What's the Best Way to Maintain Results After Using TRILUMA?

Question

I heard on the Triluma website that many patients' melamsa came back after they stopped usage. I want to counteract that when I am done with the 8 week trial of Triluma usage. If it helps, I have Black skin.

Otto Joseph Placik, MD · Answer

The best way to maintain the results after Triluma are probably avoidance of sun exposure and hormonal medications if they were associated with contributing to the original condition (Melasma or Chloasma).

Raffy Karamanoukian, MD, FACS · Answer

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

Mary P. Lupo, MD · Answer

It is very important to continue on a program once your melasma is better.

	Daily SPF and antioxidants in the morning and some type of retinoid and bleaching product at night will be  needed for an extended period of time. There are other things you can try like Lustra, Epiquin, Blanche, Hydro Q, etc, so speak to your dermatologist to keep you looking brighter! PS: you can use Triluma longer than 8 weeks too.

Arnold R. Oppenheim, MD (retired) · Answer

Triluma has a steroid ( fluocinolone acetonide) in its formula ( hydroquinone, and tretinoin...retin a being the other two ingredients). Since steroids can ultimately thin the skin, it is advised that Triluma usage be limited to two months. 

	  At that point most dermatologists switch their patients to a pure hydroquinone such as Aclero, Epiquin, Claripel ( this has a sunscreen in it) etc. I would recommend continuing the benefits of the Tretinoin part of the Triluma by using Retin A ( or Refissa, Atralin or generic) at night with your hydroquinone. The next morning be sure to use a sunscreen, the importance of this cannot be overestimated.

	   There are a number of great sunscreens out there. Two of the less talked about ones are NIA 24's Sun Damage Prevention 100% Mineral Sunscreen and Licorice Brightener Sunscreen by HerbalMinerals. The former contains Niacinamide which decreases melanin synthesis and the latter as its name indicates bears licorice which also inhibits the enzyme tyrinosinase, and thereby lessens melanin synthesis. Be careful with the Licorice Brightener product however, since it contains lavender and chamomile, both of which, on occasion, can cause skin allergies. ( By the way, I do not sell sunscreens out of my office).

	  There are a number of excellent OTC products which can be used instead of prescription strength hydroquinone. Such ingredients as arbutin, kojic acid, azelaic acid, Vitamin C, and glycosamine, that also work quite well against pigmentary flaws.

What's the Best Way to Maintain Results After Using TRILUMA?

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