control: Scler-X PIH Relief Complex from VenaSmart or Pigmentation Correction Complex from KareSkin.
You will need wide spectrum UV protection with SPF 30+ sunblock as well. 
H Karamanoukian MD FACS

No, all good, just as long as its protected from UV. As you know, Triluma is only one of the pieces of the melasma puzzle. SPF, sun avoidance hats, etc.. play the most important role. Most specialist combine treatments to give a better outcome. Melasma is a very common cause of skin pigmentation. It 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. This forms the foundation of all treatments.

I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’)

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.