Custom-Made Tri-luma for me– and you too

Tri-luma was a popular combination of tretinoin ( the generic name for Retin-A), hydroquinone  to lighten the skin and a medium strength steroid  by the name of flucinolone. The tretinoin  would hasten skin growth and exfoliation to shed darkened skin; the hydroquinone would  decease melanin production and the steroid would avoid redness and swelling from the other two turbo driven ingredients. It worked  well  for my under eye shadows and was the go to-product for brown patches  known as melasma.

It would take  at least three weeks  to see results  for Tri-luma, but when it worked, it WORKED.  You had to be complusive about sunscreen using at least a 30SPF during and after Tri-luma  since  the ingredients increased sun sensitivity to the sun.Then one  day Tri-luma seemed to disappear from pharmacy shelves.    THere was no FDA recall, no  clear statement from the manufacturer.  Nothing.

Then I started hearing rumors  on the web  that specialty  pharmacists could compound it individually for their customers who brought in a  prescription from their dermatologist. I asked my go-to dermatologist Dr Albert Lefkovits  about the idea and he was wonderfully supportive.  It turns out that the   Tri-luma formula was actually  developed by Albert Kligman, considered  by many  to be the father of cosmetic dermatology.

Dr Lefkovits made a slight change  in the Kligman formula substituting a  milder steroid called desononide.  One of the concerns about Tri-luma was  the strong steroid could cause  thinning of the skin and lead  to the development of rosecea.  Using desonide takes down the risk of these problems.

I never had a personally compounded product before  and I was excited to pick it up at Caligor pharmacy in NYC near Bloomingdales.   The small elegant store  had  it ready for me.  Rahter than a tube, the custom compound was in a small jar.  The pharmacist suggested that I keep it in the frig  to maintain potency.  What a good idea. I had noticed that my $300 tube of Tei-luma soon turned yellow and started to small like rotten eggs. 

The strange smell  was due to the deterioration of the sulfite preservative  and was so aunappealing I stopped using  the tube when it was still half full.  Refrigeration will stabilize  the formula so I’m hoping to be able to use it to the last drop.  Oh, and the best part?  My own personal Tri-luma like cream was more than $100 less than  the brand name product. Let the bleaching games begin.

31 thoughts on “Custom-Made Tri-luma for me– and you too

  1. Recently, I got a sample of HQRA and tried it. I think it’s like Triluma. The main ingredients are 7% Hydroquinone, 0.05% Tretinoin, 0.05% Hydrocortisone. With the small sample I got, I was able to apply it all over my face for 11 times over a 3 month period. I spaced out my applications to weekly or biweekly depending on how my sensitive skin was reacting. I noticed my spots did get lighter but not gone. So I may just buy the full size prescription. It comes in a 1.75 oz airless pump bottle and it cost about $80. It’s definitely not something that I can use long term and everyday but just glad to find something that works.

  2. WHat a great find! THat’s definately a Tri-luma like formula. And at $80, its definately more affordable. I think you might get better results if you used it three times a week for up to eight weeks. You need to use an especially effective sunscreen both to protect more sensitive skin and prevent new melanin formation. THen you willneed to take an eight week time-out period before using it again. Please let me know how things develop.

    • HI! My dermatologist gave me this compound recently to help me get rid of stubborn sun spots under my eyes. But it has the stronger steroid FLU.

      I cant remember the exact percentages but although the spots have started to disappear, my skin has started getting redder , like a butterfly rash. Also the skin near my eyes appear a little broken. Like i can see some capillaries.

      What should I do?

      I also have a lot of blotchiness on my back left over from years of bacne. It looks more like there was pigmentation in the areas that were worse affected. I started using this on my back and I do think i noticed some improvement, but now am starting to feel an eczema type situation going on back there.

      Any suggestions?

      Please help 🙂

      • I would definately stop using the steroid and go back to the doctor. You could be developing a steroid related rosacea. I would also have him take a look at your back. THere are effective medications for exzema and its also helpful to see if they can identify what is triggering the problem.

  3. Hmm, I got a similar custom compound directly at my dermatologist’s office and it worked nothing like Tri-Luma. I suspect she gave me a lower dosage of the Tretinoin portion but the results just weren’t comparable. Tri-Luma was a miracle! I was unsure of why it didn’t work very well and thought that perhaps the steroid made it “penetrate” or something; but it appears from your post that the steroid is just for reddening which I never had a problem with anyway. I’ll make another appointment and tell my dermatologist about my lackluster (no pun intended) results.

    • Yes, some dermatologists alter the custom formula lowering the hydroquinone or changing the type of steroid. I am working on a post about the different forms of steroids and that may give us a betterr idea of how to get those good results. Can you find out the eact formula she used?

  4. I have a compound mixed by my dermatologist of .05% retinA, .05% hydrocortisone, and 7% hydroquinone. Only been on it 10 days but am taking it nightly. Skin irritation decreasing & skin feels smoother, but no fading of spots yet. Anyone know I’d I can moisturize immediately after or should I wait a few minutes?

    • Wow, that’s a lot of hydroquinone and should be very effective. It takes at least a month for enough pigmented cells to fall off to see a fading of the spots. Depending on your skin color, dermatologists may recommend jump-starting the process with an IPL treatment. This is a type of low level laser that literally explodes the dark spots and leaves the skin amazingly clear.

  5. Would you be willing to post an update on how this compound has worked for you? Or do you already have one somewhere that you might refer me to? Thanks!

    • I developed a super sensitive skin this spring and had to stop using everything for months. THe wizard of Park Avenue ( Dr Albert Lefkovits) finally figured out what was happening and got my skin under control with a change in diet, new medication and peels. Now I’m looking forward to using the compounded Triluma again. On my Facebook Fan Page can you can find an album of before and after photos that included a series with traditional Triluma.

  6. I am on day 2 of using a compounded 4% cream. I am not sure the exact proportions or of even the ingredients that are in here because all the jar says is “Tri – Bleaching 4%”. My dermatologist also prescribed “Metrogel 1%” due to some recent flare ups I have had. I am not sure if this combo will work but I am hopeful. I will post back to let you know of any progress or results. As a side note, the dermatologist assistant told me that the only over-the-counter product that would work on me is the Obagi line of products, which I have not tried.

    • Hmm, I’m guessing here but I think the 4% refers to the concentration of hydroquinone. Now metrogel is used for Rosacea and seborrheic dermatitis. I basically kills yeast and bacteria that might be behind redness and reuptions. It worked miracles for me, but other report no effect. I would love to hear how it worked for you. Obagi products are often well formulated, but pricy– in some cases more expensive that equivilent prescription products.

  7. I just ordered four 15-gram tubes of generic tri-luma but am worried it will go bad before I finish. Can you give me an approx. shelf life and for how long can I use it? Thanks for any advice re. this treatment (for age spots).

    • First of all I’m surprised to hear that there is a generic version of Triluma. Branded Triluma was off the market for more than a year and now its back. I’d love to know who is offering a generic version.
      THe problem with Triluma is that it can’t be used continually like Retin A. Most dermatologist recommend using it for three months at a time , then taking a three month Triluma holiday before using it again. A regular tube of Retin a, used a year lasts about a year. THe same size tube of Triluma can be used only six months out of a year so it should last you about 2 years. I found that my Triluma became yellow and started to smell very odd after nine months. I had to throw out more than half a tube. In four tubes you have about an 8 year supply and I doubt it will stay useable that long. I suggest selling or giving it to three friends. Once it starts to break down, it doesn’t offer any benefits to your skin.

      • I did not get Triluma online. I bought it at neighborhood pharmacy. I had a bad experience with online etin A and decided only to buy these products in pharmacy.

  8. I just started using a compound tonight. 6/7/13. It is 4% Hydroquinone, with Retin A for scarring and something else for itching/inflammation. I am happy to post the progress of this medication. I am really excited because I tried Trivectin TL (a product from Macy’s) for over 6 weeks and it did not do anything. It was a nice moisturizer, but that is not what I wanted. It cost $89. So, I finally went to my dermatologist. I am 53 years old and asked to be taken off the Estrogen portion of my birth control pills, as I heard this could contribute to the dark blotches. So happy to find a site that is talking about this product. I have medium dark skin, psoriasis, and extremely sensitive skin. So, I am hoping for good results.

    • It sounds like you are using Tri-luma which is finally available agin. I think you bought Strivectin which is just a good moisturizerr but others have told me it does not help dark spots. Try to take it back for a refund. I like to buy my beauty products at Sephora because they will refund your money if a product is unsatisfactory. You can also ask a dermatologist for 70% glycolic peels for dark patches, but stay away from all types of lasers since they can actually increase pigmentation in darker complexions. Let me know how you are doing.

      • Tomorrow will be a week since I started the TriLuma 4% (custom). My med. dark, sensitive skin has had no reactions to the meds so far. I even put a bit more on the darker spots before I go to bed, or if I feel like I sweated some meds off. I don’t know how long to wait before moisturizing, my skin is very dry so I have to at some point. I have been waiting about 5 (ish) minutes to put the moisturizer on. It was suggested I use CeraVe PM at nights. It is impossible to avoid all sun in Florida, but I do put lots of sun screen, wear a visor and sunglasses. I took a picture on the first day and I will take one every Friday to see the progress of this medication. The pharmacist told me that there were many, many people that use it even males. I will write every week to advise progress. If I can help someone else out, it would make me happy.

  9. I’m so confused with all the Tri-Luma thing. My doc prescribed the 7% but pharmacy is standing it doesn’t exist ! The 4% did nothing to me. Tried with addition with other meds but don’t see anything good happening. Can anyone explain it to me ?

    • Tri-luma does not always help. If you describe your skin type and what changes you were hoping to see I might be able to offer other options.

  10. Can you advise please, Isnt it dangerous to be using steroid on the skin. Ive heard the skin becomes beautiful momentarily, but the much worse later on.

    • You’re right. Steroids potentially harm the skin if used at too high a concentration or for too long. Many doctors recommend using steroids for no more than three months at a time. Steroids can give you a quick recovery from many skin problems, but they are a temporary solution.

  11. Its been 3 weeks and I am mostly happy with the TriLuma I mentioned the first week in June. Two things, sometimes I feel a burning sensation, and if I think it is too much, I will skip a day. The other thing is I am worried about using a steroid for too long, so I will either ask to have it lowered or removed from the prescription. Otherwise, the spots are fading and so far, I am happy with the product except the two things I mentioned above. I always pack on the sunscreen when I go outside, I live in Florida. I have been taking photos, and would like to post the progress, but at this time, I dont know if it can be done on this blog.

  12. Hi, Im using a prescription for .25% retin-a, 4% hydroquinone. I think there is a third ingredient as well just listed as velv. Not sure what that it. I’m not using for acne but for anti-aging properties. When will I see results from daily use? I have been using it over a week and have very mild peeling. Also, can/should this be refrigerated?

    • Hmm,I really can’t tell what you are using. I’m thinking its triluma, but I need to get a better idea of the ingredients. WHere did you get the product?
      THe mild peeling is a sign that something is happening. It takes at east six weeks to see some real changes and in the summer refrigeration is a great idea! Please let me go how things are going.

  13. Today 01/28/14 my dermatologist prescribed me a form of triluma because I just can’t afford to spend $200 or even $100 on a tube of cream. It’s hydroquinone 4% tretinoin 0.025% and desonide cream 0.05 % I really hope this works I am African American and medium brown with sensitive skin.the dark spots are wrapped around my neck and spots on my face as well. I’m hoping by June it will be some what gone seeing I’m getting married that month . If anybody has tried this formula please let me know. thanks .

    • Actually this is a custom formulation of the very effective Triluma brand prescription treatment for dark patches. Its considered by many experts to be the most effective way of dealing with uneanted pigmenttion. You have an excellent doctor, but both prescribing this option, as well as finding the least expensive form. And congratulations on your wedding!

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