Fluocinolone / Hydroquinone / Tretinoin

What it is and how it works

Hydroquinone inhibits tyrosinase and so reduces melanin production; tretinoin increases epidermal turnover, enhances hydroquinone penetration and disperses melanin granules; fluocinolone acetonide, a corticosteroid, reduces irritation from the other components and suppresses melanocyte activity. Together they lighten hyperpigmented skin.

Indications

Short-term treatment of moderate to severe facial melasma, used together with sun avoidance and sunscreen.

Dosage and administration (summary)

Topical, a thin film applied once daily at night to the affected areas at least 30 minutes before bedtime, usually for up to 8 weeks; it is not intended for continuous long-term use.

Contraindications

Pregnancy, hypersensitivity to any component, and use on broken, eczematous or sunburnt skin.

Warnings and precautions

Local irritation, erythema, peeling, burning and dryness are common; strict sun protection is needed because tretinoin increases photosensitivity. Hydroquinone may rarely cause exogenous ochronosis (blue-black discolouration), and prolonged corticosteroid use can cause skin atrophy, telangiectasia and rosacea-like eruptions; contact with eyes, mouth and mucous membranes should be avoided.

Pregnancy

Contraindicated in pregnancy because of the retinoid component.

Storage and supply

Store below 25 °C; do not freeze; keep the tube tightly closed.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.