Tri-Luma
Tri-Luma is a cream that's used to treat adults with melasma, or dark skin patches, on the face. The cream contains three active ingredients: fluocinolone (a steroid to lessen inflammation); hydroquinone (a melanin synthesis inhibitor to lighten skin color); and tretinoin (a retinoid to help with new skin growth). You apply Tri-Luma onto the dark patches on the face once a day, but side effects like skin redness and burning are common. It can take about 1 to 2 months to see results after you start treatment. Tri-Luma isn't approved to treat areas of hyperpigmentation that isn't related to melasma.
What is Tri-Luma?
What is Tri-Luma used for?
Melasma of the face
How Tri-Luma works
Tri-Luma is a combination of three medications that help treat melasma on the face.
Fluocinolone is a corticosteroid. It works to lessen skin irritation and inflammation.
Hydroquinone is a melanin synthesis inhibitor. It works by blocking the skin cells from making melanin, the chemical that gives color to your skin. This helps lighten the color of the skin.
Tretinoin is a retinoid. It's a form of vitamin A, a nutrient that plays a role in promoting new skin growth.
Drug Facts
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What are the side effects of Tri-Luma?
Common Side Effects
- Skin redness (41%)
- Skin peeling or flaking (38%)
- Burning sensation on the skin (18%)
- Dry skin (14%)
- Itchy skin (11%)
Other Side Effects
- Acne
- Skin irritation
- Spider veins
- Extra sensitive skin
- Changes to the color of your skin
Serious Side Effects
- Allergic reaction: swelling of your face, eyes, lips, tongue, or throat; trouble breathing; severe itching; skin rash; hives
- Severe skin reaction: severe burning, severe swelling, severe skin irritation
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Redness, peeling, drying, itching, or burning of the skin
Less common
Darkening of normal skin color
irritated skin
rash
Incidence not known
Blistering, crusting, or flaking of the skin
burning and itching of the skin with pinhead-sized red blisters
lightening of normal skin color
redness and scaling around the mouth
severe redness, soreness, or scaling of the skin
thinning of the skin with easy bruising
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Tri-Luma
Pros
Only need to apply once a day
Easier to use a combination cream instead of two or three separate medications
Cons
Might take 1 to 2 months to see results
No lower-cost generic available
Pharmacist tips for Tri-Luma
Gently wash and dry the affected areas of your skin before you apply Tri-Luma. Then, wash your hands after you use the cream to prevent it from getting in your eyes. Rinse your eye well with water if the medication accidentally gets in your eye.
When you apply Tri-Luma onto the face, be sure to avoid the areas near your mouth, nose, eyes, or open wounds. Otherwise, these sensitive areas can get irritated.
Don't apply Tri-Luma more than once a day. Using too much of this medication or using it too often won't give you faster or better results. Instead, it could irritate your skin even more.
Itching or burning after you apply Tri-Luma onto the skin are common side effects. But contact your prescriber if you notice a rash appear; this might be a sign of an allergic reaction.
It's best to use a moisturizer in the morning after you wash your face to help with any dry skin from Tri-Luma. You can continue to use the moisturizer as needed throughout the day if the medication makes your skin really dry.
Be sure to avoid sun and tanning bed exposure, wear a wide-brimmed hat, and use sunscreen with an SPF of at least 30 while you're using Tri-Luma. This is helpful to do even during the winter and on overcast days. This helps prevent your melasma from getting worse when you're in the sun or exposed to ultraviolet (UV) light.
Hormonal birth control can cause melasma to become worse. Discuss alternative options with your primary care provider or obstetrician-gynecologist (OB-GYN).
Tri-Luma might improve the appearance of melasma, but it isn't a cure. Once you stop using this medication, the discolored skin might come back. Speak with your dermatologist about long-term treatment options for your melasma.
Talk with your HCP if you're allergic to sulfites. Tri-Luma contains sulfites. Sulfites are different than sulfa medications, so it's possible for you to safely use Tri-Luma if you have a sulfa allergy. It's always a good idea to discuss all allergies with your HCPs at every visit or before starting any new medications.
Keep the tube of Tri-Luma cream in the refrigerator (between 36 and 46 degrees Fahrenheit). Make sure not to freeze the medication.
Frequently asked questions about Tri-Luma
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What are the risks and warnings for Tri-Luma?
Tri-Luma can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reaction
Risk factors: Sulfite allergy
Tri-Luma contains a sulfite. Although rare, sulfites can cause a serious allergic reaction. Let your healthcare team know before you start treatment if you know you have a sulfite allergy. Keep in mind that sulfite and sulfa aren't the same thing, and many people with sulfa allergies can still use medications containing sulfites.
Call a healthcare professional or get medical help right away if you notice hives, a rash, swelling of the lips or tongue, or difficulty breathing after you apply Tri-Luma onto the skin.
Blue-black darkening of the skin
Risk factors: Black people
Tri-Luma contains hydroquinone, which is known to cause blue-black patches on the skin. This is more likely to happen if you're Black, but it can also happen to people of any race. For some people, this blue-black color on the skin is permanent. Contact your prescriber as soon as you can if you notice any unusual discoloration of your skin or worsening of your melasma. This side effect might be easier to manage when it's caught early.
Change in adrenal hormone levels
Risk factors: Using Tri-Luma for a long time
Using medications containing corticosteroids, including Tri-Luma, for long periods of time can cause changes in the level of adrenal hormones in your body. These adrenal hormones are important for many bodily functions. Rarely, changes in your adrenal hormone levels can cause your skin to thin or your immune system to weaken. And when you suddenly stop using Tri-Luma after long-term use, your skin might become irritated again. Use Tri-Luma as directed. Don't apply this medication for a longer period of time than instructed.
Skin irritation and other skin reactions
Risk factors: Weather extremes, like very hot or very cold
Skin irritation, including skin redness, skin peeling, dry skin, itching, and a burning sensation, are all common side effects of Tri-Luma. These side effects are usually mild and happen where you applied the medication on the skin. Contact your prescriber if you develop very bothersome skin reactions, such as rash or blisters, on the face, especially if they happen on areas where you didn't apply Tri-Luma.
Tri-Luma dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30g of 0.05% | 1 tube | $244.91 | $244.91 |
Typical dosing for Tri-Luma
Apply a thin layer of cream to the darker patches of skin on the face once daily, at least 30 minutes before bedtime. Be sure to also cover about one-half inch of the skin surrounding each of the discolored areas with Tri-Luma.
Interactions between Tri-Luma and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aminocaproic Acid
- Aprotinin
- Bemiparin
- Chlortetracycline
- Demeclocycline
- Doxycycline
- Eravacycline
- Lymecycline
- Macimorelin
- Meclocycline
- Methacycline
- Minocycline
- Nadroparin
- Omadacycline
- Oxytetracycline
- Rolitetracycline
- Sarecycline
- Sargramostim
- Tetracycline
- Tigecycline
- Tranexamic Acid
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Tri-Luma cost?
What are alternatives to Tri-Luma?
Lightening or bleaching of dark spots on skin (hyperpigmentation)
What is the latest news about Tri-Luma?
Tri-Luma images
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References
Best studies we foundAmerican Academy of Allergy, Asthma & Immunology. (2024). Sulfite and sulfa drugs.
American Osteopathic College of Dermatology. (n.d.). Hyperpigmentation.
American Osteopathic College of Dermatology. (n.d.). Melasma.
Galderma Laboratories, L. P. (2024). Tri-Luma- fluocinolone acetonide, hydroquinone, and tretinoin cream [package insert]. DailyMed.
Lazar, M., et al. (2023). Exogenous ochronosis: Characterizing a rare disorder in skin of color. Journal of Clinical Medicine.
Lee, S. Y., et al. (2014). Natural, semisynthetic and synthetic tyrosinase inhibitors. Journal of Enzyme Inhibition and Medicinal Chemistry.
Ludmann, P. (2022). Melasma: Overview. American Academy of Dermatology Association.
MedlinePlus. (2022). Melanin.
Motamedi, M., et al. (2022). A clinician's guide to topical retinoids. Journal of Cutaneous Medicine and Surgery.
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