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Twice-weekly TC cream won't prevent melasma relapse

Article-Twice-weekly TC cream won't prevent melasma relapse

Los Angeles — The good news from a recently completed study is that using triple combination (TC) cream daily for 12 weeks reduces melasma severity enough for treatment to be cut to twice weekly.

The not-so-good news is that most patients relapse and have to resume daily therapy, HealthDay News reports.

In a study headed by Pearl E. Grimes, M.D., clinical professor of dermatology at the University of California, Los Angeles, 70 melasma patients underwent daily treatments with TC cream containing hydroquinone (4 percent), tretinoin (0.05 percent) and fluocinolone acetonide (0.01 percent) for 12 weeks.

If melasma cleared or almost cleared after this period, patients were instructed to apply the TC cream twice a week for an additional 12 weeks. In cases in which little or no clearing was observed, daily TC treatment was continued for 12 more weeks.

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.

After 12 and 24 weeks, however, there was a significant reduction in melasma severity in all groups. Adverse events occurred in 53 percent of patients and 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, which appeared in the June issue of the Journal of the American Academy of Dermatology, was supported by Galderma Laboratories, to which several authors disclosed financial ties.

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