Alternative Treatment Options

The following options are not available here, as we only prescribe the most effective
triple therapy creams.

The reason for detailing other options here is to allow clients to make an informed decision before deciding whether to request a triple therapy cream or not.

  • Azelaic acid 20% - this isn’t as effective, but it is much better tolerated, can be used for years at a time, and usually a prescription isn’t needed.

  • Skin peels – There have been reports of chemical peels alone improving melasma, but they’re much more likely to help in combination with lightening creams.

Natural Alternatives to Hydroquinone

Hydroquinone is the most effective lightening agent, and the main ingredient that makes a difference in triple therapy creams.

As hydroquinone is available on prescription only, and can’t just be bought – there are a lot of alternatives sold – but these don’t work anywhere near as well.

Plant extracts which break down into hydroquinone when absorbed into skin:

  • Mitracarpus scaber (madder) extract

  • Uva ursi (bearberry) extract

  • Morus bombycis (mulberry)

  • Morus alba (white mulberry)

  • Broussonetia papyrifera (paper mulberry)

  • Arbutin (bearberry plant)

  • Arbutin is known to be effective, but is not as good as hydroquinone itself.

    Plant extracts like arbutin might be sold as “hydroquinone-free and natural”, which may be true, however as they do break down into hydroquinone, the theoretical risks remain the same.

  • Kojic acid is a chemical derived from mushrooms, or fermented rice, that blocks the tyrosinase enzyme like hydroquinone does.

  • Tranexamic acid is a medication that when taken as a tablet, increases blood clotting. It also has been shown to reduce hyperpigmentation, but this drug has some risks, and we can’t justify using it just to improve the skin cosmetically.
    Tranexamic acid serums (2-3% strength) might help with skin lightening. They are suitable for all skin types, don’t seem to be irritating, and can be combined with any other lightening ingredients.

Clinic treatments for hyperpigmentation

IPL and lasers can be used to treat pigmentation, but neither seem to be very effective.

Almost any beneficial skin ingredient can potentially reduce uneven pigmentation.

Sunblock protects against UV damage, antioxidants (most vitamin serums, such as vitamin C creams) are the next line of defence against damage, and AHAs and retinol increase cell turnover.

There are a huge number of treatments marketed towards hyperpigmentation or to “brighten skin”.

Triple therapy is much more effective than any product that can be purchased without a prescription.

REQUEST TREATMENT FORMMORE ABOUT MELASMA

Gold Standard Treatment for Melasma

Triple therapy is when we use hydroquinone, tretinoin and a steroid together in a special (prescribed) combination cream – e.g., “Pigmanorm”, or “Tri-Luma”.

LEARN MORE