- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Brand Name: Tri-Luma
Drug Class: Corticosteroids, Topical; Depigmenting Agents
What is fluocinolone/tretinoin/hydroquinone, and what is it used for?
Fluocinolone/tretinoin/hydroquinone is a combination medication used for short-term treatment of melasma, a skin disorder that causes patches of dark skin discoloration to appear on the face, particularly on the cheeks and forehead.
Melasma occurs more commonly in women, often with pregnancy or the use of contraceptives or hormones. Fluocinolone/tretinoin/hydroquinone helps lighten the dark skin patches and is used in addition to measures to avoid sun exposure, including the use of sunscreens.
The three drugs in the combination work in different ways to treat melasma:
- Fluocinolone: Fluocinolone is a topical corticosteroid that reduces inflammation and itching and constricts swollen blood vessels in the skin. Fluocinolone works by suppressing the synthesis and release of inflammatory chemicals including histamine, kinins, prostaglandin and liposomal enzymes.
- Tretinoin: Tretinoin is a vitamin A derivative that helps in loosening and shedding of dead skin cells, and increasing the turnover of skin cells.
- Hydroquinone: Hydroquinone inhibits the synthesis of melanin, the pigment that causes dark skin color, by interfering with metabolic processes in melanocytes, the cells that produce melanin.
- Do not use fluocinolone/tretinoin/hydroquinone in patients with hypersensitivity to any component of the formulation.
- Fluocinolone/tretinoin/hydroquinone cream contains sodium metabisulfite that may cause allergic reactions in some people, including asthma episodes or serious life-threatening reactions (anaphylaxis). In case of such reactions, discontinue the drug immediately and institute appropriate treatment.
- Hydroquinone in the formulation can cause gradual blue/black darkening of the skin (ochronosis), particularly in dark-skinned people, but may occur in light-skinned people as well. Discontinue the drug immediately if ochronosis develops.
- The corticosteroid fluocinolone in the formulation may lead to suppression of the hypothalamic-pituitary-adrenal (HPA) axis, which can cause insufficiency of cortisol, the stress hormone. Systemic absorption of corticosteroids can cause excessive cortisol levels, and associated conditions such as Cushing’s syndrome, hyperglycemia, and glucosuria. Children are more at risk for systemic absorption.
- Fluocinolone/tretinoin/hydroquinone can cause mild to moderate local skin reactions including irritation, peeling, dryness, and itching. Skin reactions may be aggravated by the concurrent use of abrasive soaps and cleansers, skin care products with drying and astringent effects, or other topical medications that can irritate the skin.
- Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma, a type of cancer.
- The safety and efficacy of fluocinolone/tretinoin/hydroquinone treatment have not been studied in darker skin, it may cause excessive bleaching.
- The safety and efficacy of fluocinolone/tretinoin/hydroquinone in the treatment of hyperpigmentation conditions other than facial melasma have not been studied.
- Fluocinolone/tretinoin/hydroquinone is meant for short-term treatment and not for maintenance treatment of melasma.
IMAGESBrowse our medical image collection of allergic skin disorders such as psoriasis and dermatitis and more caused by allergies See Images
What are the side effects of fluocinolone/tretinoin/hydroquinone?
Common side effects of fluocinolone/tretinoin/hydroquinone include:
- Skin redness (erythema)
- Peeling skin (desquamation)
- Dry skin (xeroderma)
- Itching (pruritus)
- Acne vulgaris
- Spider veins (telangiectasia)
- Skin irritation
- Changes in skin pigmentation (dyschromia)
- Small bumps in the skin (papules)
- Fluid-filled blisters (vesicles)
- Acne-like rash
- Abnormal skin sensations (paresthesia)
- Reduced skin sensation (hypoesthesia)
- Dry mouth (xerostomia)
Less common side effects of fluocinolone/tretinoin/hydroquinone include:
- Inflammation of follicles (folliculitis)
- Acneiform eruptions
- Reduced skin pigmentation (hypopigmentation)
- Skin inflammation around the mouth (perioral dermatitis)
- Allergic contact dermatitis
- Secondary infection
- Sweat rash/prickly heat (miliaria)
- Loss of skin tissue (skin atrophy)
- Stretch marks (striae)
- Blue-black discoloration of the skin (ochronosis)
- Suppression of the stress axis (hypothalamic-pituitary-adrenal [HPA] axis) that reduces the production of the cortisol stress hormone
- Cushing’s syndrome, a disorder caused by excessive cortisol production due to systemic absorption of the corticosteroid
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of fluocinolone/tretinoin/hydroquinone?
- 0.01%/0.05%/4%/30 g
- Indicated for short-term treatment of moderate to severe melasma
- Apply to face at night, at least 30 minutes before bedtime
- Wash face gently before application; rinse and pat dry
- Apply a thin film of Tri-Luma to the hyperpigmented area and ½ inch surrounding skin
- Do not use an occlusive dressing
- Safety and efficacy not established
- Overdose of fluocinolone/tretinoin/hydroquinone is unlikely to result from topical application.
- Oral ingestion of the drug may be harmful, there is no information on symptoms or treatment.
- Report your symptoms to Poison Control in the event of accidental ingestion.
What drugs interact with fluocinolone/tretinoin/hydroquinone?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Severe interactions of fluocinolone/tretinoin/hydroquinone include:
- Fluocinolone/tretinoin/hydroquinone has no listed serious interactions with other drugs.
- Moderate interaction of fluocinolone/tretinoin/hydroquinone include:
- aminolevulinic acid (topical)
- methoxsalen (systemic)
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.
Pregnancy and breastfeeding
- There are no adequate and well-controlled studies on the topical use of fluocinolone/tretinoin/hydroquinone in pregnant women. Clinical trials were conducted only after a negative pregnancy test, however, some women became pregnant during treatment, but most of the pregnancy outcomes are unknown.
- Fluocinolone/tretinoin/hydroquinone cream should be used during pregnancy only if the potential benefits outweigh the potential risks to the fetus.
- It is not known if topical administration of fluocinolone/tretinoin/hydroquinone can result in sufficient systemic absorption to be present in breastmilk. Use the cream with caution in nursing mothers and avoid letting the breastfed infant come into contact with the cream.
What else should I know about fluocinolone/tretinoin/hydroquinone?
- Use fluocinolone/tretinoin/hydroquinone cream exactly as prescribed. Do not use for any skin disorder other than that for which it is prescribed.
- Do not apply excessive quantities and avoid prolonged use. Wash your hands after each application.
- Switch to nonhormonal contraceptives while on fluocinolone/tretinoin/hydroquinone treatment.
- Avoid contact with eyes, nose, angles of the mouth, mucous membrane, and open wounds.
- Avoid exposure to ultraviolet light and sunlight, including sunlamps, by using protective clothing and sunscreen.
- Use moisturizer after washing the face in the morning to prevent skin dryness.
- Discontinue use and consult with your physician if you develop hypersensitive reactions.
- Local irritation and other skin reactions may occur temporarily. Stop use and seek medical attention if you have persistent irritation, blistering, burning, and swelling, or allergic contact dermatitis.
- Store safely out of reach of children.
- In case of oral ingestion or overdose, contact your physician or Poison Control.
Fluocinolone/tretinoin/hydroquinone is a combination medication used for short-term treatment of melasma, a skin disorder that causes patches of dark skin discoloration to appear on the face, particularly on the cheeks and forehead. Common side effects of fluocinolone/tretinoin/hydroquinone include skin redness (erythema), peeling skin (desquamation), burning, dry skin (xeroderma), itching (pruritus), acne vulgaris, spider veins (telangiectasia), skin irritation, changes in skin pigmentation (dyschromia), small bumps in the skin (papules), fluid-filled blisters (vesicles), rash, acne-like rash, rosaceae, abnormal skin sensations (paresthesia), reduced skin sensation (hypoesthesia), and dry mouth (xerostomia). Consult your doctor before taking if pregnant or breastfeeding.
Multimedia: Slideshows, Images & Quizzes
Rosacea, Acne, Shingles, Covid-19 Rashes: Common Adult Skin Diseases
Learn to spot and treat skin conditions commonly found in adults such as acne, Covid-19 rashes, eczema, shingles, psoriasis,...
Acne: Causes, Solutions and Treatments for Adults
Adult acne causes include hormones, medications, makeup, and other things. Adult acne is treated with medications, products, face...
Skin Health: How to Get Clear Skin
Acne, pimples, zits and blemishes often appear on the face, back, chest, neck, and shoulders where skin has the most amount of...
How to Get Rid of Acne: Skin Care Tips
Want to know how to get rid of blackheads? Discover tips on clogged pores, sunscreen SPF and how to remove makeup for different...
Picture of Cystic Acne
Cystic acne is a type of abscess that is formed when oil ducts become clogged and infected. See a picture of Cystic Acne and...
Picture of Erythematous Deep Acne Scars
Acne scarring is a common sequel of severe inflammatory or cystic acne. It can present in a mild or cosmetically disfiguring...
Picture of Acne Vulgaris Nodulocystic
The common form of acne, in teens and young adults, that is due to overactivity of the oil (sebaceous) glands in the skin that...
Dry Skin Quiz
Dry, itching, flaky skin? Take the Dry Skin Quiz to learn what's causing your dry skin and what you can do about it beyond...
How to Get Rid of Acne: Medication, Best Treatment, Cystic Acne
What is the best treatment for acne vulgaris? Can food choices influence acne? How can you get rid of blackheads? Learn why it's...
Acne: Foods That Cause and Fight Acne and Pimples
How can you get rid of acne breakouts with nutrition? Does this food cause acne? Milk, chocolate, and seaweed are all considered...
Skin Quiz: Acne, Dry Skin, Dandruff & More
What's that all over you? Skin, of course! Test your knowledge of your most amazing organ with the Skin Quiz!
Acne (Pimples) Quiz: Test Your Medical IQ
Acne is the most common skin disorder in the world. If you suffer from acne, you are not alone and many treatment options are...
Picture of Melasma
Pigmentation of the face, most commonly on the malar area (the upper cheek), bridge of nose, forehead, and upper lip, that occurs...
Picture of Acne
Exactly what causes acne? Acne develops when cells and natural oils begin to block up tiny hair follicles in the skin. See a...
Picture of Baby Acne
Pink pimples ("neonatal acne") are often caused by exposure in the womb to maternal hormones. See a picture of Baby Acne and...
Health and Beauty: What You Should Know Before Getting Facial Fillers
Facial fillers can help with wrinkles and other skin issues. Here’s what to expect when you inject.
Acne Care Pictures: Skin Care Dos and Don'ts
Explore quick acne cover-ups, dos and don'ts. See solutions on how to best handle pesky pimples and remedies to avoid.
Facial Health: What Your Skin and Face Symptoms Can Reveal About You
What medical problems appear on your face? Look into the mirror and find out. Jaundice, glaucoma, skin cancer, and cracked lips...
Skin Problems and Treatments: Causes of Skin Discoloration
Too much sun, certain diseases, and medication can change your skin color. Learn more about skin discoloration.
Related Disease Conditions
How Can I Remove Facial Hair Permanently at Home?
The only advanced technique for hair removal that can permanently remove unwanted facial hair is electrolysis. Methods you can try for hair removal at home include shaving, waxing, depilatory creams, prescription medications, and homemade masks.
Dry skin (xeroderma) may be caused by external factors, like cold temperatures, low humidity, harsh soaps, and certain medications, or internal factors, such as thyroid disease, diabetes, psoriasis, or Sjogren's syndrome. Symptoms and signs of dry skin include itching and red, cracked, or flaky skin. The main treatment for dry skin is frequent, daily lubrication of the skin.
Acne is a localized skin inflammation as a result of the overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Skin Care for Dry Skin
Second Source article from WebMD
Why Does My Acne Stink?
If you have smelly acne, it may be due to bacteria and other material in the pus that produces a bad odor. Learn about the factors that can cause your acne to stink and how acne is treated by severity level. Check out the center below for more medical references on acne, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.
How Do You Tell if You Have Athlete’s Foot or Dry Skin?
Learn about the differences between athlete’s foot and dry skin, what causes these conditions, the different symptoms to watch for, and how they’re treated.
What Causes Sudden Acne Breakouts in Adults?
While acne in teenagers typically occurs due to a surge in hormones, acne breakouts in adults often result from bacteria on the skin or a buildup of oils.
How Do You Get Rid of Acne Scars Naturally?
Approximately 80% of people between the ages of 11 and 30 years old have acne due to hormonal changes, stress, menses, oil-based cosmetics or birth control pills. A variety of remedies including tea tree oil, coconut oil, honey and other substances may help get rid of acne scars naturally. The dermatologist has prescription treatments and procedures to reduce the appearance of acne scars.
Melasma is a patchy brown discoloration of the skin on the face. When it occurs in pregnancy, it's called chloasma. Melasma is commonly treated with hydroquinone creams.
How Do You Get Rid of Acne Scars Overnight?
Acne breakouts are common and quite frustrating. Strategies to get rid of acne will take time to work, so you must be regular and diligent in their application. Aloe vera, apple cider vinegar, cocoa butter, honey and cinnamon, green tea, tea tree oil and other substances improve skin's appearance.
Cystic acne is distinguished by painful nodules on the chest, face, neck, and back. This form of acne is known to scar. Treatment may incorporate the use of hormonal therapies, oral antibiotics, and prescription medications.
Which Birth Control Is the Best for Acne and Weight Loss?
Birth control or contraceptive methods include several medications, devices, or tricks for preventing pregnancy. Birth control methods vary in their mode of action, effectiveness in preventing pregnancy, and the presence of any beneficial or undesirable effects.
How Do I Get Rid of Dry Skin in My Private Area?
Dry skin in your private area can usually be treated by avoiding harsh products, tight clothing, and hot showers. Here are tips for getting rid of irritation down there.
How Long Does Cystic Acne Last?
What is cystic acne? Learn the signs of cystic acne, what causes cystic acne, how doctors diagnose cystic acne, and what you can do to treat cystic acne.
Can Too Much Acne Medication Make Acne Worse?
Using too many acne medications at once may make your skin irritated and result in more breakouts.
What Are the Best Treatment Options for Acne Rosacea?
Learn what medical treatments can help ease your rosacea acne symptoms and speed up your recovery.
What Are the 3 Types of Acne Scars?
The 3 types of acne scars include atrophic scars, hypertrophic and keloid scars, and post-inflammatory hyperpigmentation.
What Is Considered Severe Acne?
Severe acne causes breakouts that often extend deep into the skin. In severe acne, a single pimple or cyst can stay on the skin for weeks or months at a time. Grade III acne is considered severe acne.
Hidradenitis Suppurativa (Acne Inversa)
Hidradenitis suppurativa (HS or acne inversa) is a chronic skin condition that causes painful red abscesses in the groin and armpits that may drain foul-smelling pus. Treatment options include weight loss, smoking cessation, topical antibiotics, and avoidance of tight-fitting underwear. Finasteride and adalimumab may be helpful for those with resistant cases of HS.
What Is the Difference Between Acne Blackheads and Whiteheads?
Learn the difference between acne whiteheads and blackheads and how to treat each condition.
Natural Remedies for Acne Scars
What are acne scars? Learn how to treat acne scars and get rid of acne scars naturally.
How Do You Treat Cystic Acne?
Whether you get occasional whiteheads or persistent pimples, acne can be painful and frustrating. Luckily, most acne breakouts will clear up on their own. Cystic acne is different. Learn what medical treatments can help ease your cystic acne symptoms and speed up your recovery.
How Do You Treat Aging Dry Skin?
Dry skin is common in older adults. Treat aging dry skin my moisturizing, bathing in warm water, and using a soft washcloth.
Can Drinking Water Get Rid of Acne and Help Clear My Skin?
Keeping your body hydrated is a well-known wellness tip. Water improves other functions that in turn improve the appearance of the skin.
What Causes Melasma During Pregnancy?
What is melasma, and what causes it during pregnancy? Learn the signs of melasma during pregnancy and how to treat the condition.
What Causes a Rash That Looks Like Acne?
Perioral dermatitis is a skin condition that can cause breakouts that resemble acne in people around the mouth, nose, eyes, or genitals. Check out the center below for more medical references on skin conditions, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
What Causes Red Patches on the Legs?
Red patches on the legs are often caused by several medical conditions, including folliculitis, hives, eczema, and keratosis pilaris. Check out the center below for more medical references on skin conditions, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
How Do I Treat Dry Skin on My Face?
Here are 10 simple ways to help heal and soothe dry skin and prevent recurrences.
What Causes Skin Discoloration?
Skin discoloration may result from several factors, such as excessive sun exposure, hormonal fluctuations, autoimmune diseases and genetics.
How Do I Get Rid of Hormonal Acne?
Hormonal acne can be frustrating to deal with, but it’s usually treatable. Learn how to get rid of hormonal acne with these treatment options.
How Does Stress Cause Acne?
Excessive amounts of sudden and prolonged stress may cause changes in the brain and body chemistry. Stress increases the risk of acne by drying out the skin, ramping up oil production and increasing levels of stress hormones which ages the skin.
13 Powerful Home Remedies for Acne
Acne is a common skin problem creating small bumps on the skin. Most adolescents are affected by acne when they attain puberty.
What Triggers Facial Psoriasis?
Possible triggers of facial psoriasis include smoking, obesity, medications, infections, skin injury, stress, vitamin D deficiency, and stress.
What Is the Best Treatment for Acne?
There are several treatments for acne available that can help restore your healthy skin. The first step in controlling acne is implementing good skincare habits.
How Can I Get Rid of Dry Skin Fast at Home?
Dry skin may be associated with deep cracks, redness, fine lines, itching, skin tightness, and rough-looking skin. Get rid of dry skin at home fast by avoiding long showers, moisturizing your skin, wearing lip balm, or applying coconut oil, petroleum jelly or aloe vera.
How to Get Clear Skin: 15 Proven Tips for Fighting Acne
Acne is the most common skin problem that affects more than 80% of people at some point in their life. If not treated properly, it can lead to scars and dark marks on the skin which might take longer to go away.
What Triggers Acne in Adults?
Learn the ten most prevalent causes and triggers of acne in adults, which include hormonal changes, skin products, medications, and stress.
Treatment & Diagnosis
- Skin FAQs
- Acne FAQs
- Dry Skin FAQs
- What Causes White Patches on the Skin?
- Accutane (isotretinoin) for Acne linked to birth defects, depression and suicide
- FDA Proposes Hydroquinone Ban
- Can Dermabrasion Cure Acne Scars?
- Is it Safe to Use Accutane for Acne?
- Can You Still Retain Symptoms Of PCOD (Acne, Obesity, Etc.) After Hysterectomy?
- How Does PCOS Affect Your Appearance?
- What Condition Causes Severe Facial Nerve Pain?
- How to Get Rid of Acne
- Do Fish Oil Supplements Cure Dry Skin?
- Is Skin Discoloration a Side Effect of Cortisone Injection?
Medications & Supplements
- tretinoin (Retin-A, Retin-A Micro, Atralin, Avita)
- isotretinoin (Accutane, Claravis, Amnesteem, Absorica, Zenatane)
- Side Effects of Accutane (isotretinoin)
- Side Effects of Retin-A (tretinoin)
- fluocinolone (eczema) oil - topical, Derma-Smoothe/FS
- fluocinolone acetonide - shampoo, FS Shampoo
- hydroquinone - topical, Eldoquin, Epiquin Micro, Lustr
- sodium sulfacetamide suspension - topical (acne only), Klaron
- hydrocortisone/yerba santa drops - otic, Earsol-HC
- fluocinolone/tretinoin/hydroquinone - topical, Tri-Luma
- alitretinoin gel - topical, Panretin
- Veltin (clindamycin phosphate and tretinoin) Gel
- hydroquinone/sunscreen - topical
- Retisert (fluocinolone acetonide intravitreal implant)
Prevention & Wellness
- 11 Foods to Avoid for Reducing Facial Bloating: Plus Morning Remedies
- How Do You Know If Acne Is Hormonal?
- Hormonal Acne Diet: What to Eat to Improve Your Acne
- Top 12 Foods That Can Cause Acne
- Do Biotin Supplements Cause or Treat Acne?
- What Foods Help Clear Acne?
- How Do You Get Rid of Dry Skin on Your Feet?
- What Is the Best Acne Treatment for Guys?
- How Can I Do a Natural Facial at Home?
- Can You Cure Your Acne With Apple Cider Vinegar?
- Vitamin C for Acne Benefits and Uses
- What Is the Best Product for Acne?
Skin Problems and Treatments Resources
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.