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    Triple Combination Cream Reduces Melasma Severity

    However, twice-weekly maintenance not sufficient to prevent a relapse in most patients

    TUESDAY, June 8 (HealthDay News) -- Although using daily triple combination (TC) cream for 12 weeks is safe and effective in reducing melasma severity enough for patients to reduce administration to twice per week, most patients relapse, requiring resumption of daily therapy, according to a study in the June issue of the Journal of the American Academy of Dermatology.

    In an open-label study, Pearl E. Grimes, M.D., of the University of California in Los Angeles, and colleagues evaluated 70 melasma patients treated with daily TC cream containing hydroquinone (4 percent), tretinoin (0.05 percent), and fluocinolone acetonide (0.01 percent) for 12 weeks. If melasma was cleared or almost cleared after this period, patients were instructed to start a maintenance program of applying the TC cream twice per week for an additional 12 weeks; otherwise, daily TC treatment was continued for another 12 weeks.

    The researchers found that 25 patients completing the study per protocol were treated with the daily regimen for 24 weeks; six patients were treated with daily TC cream for 12 weeks followed by maintenance therapy for another 12 weeks; and 21 patients were treated with daily TC cream for 12 weeks, relapsed while undergoing maintenance therapy and then resumed daily TC treatment. However, after 12 and 24 weeks, there was a significant reduction in melasma severity in all groups, and adverse events -- which occurred in 53 percent of patients -- were mostly mild.

    "Twice-weekly maintenance therapy was not sufficient to prevent a relapse in the majority of the patients who achieved a status of clear or almost clear at 12 weeks of treatment," the authors write. "A thrice-weekly regimen may have been more successful. Alternatively, an agent containing a lower concentration of hydroquinone or a different depigmenting agent might have been successful as daily maintenance therapy."

    The study was supported by Galderma Laboratories, to which several authors disclosed financial ties.

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